Excision, excessive skin and subcutaneous tissue (includes lipectomy); abdomen, infraumbilical panniculectomy
CPT4 code
Name of the Procedure:
Excision, excessive skin and subcutaneous tissue (includes lipectomy); abdomen, infraumbilical panniculectomy. Common names: Panniculectomy, Stomach Fat Removal Surgery, Lower Abdominal Skin Removal
Summary
A panniculectomy is a surgical procedure aimed at removing excess skin and subcutaneous tissue (fat) from the lower abdomen, specifically the area below the belly button (infraumbilical region). This procedure is commonly done to improve the appearance of the abdomen and to alleviate discomfort or medical issues related to excess abdominal skin and tissue.
Purpose
The primary purpose of a panniculectomy is to address issues caused by excess skin and fat in the lower abdomen. These can include discomfort, skin irritation, infections, or difficulty with hygiene. The goals are to improve the patient's physical comfort, reduce the risk of skin problems, and enhance the appearance of the abdominal area.
Indications
- Excessive, sagging skin in the lower abdomen, often due to significant weight loss
- Recurrent skin irritation or infections in the folds of excess skin
- Difficulty with maintaining hygiene in the abdominal area
- Physical discomfort or difficulty with activities due to excess abdominal skin
Preparation
- Patients may need to fast for a specified period before the procedure.
- Adjustments to medications may be required, especially blood thinners.
- Diagnostic tests such as blood work and imaging studies may be necessary to assess general health and for surgical planning.
- Smoking cessation is often recommended to promote better healing.
Procedure Description
- Preoperative Preparation: The patient receives anesthesia, usually general anesthesia.
- Incision: The surgeon makes a horizontal incision above the pubic area, the length and shape will depend on the amount of skin being removed.
- Tissue Removal: Excess skin and subcutaneous fat tissue are excised.
- Wound Closure: The remaining skin is pulled down, and the incisions are closed with sutures.
- Drains: Temporary drains may be placed to remove any excess fluid that accumulates post-surgery.
Tools and Equipment: Surgical scalpel, sutures, drains, surgical retractors.
Duration
The procedure typically takes 2 to 5 hours, depending on the extent of the surgery.
Setting
A panniculectomy is usually performed in a hospital or a specialized surgical center.
Personnel
- Surgeon (Plastic or General Surgeon)
- Anesthesiologist
- Surgical nurse
- Surgical assistants and operating room staff
Risks and Complications
- Common: Infection, scarring, bleeding, fluid accumulation.
- Rare: Blood clots, anesthesia reactions, poor wound healing, asymmetry or irregular contours.
Benefits
- Improved physical comfort and reduction of skin irritation or infections.
- Enhanced cosmetic appearance of the lower abdomen.
- Easier to maintain hygiene in the abdominal area.
- The benefits are realized as the patient heals, typically several weeks post-surgery.
Recovery
- Patients are generally advised to take it easy and avoid strenuous activities for several weeks.
- Pain management may include prescribed pain medications.
- Instructions will include proper wound care, wearing a supportive garment, and possibly managing drains.
- Follow-up appointments will be scheduled to monitor recovery.
- Full recovery and final results might take several months.
Alternatives
- Non-surgical approaches, such as weight loss, though they may not address excess skin.
- Abdominoplasty (tummy tuck), which also tightens abdominal muscles.
- Liposuction, focusing on fat removal only, without excess skin excision.
Patient Experience
- Patients will be under general anesthesia and feel no pain during the procedure.
- Post-procedure, patients may experience soreness, swelling, and bruising, which can be managed with pain medication and supportive garments.
- Gradual improvement in symptoms and appearance can significantly enhance the patient's comfort and quality of life.