I Had A Panniculectomy and Here Are My Thoughts With Before and After Photos
Procedure specific satisfaction rating
After losing over a 100 pounds, I was very disappointed with the way my body looked. I had lost all of the weight naturally, without the assistance of gastric bypass, bariatric surgery or any other operation that results in massive weight loss, but like patients who had those weight loss procedures, I was left with a significant amount of excess skin. The worst part was the abdominal apron area. You know, that lower part of your abdomen by the hips. It was a place where my body chose to store a considerable amount of fat. After my weight loss, I was left with with excess skin that stretched down and covered part of my genital area. I was not only horrified by the sight of this, but the excess skin rubbed against my pubic region and caused a lot of irritation. This irritation was especially apparent during my workouts, which I did 5-6 days per week. Having this apron made some exercises hard to do and put extra strain on my body, causing severe hip and pelvic pain.
As you can imagine, this was a very frustrating time in my life. After battling obesity for many years and finally losing the weight, I felt like being left with a panniculus (sometimes called a pannus) was punishment for all the hard work I had done. After speaking with my husband, we both agreed that I should have a panniculectomy. For those of you that don't know, a panniculectomy is a surgical procedure, where the doctor removes an excess amount of lower abdominal skin. This procedure is also referred to as apron lift.
Once I was set on having panniculectomy surgery, I needed to find a good plastic surgeon to perform the procedure. I decided to ask my son's plastic surgeon Dr. Losee, who is the Chair of Pediatric Plastic surgery at “Children’s Hospital of Pittsburgh” (my son was born with a birth defect and Dr. Losee did amazing work!). Dr. Losee referred me to Dr. Rubin, as he is an Endowed Professor and chair of the Plastic surgery division at the University of Pittsburgh Medical Center (UPMC). Dr. Rubin's credentials were very extensive and his surgical specialties included body contouring after weight loss. He is especially well known for creating his own surgical procedure for breast lifts.
I decided to call Dr. Rubin's office to set up a consultation and ended up speaking to his lovely office manager for quite some time. I was able to tell her about my issue and ask her many questions on various topics, which she was very helpful in answering. I decided to make an appointment with Dr. Rubin after speaking with her.
On the day of my consultation, I was very nervous. I knew I would have to undress and show people my body and this was not something I was too happy to do. All of that fear went away when Dr. Rubin, with a big smile on his face, entered the examination room. One glance at this man and you could tell he was a kind, caring doctor. He instantly put me at ease. Since UPMC is a training hospital, Dr. Rubin did have several residents with him, and I was a bit nervous to undress in front of everyone. As the consultation went on, Dr. Rubin asked me many questions about what I wanted to achieve with this surgery. After that, he explained the procedure and the expected recovery time (about 6 weeks post-op). Then came the part I had feared! It was time to get naked for before pictures to be taken. Even though I was a bit embarassed at first, I quickly got over it due to the kindness and professionalism of the doctor and his staff. They ended up taking many pictures of my lower abdominal area from many different angles.
At the end of the consultation, Dr. Rubin told me I met all the criteria to be an ideal candidate for a panniculectomy. He told me to get the medical record from my primary care physician (PCP), showing that I had used many different skin creams to try and alleviate the irritation the excess skin from panniculus was causing me, because he said my health insurance would likely cover the procedure.
To conclude my consultation, I was given some before and after pictures to look at. All of them looked amazing and I was completely sold on both Dr. Rubin and the procedure itself. It was time to take the next big step in my weight loss journey.
As soon as I returned home from the consultation, I immediately contacted my PCP to have my medical records faxed to Dr. Rubin. Dr. Rubin's office then sent my medical records, along with the photos that were taken, to my insurance company. After a week, the insurance company had decided to approve my surgery! I couldn’t have been happier!
Prior to my surgery, I had to complete pre-surgical tests for approval to go under the knife. I believe I had a CBC and nicotine test. (Dr. Rubin does not operate when people have nicotine in their systems, because if I remember correctly, it constricts the blood vessels and can compromise the healing process). Once I did all of the required tests, I was found to be healthy and was approved for surgery. I immediately scheduled my surgery date.
