What are the panniculectomy procedure steps?

What are the steps I should be taking before panniculectomy surgery? I probably need to take some medical tests. Does anyone know which ones?


F, 42, New York

Tags:woman age 35-44 procedure

In preparation for my panniculectomy surgery, I had a medical examination that included measurements of my excess skin and fat along with a complete set of lab work. My surgeon completed a thorough check of my health history and reviewed all of the medications that I was taking to make sure that I was in good health. I was so happy to find out that I was a good candidate for the procedure.

Your surgeon will provide you with a list of drugs that you need to avoid before the surgery, including aspirin and anti-inflammatory drugs. Smoking slows the healing process; so, it is best to quit. My surgeon also gave me dietary recommendations and some pre-surgery exercises to increase circulation and promote a better recovery. Your surgeon will share the possible risks with you and will provide you with a list of aftercare instructions. Following all of the aftercare instructions, such as wearing the compression garment, will ensure that you recover without complications.

Most of my life I have suffered with obesity. So, I was thrilled when I started to see the results of my gastric sleeve surgery. Unfortunately, I was left with a significant amount of hanging abdominal skin. My skin was hanging well below my pelvic bone. I knew what to expect going into the surgical procedure because my doctor explained the entire procedure to me. I didn't feel any pain because I was under a general anesthesia for the procedure. There were two incisions made. One incision is from just below my breast bone down to my pubic bone. Another incision was made horizontally across my pubic area at my bikini line. My excess skin and fat were removed through the horizontal incision. My surgery took about 4 hours. I stayed in the hospital after my procedure for almost a week. I did have drains to remove excess fluid. My drains stayed in for 12 days.

I had never done any type of plastic surgery before my panniculectomy surgery. This was in 2012 so I didn’t really look up too much information about it beforehand. In fact, I thought I was going in for a tummy tuck, but the doctor explained what I wanted to remove my “apron” was a panniculectomy. The two are similar but the panniculectomy procedure helps mostly when you have pregnancy overhang or a lot of fat that pushes your tummy over your pelvis.

With that said, I talked to the doctor on two occasions before the procedure. They run blood tests, take x-rays, and make sure that you’re approved for the surgery, meaning that you don’t have any risk of infections or blood disorders. On surgery day, I was put under and woke up with my tummy wrapped tightly in bandages. It was very painful that first day and the second day. In fact, the whole week after was a lot of laying down and not moving. My doctor explained all of this beforehand. Since the procedure is removing fat and skin from the torso, it’s very vulnerable to pain.

My doctor prescribed Percocet for the pain though, and I was able to manage it for a couple of weeks until it went away and I could finally start walking and jogging without a lot of discomfort. I think overall, it was an easy procedure to get through. I’ve heard horror stories about tummy tucks and just was super glad that my stomach was flat, healthy, and I was good to go within two weeks.

First off, it's great that you're doing the necessary research to know how your procedure will play out before actually undergoing it. In order to prepare for a surgery as extensive as a panniculectomy, your plastic surgeon or doctor may ask you to do the following:

  • Get lab testing or undergo a medical evaluation.
  • Take specific medications or adjust your current set of medications.
  • As smoking may interfere with the success of your surgery, you may be asked to stop smoking.
  • Don't take aspirin or any other anti-inflammatory drugs (even herbal supplements should be avoided) because they can increase your chances of bleeding, and that's not something you want to risk with such a serious surgery.

Just to make sure you're well versed in possible consequences, it's possible to suffer from bleeding, infections, and the most severe side effect, blood clots post surgery.