Tummy Tuck vs. Panniculectomy

A tummy tuck and a panniculectomy are procedures that both involve the removal of excess skin in order to improve the appearance of the abdomen. A panniculectomy is the simpler of the two procedures – it involves removing the skin that is hanging over the abdomen in order to smooth the contour of the abdomen. A tummy tuck also removes lower abdominal skin (usually a greater amount) but also includes tightening of the abdominal muscles to help improve the contours of the abdomen.

A panniculectomy is performed if a patient has too much lower abdominal skin that prevents them from exercising, moving properly, or if the skin is causing them hygiene issues. It is a reconstructive type of procedure and can sometimes be covered by insurance plans.

A tummy tuck includes the components of the panniculectomy in that a component of the tummy tuck is the removal of lower abdominal skin. The tummy tuck process involves an incision at the lower part of the abdomen to separate the skin and the fat from the muscular abdominal wall that holds in the organs. The surgeon cuts around the belly button and separates the skin beyond and above the level of the belly button all the way up to the ribcage to lift up that skin. Then, the muscular abdominal wall is tightened.  In this part of the procedure, the “six pack” muscles, which are commonly stretched out during pregnancy or after weight fluctuations, are able to shrink back afterwards. The muscles are tightened to give the abdomen a slim contour. Finally, the skin is pulled down as much as possible and then the belly button is reset leaving  the patient with a tighter abdomen. A tummy tuck basically does what a panniculectomy starts with and includes tightening of the abdominal muscles and repositioning of the belly button.

IDEAL CANDIDATE

Anyone who needs to get rid of any excess skin and wants to improve contour their body is a good candidate for either procedure.  They must be physically fit for the procedure and require an evaluation by their plastic surgeon. It is very important that they not smoke in the time before or after the procedure.

LIMITATIONS

With a tummy tuck, the main limitation is having enough excess skin to do the procedure. There can also be some medical issues that limit a patient from undergoing either procedure because a person has to be healthy enough to tolerate the operation.  Sometimes preoperative tests and evaluation by an internist may be part of the preparation for the operation.

RISKS

There are always certain risks that are standard to most surgical procedures. These risks include bleeding, infection, and injury to blood vessels or nerves or other structures.

More specific risks associated with a panniculectomy and a tummy tuck include: Development of a blood clot within the abdomen (hematoma), skin loss, loss of the belly button, seroma (development of a fluid collection under the abdominal “flap”).

Other more rare risks include numbness of the abdomen and neuromas or nerve inflammation.

RECOVERY

For patients who have a standard desk job, they should take about two weeks off from work. In general, patients will initially be very hunched over because of the need to pull all the skin together. The pulling of the skin makes the area very tight and they will be very sore at first.

Patients need to start walking around the day of the surgery and get moving so they can avoid blood clots in the legs and speed their recovery.

RESULTS

The results are typically seen almost immediately because of the dramatic skin removal and muscle tightening (in the case of a tummy tuck). The results typically improve as time passes because there is a good amount of swelling initially, which will reduce over the following weeks and months. It commonly takes three, six,or even twelve months to see the final results from the operation.

REDOING A TUMMY TUCK

A tummy tuck can be redone but it is a difficult procedure, so patients are encouraged to work hard to maintain their weight and to eat well. A tummy tuck is difficult to redo because of scarring and also because the skin has already been pulled so tight that there is not a lot of extra skin to pull down.

FINAL THOUGHTS

While both a panniculectomy and a tummy tuck involve the removal of skin in the abdomen, the amount of skin removed and involvement of muscle tightening are some of the differences between the procedure. Patients should consult with a board-certified plastic surgeon to determine which procedure is the best choice to achieve their desired results.

Written by Cosmetic Town Editorial Team- MA

Based on an interview with Joubin Gabbay, MD in Beverly Hills, CA