Panniculectomy St. Louis

After significant weight loss, men or women may be left with extra, loose skin and fat in the lower abdomen below their belly button. This is referred to as an apron or β€œpannus”. In severe cases, this tissue can reach the ground and limit mobility. A panniculectomy is a procedure to remove this excess tissue.

Generally, a panniculectomy is a reconstructive procedure and may be covered by certain insurance providers. An abdominoplasty, on the other hand, includes a panniculectomy but also entails removal of tissue above the belly button, repositioning the belly button and tightening of the abdominal muscles to contour the torso. Most patients in Dr. Cabbabe’s experience, need full tummy tuck surgery or abdominoplasty rather than just panniculectomy alone since only the tissues below the belly button, as opposed to the entire abdomen, are the ones treated with this procedure.

Dr. Cabbabe incorporates his experience with reconstructive and cosmetic surgery of the body to give his patients the best results possible to meet their desires. He is an expert in cosmetic, reconstructive and minimally invasive body surgery. During your consultation, Dr. Cabbabe will carefully examine you and will make recommendations in order to help you achieve your desired result.

Preparing for Surgery

Dr. Cabbabe will ask that you refrain from taking any aspirin, plavix, ibuprofen, Coumadin or any other type of blood thinner. He may also recommend that you stop any hormones or oral contraceptives to reduce the risk of blood clots in the legs around the time of surgery.


Prior to surgery, Dr. Cabbabe will place markings on the abdomen and any planned areas of liposuction. Nerve blocks may be done by the anesthesiologist to minimize pain after surgery. Numbing solution is used to minimize blood loss and assist with pain control.

Skin and fat are removed from the lower abdomen while keeping the scar as low as possible. As much tissue as possible is removed. The belly button is stretched into a lower position or sometimes detached and lowered. No abdominal muscle tightening is done in this procedure.

Sutures are used internally to minimize the need for drains. In select patients, no drains are needed. In other patients, 2 drains are placed inside the abdomen and removed within 1-2 weeks.


If this procedure is done by itself, most patients are able to go home the same day. Pain medication and antibiotics will be prescribed. There may be some numbness on the abdomen which slowly improves with time. Most patients are able to shower within 24 hours. If drains are placed, they are generally removed within 1-2 weeks of surgery. Recovery time is 2 to 3 weeks. Dr. Cabbabe will ask you to wear compression garments for 2 weeks after surgery to help minimize swelling and maximize your result.


Heavier patients (BMI >30) experience more complications. If your BMI is greater than 35, Dr. Cabbabe may not recommend surgery. Complications include bleeding after surgery, fluid collections which may result in infection, thickened scars, skin necrosis, asymmetries and blood clots. These may require additional procedures to correct.

Dr. Cabbabe takes measures to prevent complications including appropriate use of antibiotics and drains to prevent infections, leg sequential devices to prevent blood clots in the legs and careful tissue handling to prevent skin necrosis. Board – certified anesthesiologists are used for all of his surgeries.

Before and Afters