Remove hanging abdominal skin for an improved look and contour.


The panniculus is the pronounced pocket of fat in the lower abdomen. This paunch may appear following weight gain or pregnancy, and it generally will become more pronounced with age. A panniculectomy removes this skin and tissue to slim down a prominent lower belly. It’s common to include a panniculectomy along with a tummy tuck.

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Contact us online today to learn more about your options for a panniculectomy, with or without a tummy tuck. The Institute of Reconstructive Plastic Surgery of Central Texas helps men and women from Austin, Round Rock and throughout Texas.

Benefits of a Panniculectomy

The panniculus is made up solely of excess skin and fatty tissue deposits. In some cases, the panniculus may be the result of stretched out skin and excess fat deposits following a pregnancy. Weight gain and obesity can also cause the formation of a panniculus.

There are five different grades of panniculus:

  • Grade 1 panniculus will just cover the pubic hair line, up to the mons pubis
  • Grade 2 fully covers the genitals.
  • Grade 3 extends enough to cover the upper thigh
  • Grade 4 reaches down to the mid-thigh
  • Grade 5 covers the knees or even lower

A pronounced panniculus can cause health problems like skin chafing and even ulcers. Physical discomfort is common with more serious grades, including back strain from carrying extra weight in the belly. Severe grades can even hamper walking and normal movement. Surgical removal is the only way to get rid of the panniculus, which doesn’t respond to diet or exercise. Although weight loss can help decrease the fatty deposits, extra skin often remains behind.

Understanding the Procedure

Although a panniculectomy is similar in many ways to a tummy tuck, there are some differences as well. The main difference is that a tummy tuck tightens loose abdominal muscles in order to restore structure to the belly. A panniculus is only fat and skin tissue, so a panniculectomy doesn’t impact the abdominal muscles.

Since the two procedures are both intended to slim down the tummy, they are often performed at the same time. If muscle laxity is contributing to the appearance of a prominent belly, a tummy tuck may be recommended instead. In some cases, liposuction may be included for fine tuning and removing additional fatty deposits. However, liposuction alone is not enough to remove a higher grade of panniculus.

It’s important to understand that a panniculectomy is not a solution for weight loss. In fact, this surgery offers the best results for patients who have already reached their target weight. It’s a good idea to maintain a steady weight for several months before surgery.

Recovery and Results

Most of our patients experience some initial discomfort after a panniculectomy. It may feel painful to stand all the way upright at first, since that motion puts strain on the repaired area. You should notice a change in your appearance immediately. As healing continues, your final results become more visible. Most patients are able to return to work about two weeks after surgery.

A panniculectomy from the Institute of Reconstructive Plastic Surgery of Central Texas will help resolve the appearance of a prominent lower belly by removing excess skin and tissue. After surgery, you can expect your low abdomen to look flatter and smoother. Most patients also notice a new boost in their self-esteem after their panniculectomy because they feel more positive about their appearance.