Panniculectomy (skin removal surgery): preparation and recovery

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Surgery to remove excess skin from the lower abdomen (such as the panniculus) is called a panniculectomy. This skin removal surgery is routine and performed to relieve symptoms caused by a sagging skin apron that can be irritating and interfere with daily activities. This excess skin is usually the result of significant weight loss.

What is panniculectomy?

A panniculectomy is the surgical removal of stretched, bulging skin and fat in the lower abdomen (such as a pannus or apron).

The surgeon makes a horizontal incision over the pubic area between the thighs and possibly another incision from the breastbone to the pelvic bone to remove fat and excess skin .

The operation can be performed both in a hospital and on an outpatient basis. You and your surgeon will schedule this elective surgery if you decide to be a good candidate.

Contraindications

You may not be eligible for skin removal surgery if you also have other medical conditions that are not well controlled, such as diabetes, heart disease, and lung disease. Obesity can also increase the risk of complications. You may also not be eligible for skin removal surgery if you currently smoke.

Panniculectomy is often performed in adults and, in some cases, adolescents after bariatric weight loss surgery. As a general rule of thumb, you should maintain a stable weight for six months before having a panniculectomy.

If you plan to lose a lot of weight, your doctor will most likely suggest that you postpone the surgery.

Potential risks

The risks of panniculectomy include :

  • Loose skin
  • Scars
  • Skin loss
  • Nerve damage
  • Infection
  • Poor wound healing
  • Fluid accumulation
  • Tissue death

Panniculectomy appointment

Excess skin can be caused by significant weight loss due to gastric bypass surgery or lifestyle changes. It can also be caused by aging, previous surgery, pregnancy, or heredity.

Your healthcare provider may recommend skin removal surgery if you have excess skin and fat in your lower abdomen that hangs over your thighs, especially if it causes sores and rashes and interferes with daily activities such as walking or walking. personal hygiene. A panniculectomy can help prevent recurrent skin irritations and infections under the skin fold.

Panniculectomy can be considered a way of shaping the body, as it produces a contraction of the abdominal area. But skin removal surgery is only intended to remove excess skin and fat and is not considered cosmetic surgery.

If your end goal is really just looks, you can go for a tummy tuck instead. This cosmetic surgery, better known as a tummy tuck, not only removes fat but also tightens the abdominal muscles.

Eligibility

Your doctor will help you determine if a panniculectomy is medically necessary and safe for you. They may also order lab tests before deciding whether to schedule surgery.

Your panniculectomy may be covered by insurance if your condition is causing medical problems, such as rashes or sores that cannot be treated, or if it interferes with your daily activities and can be corrected with surgery. If your panniculectomy is not medically necessary, you will likely pay out of pocket.

If possible, check with your insurance company ahead of time to find out what will and will not be.

How to prepare

Before surgery to remove skin, you should make an appointment with your surgeon. This can give you an opportunity to ask questions about the surgery, including risks and typical results. Also, you can learn about their medical background, including experience and training in panniculectomy surgery.

You should also make sure that someone drives you home after your procedure and that someone stays with you for at least the first night after your procedure while you recover.

Location

Your panniculectomy will most likely be done in a hospital or licensed outpatient surgery.

What to wear

Wear or carry loose clothing that can be easily changed. Plan to put on a hospital gown before your procedure.

Food and drink

Follow your surgeon's instructions on when to stop eating and drinking before surgery .

Medicines

A few days before skin removal surgery, your healthcare provider may ask you to stop taking aspirin, advil (ibuprofen), coumadin (warfarin) , and any other medications that can cause bleeding problems. Ask your healthcare provider if you should continue taking any medications on the day of surgery.

To avoid complications, tell your doctor before surgery if you are taking any medications, including prescription or over-the-counter medications, herbs, and vitamins.

What Brig

Make sure you remember all the paperwork, your health insurance card, and a change of clothes if you want separate clothes at home or if you are staying overnight. Make sure someone drives you home after surgery.

Lifestyle changes before surgery

Surgeons often recommend quitting smoking at least three to six weeks before skin removal surgery. Smoking reduces the flow of blood and oxygen, which can cause tissue death, delayed wound healing, blood clots , and life-threatening complications such as strokes. To avoid complications, ask your surgeon about your risk before scheduling surgery.

What to Expect the Day of Surgery

Before a panniculectomy, the nurse will check your vital organs and ask about your medical history. You will be given general anesthesia to keep you asleep and pain-free .

During the operation

A horizontal incision will be made in the area between the belly button and the pubic region. Excess skin and fat will be cut with a scalpel or other surgical instrument through a horizontal incision. In some cases, the surgeon will also make a vertical incision if you have excess skin and tissue in the transverse direction.

The remaining upper part of the abdominal skin is then brought together and the incision closed with sutures. A drain, which is a thin tube, may be temporarily inserted under the skin to prevent fluid build-up.

The procedure itself usually takes three to five hours, depending on the amount of skin and fat that is removed. Talk to your doctor before skin removal surgery to confirm the methods used.

After the operation

After a panniculectomy, you will be monitored in the recovery area. When you recover from the anesthesia, you may be asked to stand up and walk a few steps. Depending on the extent of your surgery, you may go home on a day when your health is stable, or you may have to stay in the hospital for up to two days.

A gauze or bandage will be placed over the incision. After a day or two, your healthcare provider may ask you to wear an elastic support or compression garments to support your stomach while it heals.

Recovery

Patients will experience pain and swelling for several days after the procedure. Your healthcare provider will prescribe pain relievers to help control your discomfort.

If you have drains, your doctor will give you care instructions, including how to record the amount of fluid in the drains and how to empty them.

Avoid physical activity for four to six weeks after your procedure. I can probably go back to work in about four weeks.

Your surgeon will tell you when to return. At this point, the drain tubes can be removed.

Recovery

You will most likely experience pain, swelling, and bruising for several days after surgery. You may also feel numb and tired during this time.

To relieve pressure on your abdomen, try to keep your legs and hips flexed while resting. Your healthcare professional may recommend that you wait up to 48 hours to shower after surgery. It can take up to three months for the swelling to subside and the wounds to heal completely.

If you experience complications such as shortness of breath, chest pain, changes in heart rate, increased pain, or swelling, contact your doctor immediately.

How to deal with your recovery

Skin removal surgery can help you feel more confident, but it may take a while. Patients have significant scars for more than a year after surgery. Scars can take up to two years to fade and show desired results .

Research shows that those who undergo skin removal surgeries generally have to get used to it, but are generally happy with the results.

One study found that patients were embarrassed by their scars and body image for the first year after body sculpting surgery. However, the same patients reported better body image after the first year and less anxiety about their scars .

In another study, patients undergoing body shaping surgery were interviewed to find out their shape and ideal body shape. Their perception of their appearance improved significantly after surgery, even though they found the slimmer shape to be ideal. The results showed that they are excited about their appearance and their ability to achieve their goals .

Get the word of drug information

Ask your doctor about any questions regarding panniculectomy, recovery time, and expected results. A panniculectomy is a major operation that can take weeks or months to fully heal. However, if you experience excess skin after losing weight, it can change your health and improve your quality of life.

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