Panniculectomy

Excerpt

A panniculectomy is an operative procedure used for abdominal wall contouring, changing the shape and form of the abdomen by removing significant excess skin and subcutaneous adipose tissue en bloc. This procedure is performed on patients with a large overhanging abdominal panniculus. A panniculus is an apron of excess skin and fat hanging from the abdomen below the waistline. This excess skin and fat are secondary to weight gain and can sometimes cover the anterior thighs, hips, and knees. A large panniculus can lead to severe impacts on patients' mobility and activities of daily life. Skin infections and rashes are common complaints of patients with a substantially large panniculus due to constant irritation and sweating.

The size of a panniculus varies and can be graded on a scale of 1 to 5, which correlates with how far it extends. Grade 1 reaches the mons pubis, while grade 5 extends to or reaches past the knees. A panniculectomy is performed to relieve these symptoms and restore formal function. During a panniculectomy, the excess skin and fat are removed. Tightening or plication of the abdominal wall muscle is not performed, which differentiates this procedure from an abdominoplasty - a cosmetic procedure, usually involving fascial plication or otherwise addressing the underlying fascial and muscular layers of the abdomen.

Over the past three decades, there has been a significant increase in panniculectomies, which can be partially attributed to the development of, and increased frequency of, liposuction procedures. However, the reader should be aware that panniculectomy or abdominoplasty is not a benign procedure. Patients must be carefully selected and medically prepared for surgery. There are ample reports of severe bleeding, and even deaths, following panniculectomy.