What is a tummy tuck (abdominoplasty)? What is panniculectomy?
When diet and exercise fail to achieve the waistline you desire, Cleveland Clinic Cosmetic & Plastic Surgery Center offers the expertise of plastic surgeons who have perfected procedures to help you attain a flat, well-toned abdomen.
A tummy tuck, also known as abdominoplasty, removes excess fat, skin, and in most cases, can reestablish weakened or separated muscles – creating an abdominal profile that is smoother and firmer.
Panniculectomy, which can be performed alone or in combination with a tummy tuck, removes any overhanging “apron” of skin and tissue from below the belly button. This excess skin is most typically a result of significant weight loss (100 pounds or more) through diet and exercise.
The hanging skin of the abdomen, called the pannus or "apron" can cause a variety of problems, including the inability to fit comfortably into clothing, difficulty in daily hygiene, yeast infections or cysts in the folds of skin, and lower back pain. Different from a tummy tuck, which tightens the underlying stomach muscles, a panniculectomy only removes excess skin and fat.
Many people who have achieved significant weight loss can be left with large amounts of heavy, loose folds of skin around the abdomen, which can sag and lose elasticity as a result of being stretched for a long period of time. This excess skin can lead to rashes above the pubic area and along the groin and hips. A panniculectomy can offer relief of these symptoms to enhance your health and appearance.
Am I a candidate for a tummy tuck (abdominoplasty)? Am I a candidate for a panniculectomy?
The ideal candidates for tummy tuck surgery are those who have a combination of loose or excess skin on their abdomen and/or excess abdominal fat. Almost all women who have had children will also have some degree of abdominal muscle laxity. Any of these conditions, or all three, can be corrected by a tummy tuck.
Tummy tuck surgery is a good option for you if:
- You are physically healthy and at a stable weight
- You have realistic expectations
- You are a non-smoker
- You are bothered by the feeling that your stomach is too large.
Panniculectomy candidates typically suffer from obesity, have recently experienced significant weight loss or suffer post-pregnancy issues with excessive fat located below the belly button.
You may be a candidate for panniculectomy if:
- Excess fat causes health issues, including back problems, breakdown of skin, rashes, ulcers or skin disorders
- Your weight has been stabilized for at least one year
- You are participating in a proper dietary and exercise plan
- You are a non-smoker
- You have a positive outlook and realistic goals for what panniculectomy can achieve
- You are committed to leading a healthy lifestyle, including proper nutrition and exercise.
The best way to determine if you are a candidate for tummy tuck or panniculectomy is through a consultation with a plastic surgeon at Cleveland Clinic Cosmetic & Plastic Surgery Center.
How do I prepare for a tummy tuck (abdominoplasty) and/or panniculectomy?
Preparing for your tummy tuck and/or panniculectomy procedure at Cleveland Clinic Cosmetic & Plastic Surgery Center will include a discussion with your plastic surgeon about your health, desires and lifestyle.
To ensure the best results from your tummy tuck or panniculectomy procedure, be prepared to discuss:
- Why you want the surgery, your expectations and desired outcome
- Medical conditions, drug allergies and medical treatments
- Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
- Previous surgeries.
Your Cleveland Clinic plastic surgeon may also:
- Evaluate your general health status and any pre-existing health conditions or risk factors
- Take photographs for your medical record
- Discuss your options and recommend a course of treatment
- Discuss likely outcomes of the tummy tuck and any risks or potential complications
- Order bloodwork, an EKG and obtain surgical clearance (for panniculectomy)
- Ask you to stop taking aspirin-containing products for two weeks before surgery.
How is a tummy tuck (abdominoplasty) performed?
In a traditional tummy tuck, a horizontal incision is made just above the pubic hairline. The length of this lower abdominal incision is determined by the amount of excess skin.
The skin is then dissected up toward the rib cage, the muscle is tightened, the belly button is repositioned and excess skin is removed. Your cosmetic surgeon may also recommend combining liposuction with your tummy tuck procedure for the best results.
In those cases where loose skin extends towards the back, the incision can be lengthened into the back area performing a so-called “circumferential abdominoplasty.”
The tummy tuck procedure is generally performed under general anesthesia and can often be performed as an outpatient or with a one-night stay at Cleveland Clinic Cosmetic & Plastic Surgery Center. The procedure itself requires anywhere from two to four hours to perform. Drains are most often used and are removed several days following the procedure.
How is panniculectomy performed?
Panniculectomy may be performed as a single procedure or combined with a tummy tuck. The procedure may also be performed with another abdominal surgery, such as a hysterectomy, repair of the abdominal wall, or hernia repair. When done alone the panniculectomy is intended to only to remove the overhanging skin and fat and is not a cosmetic procedure.
The procedure takes approximately three to five hours and involves an incision just above the pubic area extending outward toward the hips.The length of your incision depends upon the amount of skin to be removed. Depending on the size of the pannus, the naval might get pulled down or completely removed with the panniculectomy. Your surgeon will be able advise you of this in your pre-operative consult.
Panniculectomy at Cleveland Clinic Cosmetic & Plastic Surgery Center may be an outpatient procedure or require an overnight stay, depending on the particular circumstances of your procedure.
What are the different types of tummy tuck (abdominoplasty) procedures?