The Day of Surgery:
On the date of my surgery, I arrived at the hospital early in the morning. After signing in and completing some paper work, I was taken to the pre-op area, where my blood pressure was taken. I was then hooked up to an oxygen and heart monitor. After that, Dr. Rubin and his crew of soon-to-be plastic surgeons entered the room and had me stand up, remove my hospital robe and then he began making the surgical markings that were necessary on my body. While Dr. Rubin marked me up, I remember being impressed with his patience, and how every time he made a mark he would move back and look from afar and at different angles. Eventually he was done marking me up and then came more before photos. Then it was time to be wheeled into the operating room. The time had finally come!
Once I was in the operating room, I was quickly put under with general anesthesia and the next think I remember was waking up from surgery. When I awoke, I was in pain, which was expected after such a large procedure. Fortunately, the nurses at the hospital were quickly able to get my pain under control with medication.
Not long after, Dr. Rubin came into the recovery area to check on me and see how I was doing. He told me my surgery was a success and that he was able to remove 9 lbs of excess tissue off my lower abdomen. I was shocked! Even though I was still bandaged with swelling and bruising, I remember being amazed at how flat my lower stomach was. I was already very ecstatic! I did, however, have to wear a girdle type of compression garment on my stomach for a while. It was not uncomfortable and it kept my stomach compressed, which helped to reduce swelling. Funny enough, I quickly became very attached to this garment, and found it hard to let go of when the time had come! Dr. Rubin joked around that I was not alone in feeling this way and had heard of many patients wearing their garment long after they were required to.
That night, I stayed in the hospital. I had two drains inserted during my surgery - one on each of my hips - and as they filled, the nurses would come into my room, measure the contents and then empty them. All of this was expected and was completely normal after a surgical procedure.
To be perfectly honest, the pain level for this surgery was very, very minimal. I was able to go home the day after my surgery and slowly walk up my steps. I was never in agony over the pain, and recall being surprised what little pain I had.
Once I returned home, I was in charge of emptying and measuring the contents of my own drains. I had to record the amount coming out and the time it was removed. This is so Dr. Rubin can see if the amount of fluid being excreted by my body was slowing down and he could determine when to remove my drains. It eventually took 2-3 weeks before my drains were able to be removed. Removing the drains was quick and simple. Dr. Rubin did it as a post-op visit to his office.
After my initial post-op check up, which I believe was 1 week after my surgery, I was able to start to changing my own dressings and bandages to keep my incisions clean. I did this with ease and recovered very well from the procedure. I continued to go back weekly for post op visits, then bi- weekly and as time went on, my visits were spaced further and further apart.
My Thoughts On Surgery:
Dr. Rubin and his medical staff are beyond amazing! They never made me feel like a burden, even though I had 100 questions! They were always kind, cheery, and went out of their way to make sure I was well taken care of! They always returned my phone calls promptly, and even to this day, I think very highly of them!
This procedure absolutely changed my life! I no longer felt disgusted when I look in the mirror. Once I healed, I was able to preform more exercises and activities than I was ever able to do prior to surgery! Pants actually fit me correctly and they looked great! I profess to this day, if I had to pick one procedure that changed my life (I had an arm and breast lift previously) it was definitely this one!
I would, however, like to mention that surgical procedures can have very different results and satisfaction levels depending on the patient. No two people's cases are identical, even if the procedure(s) are the same. Everyone’s body reacts differently and everyone’s needs are different. Some surgeries may be more involved and require more hospital time, while others may be less involved and require less hospital time! All of these things play into what your panniculectomy costs will be and how long your recovery will be.
As a side note, if you look at the before and after pictures I have attached, please keep in mind that I did not lose any additional weight other the weight of the skin that was removed. Also, please realize that I was 29 when I had this surgery. I am now 31.
If this is procedure you’re thinking of having done, find yourself a good, experienced, honest plastic surgeon. Have a consultation with them and if you like what you hear, go through with the pre-op testing and most importantly make sure you are doing it for you. Then go for it! Don't wait. This surgery will change your life! Trust me and best wishes to you with your journey!