After major weight loss or pregnancy,  many people develop loose skin and fat, called the pannus, that hangs from the lower abdomen. Beyond appearance, it can trap moisture, cause rashes, and make everyday movement and hygiene difficult. Day‑to‑day, that overhang can mean constant chafing, infections, trouble fitting into clothing, and even limits on exercise or basic tasks. Frequent treatments with creams or powders may give only temporary relief, and the excess skin typically does not retract on its own. 

Panniculectomy surgery removes the hanging skin and fatty tissue to reduce friction, improve hygiene and mobility, and restore a smoother abdominal contour. It is not a weight‑loss procedure, and it doesn’t tighten abdominal muscles, but for the right candidate, it can meaningfully improve comfort and quality of life. 

At Seattle Plastic Surgery, Dr. Craig Jonov can provide a transformative experience by removing excess skin, relieving discomfort, and reshaping the abdomen for a smoother, healthier contour.

What Is Panniculectomy Surgery?

A panniculectomy is a reconstructive operation that removes excess, overhanging lower‑abdominal skin and fat (the pannus). It’s performed under general anesthesia through a low, hip‑to‑hip incision; in larger cases, a vertical component may be needed. 

The procedure may include temporary drains. Unlike a tummy tuck (abdominoplasty), a panniculectomy does not tighten abdominal muscles or routinely reshape the belly button. It targets the hanging tissue only.

Modals talking about Panniculectomy Surgery

Benefits of Panniculectomy Surgery

Some of the benefits of panniculectomy surgery are: 

  • Healthier skin & easier hygiene: Removing the pannus reduces constant skin‑on‑skin contact that traps heat and moisture, prime conditions for fungal or bacterial overgrowth. Patients typically see far fewer rashes, sores, and skin breakdown under the fold. Routine showering and drying also becomes much simpler, which helps keep improvements durable.
  • Improved mobility & physical comfort: A heavy pannus can interfere with walking, bending, and exercise. By removing the loose, hanging fold of skin and fat, many people find daily movements manageable, stairs easier, and light activity more comfortable
  • More comfortable clothing & fit: Eliminating the bulk and moisture under the pannus helps clothing sit flatter and feel better. Waistbands, undergarments, and pants usually fit more predictably after surgery, which can make workwear and activewear easier to choose and wear day‑to‑day. 
  • Quality of life & self‑confidence: Beyond physical relief, many patients describe a tangible lift in confidence once the constant chafing is gone. Feeling more at ease socially and physically can be a meaningful part of recovery, provided expectations remain realistic about scars and healing time.
  • Durability of results with stable weight: When you maintain a steady weight, the contour change from panniculectomy is generally long‑lasting. Significant weight fluctuations after surgery can stretch tissue again, so long‑term lifestyle habits matter.
Ideal Candidate for Panniculectomy Surgery

Who Is an Ideal Candidate?

You may be a good candidate if you:

  • Have a pannus that hangs below the lower abdomen and causes skin problems, hygiene issues, or functional limitations.
  • Are in good overall health and at a stable weight (often for 3–6 months).
  • Don’t smoke (or are willing to quit well before and after surgery).
  • Have realistic goals and understand the risks that come with the surgery.

What Happens at Your Appointment?

  • Consultation & exam. Dr. Jonov reviews your health history, medications (including blood thinners and supplements), prior surgeries, and goals. They examine and often grade the pannus, take standardized photos for your medical record, and discuss incision options and scar placement.
  • Optimization & instructions. You’ll receive tailored pre‑op instructions: medication adjustments, smoking cessation, pre‑op testing, and fasting guidelines. If drains and compression garments are planned, you’ll learn how they’re used and when to call for concerns. 
  • Coverage documentation (if applicable). If you’re pursuing insurance preauthorization, clinics typically compile required documentation, photographs, records of recurrent rashes/infections and treatments, and proof of stable weight, to submit to your plan. Criteria differ by insurer; your benefits ultimately govern what’s covered.
  • Planning your recovery. You’ll arrange a ride home (or a short hospital stay if needed), set up help for the first 24–48 hours, and prepare your space (pillows, loose clothing, easy meals). You’ll also receive clear activity, wound‑care, and follow‑up schedules, including when drains, if placed, are typically removed.

Here is the procedure of panniculectomy surgery:

  • Anesthesia: You’ll receive general anesthesia so you’re asleep and comfortable.
  • Incisions: The provider at Seattle Plastic Surgery will make a low horizontal incision (hip‑to‑hip). In massive skin redundancy, a vertical incision may be added (fleur‑de‑lis).
  • Tissue removal. The excess overhanging skin and subcutaneous fat are removed; the remaining skin is brought down and closed. The navel may or may not be repositioned depending on the amount of tissue removed.
  • Drains & dressings. Small drains are often placed to prevent fluid buildup; a compression garment or elastic wrap may be used to reduce swelling and support healing.
  • Setting. Many panniculectomies are performed as outpatient procedures; more extensive cases or patients with medical complexities may stay in the hospital briefly.

