What is panniculectomy?

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Panniculectomy: Overview

A panniculectomy is surgery to remove fat and skin that hangs down from your belly. Often the fat and skin come from losing a lot of weight.

You will be asleep during surgery. The doctor makes one or more cuts (incisions) in your belly. Extra fat and skin are removed. Then the skin is brought together and closed with stitches, staples, or skin glue. The surgery leaves one or more scars. The scars will fade with time.

You may go home the same day, or you may spend a day or longer in the hospital. You will need to take it easy for 2 to 3 weeks at home.

How can you care for yourself after a panniculectomy?

Activity

  • Allow the area to heal. Don't move quickly or lift anything heavy until you are feeling better.
  • Rest when you feel tired.
  • Be active. Walking is a good choice. For the first few weeks after the surgery, your doctor may have you bend slightly at the waist when you stand up and walk around.
  • You can do your normal activities when it feels okay to do so.
  • You will probably need to take 2 to 3 weeks off from work. It depends on the type of work you do and how you feel.
  • Ask your doctor when it is okay for you to have sex.
  • Hold a pillow over your incisions when you cough or take deep breaths. This will support your belly and may help to decrease your pain.

Diet

  • You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
  • If your bowel movements are not regular right after surgery, try to avoid constipation and straining. Drink plenty of water. Your doctor may suggest fiber, a stool softener, or a mild laxative.

Medicines

  • Be safe with medicines. Read and follow all instructions on the label.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
  • Your doctor will tell you if and when you can restart your medicines. He or she will also give you instructions about taking any new medicines.
  • If you take aspirin or some other blood thinner, be sure to talk to your doctor. He or she will tell you if and when to start taking this medicine again. Make sure that you understand exactly what your doctor wants you to do.

Incision care

  • You will have a dressing over the cut (incision). A dressing helps the incision heal and protects it. Your doctor will tell you how to take care of this.
  • If you have strips of tape on the incision, leave the tape on for a week or until it falls off.
  • If you had stitches or staples, your doctor will tell you when to come back to have them removed.
  • Wash the area daily with warm water, and pat it dry. Don't use hydrogen peroxide or alcohol. They can slow healing.
  • You may need to wait a few days before you can take a shower. Follow the instructions that your doctor gives you for bathing and showering.

Other instructions

  • You will likely have several drains near your incision. Your doctor will tell you how to take care of them.
  • You may have a special girdle, called a binder, placed around the area where you had surgery. This binder will help ease swelling and pain. Your doctor will tell you how long to wear it.
  • Your doctor may have you sleep in a recliner, or propped up in bed, with pillows under your knees. This will help keep your stitches from breaking.

How do you prepare for a panniculectomy?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

  • Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
  • If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
  • Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

Panniculectomy: When to call

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).
  • You have severe trouble breathing.
  • You have symptoms of a blood clot in your lung (called a pulmonary embolism). These may include:
    • Sudden chest pain.
    • Trouble breathing.
    • Coughing up blood.

Call your doctor now or seek immediate medical care if:

  • You have pain that does not get better after you take pain medicine.
  • You have loose stitches, or your incision comes open.
  • You are bleeding from the incision.
  • You have symptoms of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the incision.
    • Pus draining from the incision.
    • A fever.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You do not have a bowel movement after taking a laxative.

After a panniculectomy: Overview

A panniculectomy is surgery to remove fat and skin that hangs down from your belly. Often the extra fat and skin come from losing a lot of weight.

Your belly will be sore and swollen for the first week after surgery. The skin on your belly will probably be mostly numb for several weeks to months. Feeling will come back slowly. But you may have small areas around the incisions that are always numb. Don't use a heating pad on your stomach while it's still numb, or you could have severe burns. It's normal to feel tired while you heal. It can take 5 to 6 weeks for your energy to return.

You won't be able to stand up straight when you get home. To regain your normal movement, you'll need to get up and walk every day. Between walks, move your feet and legs often.

The surgery leaves one or more scars that will fade with time. If they don't fade, check with your doctor.

What happens on the day of a panniculectomy?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
  • Follow your doctor's instructions about when to bathe or shower before your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Do not shave the surgical site yourself.
  • Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

  • Bring a picture ID.
  • The area for surgery is often marked to make sure there are no errors.
  • You will be kept comfortable and safe by your anesthesia provider. In most cases, you will be asleep during the surgery.
  • The surgery will take about 3 to 5 hours.

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