Panniculectomy Procedure in Nashville

For many men and women, a flat, toned tummy is one of the main components of a desirable physique. Although years of sticking to a regular regimen of cardiovascular exercise, strength training, and nutritious eating habits can result in a natural “six pack,” many find their ultimate goal is simply unachievable through natural means — especially after significant weight loss. For these individuals, panniculectomy may be a viable option.

Panniculectomy surgery removes the loose skin that hangs below the belly button. This loose skin has lost its ability to regain tightness after years of being stretched due to obesity. Although this “apron” is often unattractive, it can also cause health problems. Yeast infections and cysts can develop in skin folds, and the extra weight can also cause back pain. From a practical standpoint, it also makes fitting into clothes challenging.

At Southern Plastic and Reconstructive Surgical Institute, Dr. Nathan Brought provides panniculectomy surgery to qualified candidates in the greater Nashville area.

What to Know About Panniculectomy

tummy tuck

Although panniculectomy tightens and flattens the area below the belly button, it is not the same as tummy tuck surgery. In tummy tuck surgery, the stomach muscles are tightened and the entire abdominal area is addressed up to the sternum and rib margins— panniculectomy surgery, on the other hand, removes unwanted tissues such as skin and fat. In some cases, Dr. Brought may recommend a combination of panniculectomy and abdominoplasty (tummy tuck surgery). Those who have panniculectomy usually only lose about 5 to 10 pounds in unwanted tissues.

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Who Is a Good Candidate for a Panniculectomy?

Not every candidate is right for panniculectomy surgery. If you have recently lost a lot of weight and adhere to healthy diet and exercise habits — and have kept the weight off for at least one year — that is a great start. Those who maintain a stable weight will enjoy better results, which can be permanent with regular diet and exercise.

If you have back pain, or skin problems relating to excess belly tissue, you should definitely consider a panniculectomy. Sometimes the rolls of excess skin resting on each other create a rash that is very uncomfortable. The rash may also emit an unpleasant odor that is nearly impossible to wash away. One of the best ways to clear up this rash is to eliminate the situation of skin touching skin by removing the excess.

Excess abdominal skin could be needed if you were to become pregnant, so a panniculectomy is not recommended for women until after they have completed any desired childbearing.

Candidates for panniculectomy need to be physically and mentally prepared to undergo surgery and recovery. Excessive weight loss, whether due to diet and exercise or weight loss surgery, can have an underlying emotional component. Removing the excess abdominal skin resulting from your weight loss will not heal any emotional wounds related to your weight problem.

When Is The Best Time to Get a Panniculectomy?

You want to be sure your weight is stabilized before considering panniculectomy. If you lose significantly more weight after the surgery, the procedure may have to be repeated. Major weight loss also affects your physical health by bringing down blood pressure and better controlling diabetes. You need to wait for these systems to stabilize as well, so you are a good candidate for surgery. Usually one year after weight loss surgery is a good time for a panniculectomy.

When Is a Panniculectomy Considered Medically Necessary?

The medical necessity of panniculectomy is generally defined by insurance companies, but certain situations are more likely to pass their test. If the excess skin interferes with daily activities or you can demonstrate it makes walking, standing or sitting difficult, it may be deemed medically necessary to remove this excess skin.

A history of rashes and ulcers between the folds of excess skin would also make the panniculectomy a medical necessity, provided you can demonstrate at least a three-month history of the condition without healing despite conservative treatments such as topicals. You will also want to have letters available from other practitioners such as your primary care physician or a dermatologist verifying that your symptoms persist despite conservative treatment and that they recommend a panniculectomy as well.

In the event of weight loss surgery, medical necessity of panniculectomy is generally defined at eighteen months post-surgery.

A weight loss of 100 pounds or more with a stable weight for at least six months may also qualify your panniculectomy as medically needed.

Medical necessity of a panniculectomy can also be assessed by the size of the excess skin on your abdomen. If it hangs low enough to cover your genital region, or any lower, it may be considered medically necessary to remove it.

How to Prepare for a Panniculectomy

The preparation for a panniculectomy is similar to that for any surgery. Lab tests may be conducted to determine your health for undergoing the procedure and to create baseline data. You will be instructed to stop taking certain medications prior to surgery, and then you will have to fast for the last several hours before the procedure.

Perhaps more important in your preparation is what not to do. In the weeks leading up to your surgery, you want to maintain a consistent routine to keep your weight and other vitals stable. This is not the time to try to lose a few more pounds or to let your diet go and end up gaining additional weight. Managing your stress before the operation will produce the best outcome.

Contact Dr. Brought for a consultation if you think a panniculectomy could be right for you.

Panniculectomy Consultation

Achieving your desired results begins with scheduling a consultation with Dr. Brought at SPRSI. During the examination, Dr. Brought will explain the procedure and give you his best recommendations. In general, panniculectomy takes a few hours, although the length of surgery and the type of anesthetic depends on several factors.


SPRSI team

Nathan Brought, DO and SPRSI serves clients in the Nashville, Tennessee region. In addition to panniculectomy, Dr. Brought performs facelift, breast, liposuction, eyelid surgery, and abdominal surgery. He is a graduate of the Lake Erie College of Osteopathic Medicine. He’s also a member of the Tennessee Society of Plastic and Reconstructive Surgeons, the Tennessee Osteopathic Medical Association, the American College of Osteopathic Surgeons and the American Osteopathic Association.

For a panniculectomy consultation, call Dr. Brought and SPRSI at (615) 791-9090.

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