CONSULTANT PLASTIC SURGEON
PANNICULECTOMY
What is panniculectomy surgery?
The goal of panniculectomy surgery is to remove hanging skin and fat from the lower abdomen to create a smoother abdominal contour. A panniculectomy differs from a tummy tuck in that the abdominal muscles are typically not tightened during a panniculectomy. There are many reasons why an individual can develop excess skin and fat in the lower abdomen. The most common causes are age, hereditary, pregnancy, prior surgery, and massive weight loss.
"Surgeons who have the necessary training, expertise, and experience in reconstructive surgery are fit to perform cosmetic surgeries with excellent outcomes. Those surgeons only trained in aesthetic procedures will have much more difficulty doing the same. The more tools and training in plastic surgery the surgeons have, the more qualified they are! "
What panniculectomy surgery can't do?
A panniculectomy is not a substitute for weight loss or an appropriate exercise program. Although the results of a panniculectomy are technically permanent, the positive outcome can be greatly diminished by significant fluctuations in your weight. For this reason, individuals who are planning substantial weight loss would be advised to postpone a panniculectomy. The surgery cannot correct stretch marks, although these may be removed or somewhat improved if they are located on the areas of excess skin that will be excised.
Who is a good candidate for panniculectomy?
Panniculectomy surgery may be necessary for patients with hanging fat and skin on the abdomen, whether the removal is needed to address cosmetic concerns or resolve medical issues. In general, you may be a good panniculectomy candidate if you are physically healthy and at a stable weight, have realistic expectations, are a nonsmoker or have stopped smoking recently, are bothered by the appearance of your abdomen and if you have recurring or persistent rashes or infections underneath the hanging fold of skin
What should I expect during a consultation for a panniculectomy?
During your initial consultation, you will have the opportunity to discuss your cosmetic goals. Dr Ricardo will evaluate you as a candidate for panniculectomy surgery and clarify what approach is best for you. Alternative and additional treatments may be considered, once he understands your goals and medical condition. It is important to be completely honest during the consultation and be prepared to discuss your surgical goals, medical conditions, drug allergies and medical treatments, current medications, vitamins, herbal supplements, alcohol, tobacco and drug use, and previous surgeries.
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Dr Ricardo will also evaluate your general health status and any pre-existing health conditions or risk factors, examine your abdomen, take photographs, discuss the approach to your surgery, including the type of procedure or combination of procedures and tell you whether your expectations are in line with typical results, discuss any risks or potential complications and share before-and-after photos of cases similar to yours.
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The success and safety of your panniculectomy surgery depend very much on your complete candidness during your consultation. It's very important to understand all aspects of your procedure. It's natural to feel some anxiety, whether it's excitement about your anticipated new look or a bit of preoperative stress. Don't be shy about discussing these feelings with Dr Ricardo.
How should I prepare for a panniculectomy?
In preparing for panniculectomy surgery, you may be asked to get lab testing or a medical evaluation, take certain medications or adjust your current medications, stop smoking in advance of surgery and avoid taking aspirin, anti-inflammatory drugs, and herbal supplements as they can increase bleeding.
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The surgery will be performed in an accredited hospital and requires you to stay overnight for observation unless you and Dr Ricardo have made other plans for your immediate postoperative recovery. You must arrange for a friend or family member to drive you to and from surgery and to stay with you the first night following the hospital’s discharge.
Dr Ricardo and the entire staff will provide thorough preoperative instructions and answer any questions you may have. The goal is to help you achieve the most beautiful and natural-looking results, as well as to make your surgical experience as easy, comfortable, and safe as possible.​
What are the steps of a panniculectomy procedure?
Step 1 – Anaesthesia
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Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anaesthesia. Dr Ricardo will recommend the best choice for you.
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Step 2 – Surgical procedure
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A panniculectomy requires a horizontally-oriented incision in the area between the pubic hairline and belly button. The shape and length of the incision will be determined by the amount of excess skin. In some instances, a vertical midline incision is necessary for individuals who have excess skin and tissue in the transverse dimension. An incision is also typically made around the navel, although in certain cases the navel may have to be sacrificed. The remaining upper abdominal skin is pulled down like a window shade. The excess skin is trimmed and the remaining skin is sutured together. The belly button stem is then repositioned and carefully drawn through the new abdominal opening, then sutured into its revised position.
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Step 3 – Closing the incisions
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Sutures, skin adhesives (glues), or tapes close the skin incisions.
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Step 4 – See the results
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Your panniculectomy will result in a flatter, improved abdominal contour.​
What should I expect during my panniculectomy recovery?
Following your panniculectomy, gauze dressings or bandages will be applied to your incisions. An elastic bandage or compression garment may minimize swelling and support the abdomen as it heals following surgery. Small, thin tubes may be temporarily placed under the skin to drain any excess blood or fluid that may collect.
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You will be given specific instructions on how to care for the surgical site, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in your general health, and when to follow up with Dr Ricardo.
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The surgical incisions mustn't be subjected to excessive force, abrasion, or motion during the time of healing. Healing will continue for several weeks as swelling decreases and the abdomen improves.
What results should I expect after a panniculectomy?
The results of panniculectomy surgery may be initially obscured by swelling and your inability to stand fully upright until internal healing is complete. Within a week or two, you should be standing tall and confident in your improved profile. Previous abdominal surgery may limit the potential results of a panniculectomy. In women who have undergone cesarean section, the existing scars may be incorporated into the new scar. The panniculectomy scar may take several months to a year to fade as much as it will.
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Dr Ricardo will give you specific instructions on how to care for yourself. Remember to always follow his instructions to ensure the success of your surgery.