Panniculectomies and tummy tucks are both major surgeries and are often confused because both procedures involve the removal of fat and both target the abdomen, but they are two very different procedures. A panniculectomy involves the removal of excess skin and fat; whereas a tummy tuck involves the removal of fat and tightening of the abdominal muscle. These procedures are often combined or performed with other abdominal surgeries.
Misconceptions
When comparing the procedures of a panniculectomy and tummy tuck, there is a significant difference between what they aim to accomplish. Most people considering these surgeries are obese, have lost a massive amount of weight, or suffer post-pregnancy issues with excessive fat centered below the belly button. A tummy tuck, like a panniculectomy, involves the removal of excess skin and fat, but during the tummy tuck procedure the abdominal muscles are tightened. A panniculectomy only removes tissue.
Candidates
Candidates for a panniculectomy may have fat extending as low as the knees, over the hips, and around the back, which pose a number of health issues. Back problems, tissue breakdown, rashes or ulcers are just a few of the conditions that panniculectomy candidates can suffer from. These conditions can make performing everyday functions such as walking, standing, or sitting very difficult. The best candidates for a panniculectomy have maintained a stable weight for at least a year and must be following a diet and exercise regimen. The ailments for tummy tuck candidates are less severe and the procedure is more often performed for aesthetic purposes. Tummy tuck candidates are in relatively good physical shape, but have excess skin or fat in the abdominal area that is resistant to exercise because the muscles have stretched beyond the point of natural resiliency.
Procedure
A tummy tuck starts with an incision across the abdomen, along the pelvis just above the pubic area. A second incision is made around the navel to loosen surrounding skin. The skin is then separated from the abdominal wall. The surgeon will then stitch the underlying abdominal muscles into a firmer position, creating a smaller waist. Excess skin and fat are removed and the remaining skin is repositioned over the abdomen and sutured into place. A new opening is then created for the navel.
In a panniculectomy, the surgeon makes two incisions. The first is a horizontal incision that runs from hip to hip where the excess fat and skin can be gently removed. The second is a vertical incision from below the sternum to the pubic area. After the removal of excess skin and fat, the remaining skin is pulled firmly and stitched together. The length of time for both these surgeries to be performed is determined on a case by case basis. On average, patients for both procedures can expect their operation to last two to five hours.
Healing
The healing process is essentially the same for both panniculectomy and tummy tuck procedures. They are both major operations, so a considerable recovery time should be expected. Patients are often fitted for a body wrap or garment post-op that has to be worn at all times. To ensure a successful recovery, your doctor should provide a complete list of postoperative instructions to follow and medication for pain and to prevent infection. Swelling, bruising and pain are experienced in the first few days and should decrease as time goes on. Patients should refrain from engaging in any physical activity for several weeks during the healing process. Stitches will generally be removed in a about week and most patients can return to normal activity in three to four weeks. It may take several months for the results of either surgery to become apparent.
Risks
Complications can occur after any major surgery, but they can also be avoided or minimized, if patients follow the doctor's orders. The risks included in both panniculectomy and tummy tuck procedures are:
Infection
Bleeding
Excessive scarring
Fluid collection (seroma) in the newly created abdominal space
Blood clots in the leg or lungs
Revision surgery
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