There are three different types of tummy tuck procedures offered at Cleveland Clinic Cosmetic & Plastic Surgery Center. The degree of loose skin, excess fat or laxity of the stomach muscle, in addition to a full consultation with your plastic surgeon, will determine whether a traditional or complete abdominoplasty, a partial mini abdominoplasty or circumferential abdominoplasty is right for you.
Learn more about these options:
- Complete Abdominoplasty:
- A complete abdominoplasty requires an incision above the pubic hairline, an incision around the umbilicus, or belly button, and a tightening of the rectus abdominis muscles (the pair of muscles that run vertically on each side of the stomach’s front wall). Muscle tightening, as well as skin removal, is the most important step in improving the stomach’s contour. Liposuction may also be performed at the same time of a complete tummy tuck
- Partial or Mini Abdominoplasty:
- The mini abdominoplasty is performed on those patients with mild to moderate tummy contour changes, relatively little skin excess and little weakness of the abdominal wall. In the mini abdominoplasty, the navel incision is avoided. Liposuction may also be performed at the time of mini abdominoplasty surgery.
- Circumferential Abdominoplasty:
- Skin laxity or skin excess is a three-dimensional issue and involves not only the abdominal area, but also the back region. When there is significant excess fat in the back area as well, abdominoplasty can be performed with liposuction of the back region or circumferential abdominoplasty can be performed. The benefit of the circumferential abdominoplasty is that both skin and fat can be removed in the hip and back region, improving your body contour three dimensionally.
What results can I expect?
After a tummy tuck (abdominoplasty):
Whether you’re having a partial or complete tummy tuck at Cleveland Clinic Cosmetic & Plastic Surgery Center, the overall result will be a flatter, firmer abdominal contour that is more proportionate with your body type and weight. Your final results may be initially hidden by swelling and the inability to stand fully upright until internal healing is complete. Your new slimmer profile should be will begin to be apparent within a week or two following surgery. It might take several weeks or even months to appreciate the final result.
After a panniculectomy:
Most patients are very pleased with the results of the panniculectomy. The majority lose approximately five to 10 pounds in weight. You will notice that your clothing fits more comfortably. Some patients also find personal hygiene and physical activity easier.
While it will take a few months after surgery to realize final results, your body’s new contour will be permanent, providing your weight remains stable. An additional benefit for most patients is that changes in their weight do not result in accumulation in the waist as it did before the procedure.
Follow-up with a plastic surgeon at Cleveland Clinic Cosmetic & Plastic Surgery Center is the best way to ensure long-lasting results from your panniculectomy.
What is involved in recovery?
After a tummy tuck:
Following your tummy tuck procedure, the incision site will be stitched and bandaged. Your plastic surgeon may have you wear either an elastic bandage or a compression garment to minimize swelling and to support your abdomen as it heals.
It’s very important that you follow all of your surgeon’s instructions on wearing this garment (if you are given one) and caring for the bandage in the days following surgery. Your surgeon will also instruct you on how to best position yourself while sitting or lying down to help ease pain.
Tummy tuck procedures are often performed as an outpatient procedure or with a one-night stay at Cleveland Clinic Cosmetic & Plastic Surgery Center. If your tummy tuck is completed as an outpatient procedure, make certain you bring someone to drive you to and from surgery and to stay with you for at least the first night following surgery.
You will have to severely limit strenuous exercise for four to six weeks as you go through the healing process, in addition to possibly needing to take up to one month off work after surgery to ensure the recovery and results. Your cosmetic surgeon will help you determine a recovery based on your personal situation.
After a panniculectomy:
Following panniculectomy, your surgeon will instruct you regarding showering and bathing. Use a supportive abdominal garment only if your surgeon recommends it.
You will need to avoid strenuous activities for a few weeks, but most people can usually return to work within two weeks of the procedure. Any stitches in the skin are generally removed in about a week. You will also have deeper sutures that dissolve on their own.
Is a tummy tuck (abdominoplasty) and panniculectomy safe?
All surgical procedures carry some risk.
Possible risks of tummy tuck and panniculectomy procedures include:
- Bleeding (hematoma)
- Fluid accumulation
- Poor wound healing
- Skin loss
- Unfavorable scarring
- Anesthesia risks
- Numbness or other changes in skin sensation
- Skin discoloration and/or prolonged swelling
- Fatty tissue found deep in the skin might die (fat necrosis)
- Major wound separation
- Recurrent looseness of skin
- Pain (possibly persistent)
- Deep vein thrombosis, (Blood Clots) cardiac and pulmonary complications
- Persistent swelling in the legs
- Nerve damage
- Possibility of revisional surgery.
Why Choose Us
If you’re considering a tummy tuck or panniculectomy, look for a board-certified plastic surgeon with specialized training and significant experience performing abdominoplasty procedures. You should consider going to a plastic surgeon who is affiliated with a major medical center, such as Cleveland Clinic, for the best results. Ask your plastic surgeon about his or her credentials, training and how many tummy tuck procedures he or she has performed.
Is this procedure covered by health insurance?
Like all cosmetic procedures, tummy tuck procedures are not covered by health insurance. Panniculectomy is also not typically covered by health insurance, but some insurance companies will pay for the procedure if it is considered medically necessary. Ask to talk with a financial representative from Cleveland Clinic Cosmetic & Plastic Surgery Center who can explain costs of these procedures and if insurance coverage is an option for you.
This information is provided by Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.
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