A panniculectomy is a surgical procedure to remove the pannus — excess skin and tissue from the lower abdomen. This excess skin is sometimes referred to as an “apron.”

Unlike a tummy tuck, the panniculectomy does not tighten the abdominal muscles for a more cosmetic appearance, disqualifying it as a cosmetic procedure. However, removing the excess fat can make your abdominal area flatter. The panniculectomy can also be performed alongside a tummy tuck or other abdominal procedures.

Surgical costs can range from $8,000 to $15,000 for this procedure to cover anesthesia, surgeon, and facility fees. Since the panniculectomy is not typically seen as a cosmetic surgery, your insurance provider may help pay for the procedure. But, you must meet specific criteria, and the panniculectomy must be seen as a medical necessity. Contact your health insurance provider to discuss your payment options.

After losing significant amounts of weight from exercise or surgery, people may be left with excess skin and loose tissue around the abdomen. The excess skin can cause skin rashes and irritation as well as odor from moisture.

You may be an ideal candidate for panniculectomy if:

  • excess abdominal fat causes health issues such as back pain, skin rashes, or ulcers
  • you don’t smoke
  • you are in good health
  • your weight has been stable for at least six months to one year
  • you have realistic expectations from surgery
  • you are maintaining a healthy diet
  • you are physically active

A qualified plastic surgeon performs a panniculectomy. This invasive surgical procedure that can last up to five hours. During the surgery, an anesthesiologist will administer general anesthesia to put you to sleep.

Your surgeon will then make two incisions:

  • a horizontal cut from one hipbone to the next
  • in some cases, a vertical cut extending to the pubic bone

The length of the cuts depends on how much skin needs to be removed. Through the incisions, the surgeon will remove excess fat and skin. The remaining skin and tissues are then pulled together and closed with stitches, and the incision areas are taped. Doctors may insert drains during the procedure to remove excess fluid.

In some cases, the belly button may be removed or repositioned. Your doctor will advise you of this in a consultation before making the decision in surgery.

Realself is a community-driven website where people can upload before and after photos following cosmetic surgery and write reviews. Photos of the panniculectomy procedure can be found .

In most cases, a panniculectomy is an outpatient surgery. But depending on the extent of your procedure, you may be required to stay over night for observation and proper healing. Within your pre-consultation, your surgeon will advise you to have someone drive you home after surgery and help you for the first few days. There should be no heavy lifting or strenuous activities for a few weeks following your procedure.

Panniculectomy patients can expect pain and discomfort from swelling and bruising at the incision sites. Your stitches may be removed within a week while deeper sutures dissolve on their own. Complete recovery will take months and you will be required to have follow-up appointments with your doctor to ensure lasting results.

Patients are generally pleased with results and often lose 5–10 pounds from the surgery. Some patients may notice improvement in their physical activity and personal hygiene.

As with any surgical procedure, the panniculectomy can lead to some complications and potential risks. Some of these risks include:

If you begin to experience any irregular symptoms following your surgery, seek immediate medical attention.

The panniculectomy surgery is seen as a medically necessary procedure to remove excess fat from your abdominal area. This excess fat or pannus can cause ulcers and irritation and affect your physical activity.

The panniculectomy is not a cosmetic procedure, but it can be performed alongside cosmetic and corrective surgeries to improve the look of your stomach. Discuss your options and expectations with your doctor to determine the best procedure for you.