Recovery & Risks of  Panniculectomy Surgery

Recovery timeline: Expect soreness, bruising, and swelling for the first week; most people resume light daily activity or desk work in 2 weeks. Strenuous activity and lifting are usually restricted for about 6 weeks. Swelling continues to improve over months; scars mature over 6–12+ months. Drains, if used, are removed once the output is low.

Common risks: As with any surgery, bleeding, infection, anesthesia reaction, seroma/hematoma (fluid or blood collection), delayed wound healing, numbness/skin changes, asymmetry, visible scarring, and, less commonly, blood clots. Our team will review your specific risk profile and prevention steps.

How does it differ from a tummy tuck?

Abdominoplasty (tummy tuck) is cosmetic and typically tightens abdominal muscles and reshapes the navel; panniculectomy removes the hanging tissue without muscle repair. Many insurers label abdominoplasty as cosmetic, while panniculectomy may be covered when strict medical‑necessity criteria are met.

Cost of Panniculectomy Surgery

The cost of panniculectomy surgery at Seattle Plastic Surgery varies depending on the extent of correction needed and whether it is combined with other procedures. During your consultation, Dr. Craig Jonov will provide a detailed breakdown of pricing tailored to your treatment plan.

Ready to Feel Comfortable in Your Skin?

Schedule an appointment with Dr. Jonov at Seattle Plastic Surgery today. Contact us at (206) 739-0355, book online, or text us for further details.

Frequently Asked Questions 

 

Will my stomach be flat after a panniculectomy?

A panniculectomy will remove the apron of skin and fat hanging from the lower abdomen, making your stomach look smoother and flatter than before. However, it does not tighten loose abdominal muscles or remove deeper belly fat, so while the overhang is gone, the abdomen may not be completely flat like with a tummy tuck. Results depend on your body type, muscle tone, and weight stability.

Is panniculectomy surgery painful?

Like any major surgery, a panniculectomy does come with discomfort, especially during the first several days after surgery. Pain is managed with prescribed medications, and most people notice steady improvement within the first week. Soreness, tightness, and swelling are expected but gradually lessen as healing progresses.

Is panniculectomy a high-risk surgery?

A panniculectomy is considered a safe and commonly performed procedure, but it is still a major surgery that carries risks such as bleeding, infection, wound-healing problems, seromas (fluid collections), and scarring. The overall risk is higher in patients with medical conditions like diabetes, smoking history, or obesity, but for most patients carefully selected by their surgeon, complications are relatively uncommon.

How long is the recovery after a panniculectomy?

Recovery from a panniculectomy is gradual, with most people able to resume light daily activities within one to two weeks. More strenuous activity and exercise are delayed for about six weeks. While the majority of healing occurs within the first two months, it can take six months or more for swelling to fully resolve and scars to mature.

Which is better, a tummy tuck or panniculectomy?

Neither surgery is universally better; it depends on your goals. A panniculectomy is best for removing the lower abdominal apron for comfort and hygiene, while a tummy tuck also tightens the abdominal muscles, reshapes the waistline, and repositions the belly button for a more sculpted look. If cosmetic contouring is your goal, a tummy tuck may be preferable, but if function and health relief are the focus, a panniculectomy may be the right choice.

How much weight to lose before panniculectomy?

Surgeons typically recommend being close to your long-term goal weight and keeping that weight stable for several months before surgery. For people who have had bariatric surgery, this often means waiting 12–18 months after surgery and maintaining weight stability for at least six months. Being at a steady, healthy weight helps reduce complications and improve the long-term results of the panniculectomy.

Do you get a new belly button with a panniculectomy?

In most panniculectomies, the belly button is left in its original position and is not reshaped. However, if there is a large amount of excess skin extending above the navel, the surgeon may need to reposition or, in rare cases, remove it. Unlike a tummy tuck, a panniculectomy does not involve creating a new belly button for cosmetic purposes.

How long do drains stay in after a panniculectomy?

Surgical drains are often placed to prevent fluid buildup, and they stay in for about one to two weeks. The exact time depends on how much fluid is draining, and most surgeons remove them once output falls below a certain level for consecutive days. In some cases, drains may remain for a few weeks if healing is slower.

How many hours is a panniculectomy?

The surgery time for a panniculectomy typically ranges from one to three hours, depending on the extent of excess tissue being removed and whether the procedure is combined with other surgeries like a tummy tuck or hernia repair.