Plastic surgery is one of the marvels of modern medicine, with a wide range of options for face and body improvements. And today’s media outlets make it easier than ever before to gather information on the latest plastic surgery procedures. But how does this information apply to you and your concerns?
Every person is unique and has his or her own desires. What procedure or combination of treatments is right for you? And what can you really expect? EXPLORE PLASTIC SURGERY with Dr. Barry Eppley, Indianapolis plastic surgeon, who can provide you with a wealth of practical and up-to-date insights into the world of plastic surgery through his regular blog posts. In his writings, Dr. Eppley covers diverse topics on facial and body contouring procedures. You will be sure to find useful information that will help broaden and enrich your plastic surgery education.
The Abdominal Panniculectomy vs Tummy Tuck in the Extreme Weight Loss Patient
Author: barryeppley
A panniculectomy is a very close cousin to a tummy tuck or abdominoplasty. The term pannus refers to a large apron of skin and fat that hangs over the waistline.
The abdominal panniculectomy, surgical removal of a pannus, is a somewhat historic term now as it really refers to the pre-bariatric surgery era when obese individuals had a large pannus that hung down. At that time, many abdominal panniculectomy procedures were done to relieve the medical symptoms that the pannus caused. Specifically, skin irritations and rashes (known as panniculitis) resulted from the always present moisture and heat in the underlying skin fold. In some cases, the size of the pannus and its amount of overhang actually cut off some of the blood supply and lymphatic outflow resulting in swelling and infection. Surgically removing the pannus was common then but the complication rate was high due to the patient’s obesity. Today, surgical removal of any abdominal overhang would await weight loss through bariatic surgery.
The abdominal panniculectomy refers to simply cutting off the pannus. This is different than a true tummy tuck in that the skin edges are not as undermined, no muscles are tightened, and no areas are treated by liposuction. It is simply an amputation of whatever overhangs the waistline. In the obese patient, this pannus may have considerable weight anywhere from 30 lbs or higher. (the largest I have removed was 96 lbs) In today’s bariatric patient, the pannus may weigh only from 5lbs. to 10 lbs due to the prior weight loss.
In the historic obese patient, there was a significant improvement in the patient’s quality of life as the skin and infectious symptoms that it caused were eliminated as well as the weight removal improved back and knee pain. Because of the relief of medical symptoms, the abdominal panniculectomy was often covered by insurance. Since the panniculectomy procedure in the bariatric surgery patient today weighs considerably less and often only involves improvement of an undesired contour, it is often called cosmetic by one’s health insurance. To be considered medically eligible for insurance coverage, there has to be very specific criteria that are met and a documented trail of medical records that substantiate symptoms related to the pannus. Often times even with solid medical evidence, it will be denied coverage.
Most simple abdominal panniculectomy procedures are largely done in men. Men don’t need muscle tightening and a simple skin overhang removal is often enough. Women usually require a true tummy tuck to get the abdominal contour that they desire.
Dr. Barry Eppley
http://www.eppleyplasticsurgery.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis
Tags: abdominal panniculectomy, abdominoplasty, Add new tag, dr barry eppley, indianapolis, tummy tuck
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