In an obese person, there can be a large "apron" (abdominal panniculus) of excess fat and skin that hangs down from the lower abdomen. At times, this apron is so large that it covers the hips and extends around to the lower back. Panniculectomy is a surgical procedure in which this apron is removed. Abdominoplasty and panniculectomy are two different procedures. Abdominoplasty deals with muscle as well as skin and fat, whereas a panniculectomy deals only with excess skin and fat. A panniculectomy can either be performed alone or in conjunction with an abdominoplasty, depending on the patient's physical symptoms. A panniculectomy may also be performed with another abdominal surgery, such as hysterectomy. Panniculectomy can be performed on a person who is severely overweight or who has recently lost massive amounts of weight.
Generally, if a panniculectomy is performed on an obese person, it requires a hospital stay. This is because of the extensive nature of the surgery as well as the need for more medical attention during recovery. The hospital stay could be anywhere from 1 week to 3 weeks or more. Complete wound healing could take several months.
This apron can be graded on a scale of 1 - 5. Generally, higher grades occur as the weight of the patient increases. Also, the higher grades tend to have more problems and medical, physical, and social limitations.
Grade One: Apron just barely covers the hairline and the mons pubis, but not the private areas.
Grade Two: Apron covers the private areas in line with the upper thigh crease.
Grade Three: Apron covers the upper thigh.
Grade Four: Apron covers mid thigh.
Grade Five: Apron covers the knees or beyond.
As the grade increases problems such as difficulty getting in and out of bed and standing and walking upright ensue. Medical problems such as excess weight and moisture leading to skin rashes and breakdown, back pain, and loss of abdominal wall integrity may also occur.
A panniculectomy should help to relieve these symptoms.
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