From abdominoplasty to panniculectomy: Procedures to address concerns with the abdomen
The abdomen is one of the most popular areas that people seeking plastic surgery, both men and women, want to improve. For those dealing with loose skin or stubborn belly fat from significant weight changes or pregnancy, they can find their middles a source of frustration and insecurity. Tight, toned abs are often viewed as a key trait of looking fit and attractive because of the influence of social media and pop culture.
No need to fret! There are surgical options to help whittle the middle. The two most common are a tummy tuck (abdominoplasty) and panniculectomy. One corrects muscle separation and loose skin, while the other just addresses excess skin. We spoke with ASPS Member Surgeon Darrick Antell, MD, to get insights on these procedures and who each surgery is best suited for.
Abdominoplasty vs panniculectomy
These procedures focus on the same area of the body but are designed to address different concerns, so they target different types of patients.
"A panniculectomy is direct excision of excess skin that may form an apron hanging down below the belly," said Dr. Antell. "Sometimes, it can hang down covering the genitals or down to the knees or further. In that case, it can interfere with walking and cause rashes and rubbing and friction of the skin. An abdominoplasty, on the other hand, also involves tightening of the muscles and removal of fatty tissue, as well as excess skin above the pubic area. So, in summary, briefly, a panniculectomy removes the apron of excess skin that hangs below as if you were wearing an apron in a kitchen, whereas an abdominoplasty tightens muscles and goes further up towards the ribs."
Each procedure is best suited for a certain type of patient.
"Many patients who seek a panniculectomy are simply disturbed by the apron of excess skin that gets in their way," said Dr. Antell. "An abdominoplasty, however, might typically be someone who had given birth to twins, and the muscles of the abdomen are stretched out, as well as having excess skin. It gets to a point that no matter how much they exercise, they cannot get the muscles to return back to their pre-pregnancy position."
Another consideration is weight. While people of all sizes might choose a tummy tuck, panniculectomies are most commonly performed on overweight patients.
"Many patients who seek a panniculectomy are very overweight and prefer addressing their primary concern rather than trying to tighten the muscle at the same time, which on those patients could be difficult to perform," said Dr. Antell.
What to expect on your journey
Recovery is often the biggest concern for patients, and it varies depending on the procedure. A tummy tuck involves tightening the core muscles, so healing takes longer.
"There may be differences in the recovery with a panniculectomy allowing mobility of the patient much quicker because it doesn't involve tightening the muscles," said Dr. Antell. "An abdominoplasty can cause some tightness in the early postoperative period, but there is a unique type of local anesthetic that can be injected, which will numb the area for several days postoperatively, making the recovery much quicker."
While there are plenty of differences between these two popular procedures, there are also similarities. Both remove extra skin, but a panniculectomy targets the hanging "apron" of skin. A tummy tuck focuses on the overall abdominal area.
A few key steps can set you up for the best results, no matter which procedure you choose.
"Experience matters in plastic surgery, and the results vary mostly depending on the surgeon that you choose," said Dr. Antell. "Make sure that you have a good rapport, ask perhaps to see before and after photos and discuss everything with the doctor before the surgery. Also, ask where the venue will be before the operation."
Consult with a board-certified plastic surgeon to find out what procedure is best for your body type and to get the results you want.
To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area.
