Panniculectomy

A panniculectomy is a surgical procedure that is medically necessary to remove excess skin in the abdominal area after major weight loss. A panniculectomy is not a complete tummy tuck (abdominoplasty), which is a more complex procedure performed for cosmetic and aesthetic reasons involving the removal of tissue above the umbilicus and repositioning the umbilicus itself back into the midline, liposuction of the upper abdomen and flanks, and tightening of the rectus diastasis muscles. Patients with stable weight loss for more than 6 months, skin maceration, ulceration, pain, frequent infections, back strain or other physical limitations as a result of their pannus may be eligible for OHIP coverage. Cosmetic elements other than the removal of the lower apron of excess skin are never eligible for OHIP coverage. However, they may and often are combined with a panniculectomy.

The Procedure

During a panniculectomy, the pannus or panniculus (abdominal apron consisting of fat tissue covered by skin) is excised. After the excess skin has been removed, the wound is sutured closed using dissolvable stitches (no staples are used). While the overhanging excess skin is no longer there after the procedure, the muscles in the area are, however, not tightened and tissues above the umbilicus or along the flanks are not smoothed or tightened in any way, unless the patient chooses to combine the panniculectomy with additional privately paid cosmetic elements.
It is also important to know that a panniculectomy, just as a tummy tuck, is not, in any sense, a weight loss procedure. The patient will lose a slight amount of weight (likely less than 5 lbs) due to the removal of skin and fat tissue, but it’s not a meaningful amount. A healthy BMI of at least < 30 should be achieved before surgery and weight loss should be stable for 6 months. OHIP-approved panniculectomy patients may choose or be deemed safest to stay overnight in hospital.

Follow-up instructions at a glance:

  • Dressings are changed the day after surgery and at 1 week.
  • Pain medication and antibiotics are prescribed for the first week following surgery. Any post-operative pain is typically mild to moderate.
  • Patients are able to walk the day after surgery.
  • Drains inserted during the procedure are painlessly removed at 1 week.
  • Incisions are to be kept dry for the first week. Patients can shower after that.
  • Patients are able to return to light duties at work typically after 2 weeks.
  • Ends of dissolving sutures are trimmed at 3 weeks.
  • Abdominal binder given to the patient is to be worn for 6 weeks and until the final follow-up.
  • Patients are able to resume full activities and to exercise after 6 weeks.
  • Immersion of incisions in baths, hot tubs, pools, oceans should be avoided for 6 weeks.

PHOTOS

Before&After

Candidates

If you have undergone major weight loss and have been at a stable weight for at least six months and have medical symptoms from your excess abdominal apron, such as physical restrictions from the excess tissues or skin, irritation, chafing, rashes, open sores and possibly even infections, you are likely to be approved by OHIP for a panniculectomy. Dr. Chivers will determine this and discuss your surgical options with you during your initial consultation, along with any cosmetic concerns you may additionally want addressed. Even if you aren’t experiencing any of these specific problems, if overhanging skin in your lower abdomen is interfering with your daily regimen in any way and you live in the Greater Toronto Area, a panniculectomy from the Canadian Plastic Surgery Centre may be able to help you live a more comfortable life.

Recovery

The recovery for a panniculectomy is similar in length of time to a tummy tuck procedure, but usually a little longer than the recovery for a traditional small abdominoplasty because of the extensive amounts of tissue that are removed. You will be walking the same day of surgery and be able to expect to return to light duties at home or work within 2 weeks after surgery. You should avoid strenuous activities for 6-8 weeks.
If the medical problems caused by your pannus appear to be continuing even after the surgery, you should contact the staff at the Canadian Plastic Surgery Centre immediately. They are available to provide any and all assistance you need and to help speed up the recovery process as much as possible.

Schedule Your Consultation

Because a panniculectomy is a medically necessary procedure, rather than a purely cosmetic intervention for aesthetic reasons, medically necessary portions of the procedure are covered by OHIP if you meet the above criteria. During the initial consultation, Dr. Chivers will assess you, give you a thorough examination and review your medical history. He will determine whether this procedure can provide relief from any symptoms you are experiencing and make sure you fully understand your options before proceeding. If he finds that you are a good candidate, he will schedule your surgery as soon as possible, in order to lessen the time your pannus causes you discomfort.
If you are suffering from excess abdominal skin and would like a consult with Dr. Chivers within the Greater Toronto Area, simply contact the Canadian Plastic Surgery Centre to schedule your initial consultation.

Schedule a Consultation