There are many reasons why an individual can develop excess skin and fat in the lower abdomen. The most common causes are:
The most common indication for panniculectomy is after the patient experienced a dramatic weight loss, with the resultant excess lower abdominal skin overhanging the groin and pubic regions. This is often seen in patients following bariatric surgery. The risk of formation of a large panniculus post-bariatric surgery is higher in older patients and patients with a higher pre-operative Body Mass Index.
In severe cases, the panniculus can strike against the thighs as the patient walks, causing significant discomfort and irritation. This can severely limit patients' mobility and predispose them to refractory weight gain. Bariatric surgery patients typically achieve stable weight loss in 12 to 18 months, but some patients present in as few as six months for panniculectomy due to interference from the overhanging skin.
Panniculectomy is an elective procedure where medical problems must be well-controlled before considering the operation. Cigarette smoking affects blood supply and wound healing, and surgery should be avoided in active smokers and any patient with uncontrolled cardiac disease, lung disease, or diabetes. Any immunocompromised state is also a relative contraindication, owing to poorer wound healing.
Patients with morbid obesity who are postbariatric have more severe deformities, excess skin, laxity, and poor tone. These patients are at greater risk of complications with medical comorbidities, surgical scars, and nutritional deficiencies.
A large abdominal pannus can interefe with everyday activites and prevent patients from losing further weight. Also patients complain of recurrent fungal infections in the area. A panniculectomy is not a cosmetic procedure and is different than an abdominoplasty (Tummy Tuck). A panniculectomy is a medically necessary procedure and can be life changing for many patients. This procedure can and is most times covered by your insurance.