A pannus, or panniculus, also called an abdominal apron, is a flap of excess skin, fat and tissue at the bottom of the abdomen. It occurs on overweight and morbidly obese patients as well as on people who have lost large amounts of weight but still have excess skin. Doctors can remove the surplus tissue with a surgical procedure called a panniculectomy.
An excessively large pannus causes back strain. Obese patients might have difficulty moving around because the tissue hangs down over their knees or between their legs. It can also be difficult for patients to adequately wash all parts of the body, and they might have an unpleasant odor because of a buildup of sweat and moisture. Some people develop heat rashes, skin tags and skin ulcers from the constant dampness.
Medical professionals can treat the problem by performing an abdominal panniculectomy, which is a surgical procedure that removes the excess tissue and fat from the area. The operation might be covered by health insurance if the pannus descends past the groin or causes medical problems, such as skin infections and back pain. Insurance companies might not pay for the procedure if it is performed strictly for aesthetic purposes.
Severely overweight people who undergo panniculectomies are at risk of developing infection because of the depth of the cuts and the amount of tissue that is removed. Many healthcare professionals and insurance agencies require patients to lose weight before they will perform the operation, and patients should maintain a stable weight for at least one year before surgery to show that they will not need to operation again in a few years.
A panniculectomy is a serious operation that takes several hours to complete. A qualified cosmetic surgeon can perform the procedure either in an outpatient surgery center or in a hospital. Patients are anesthetized during the operation and usually spend several days recovering in the hospital afterward.
The surgeon performs a vertical incision from the breastbone to the pubic bone, followed by a second horizontal cut near the pubic area. He removes the fat and tissue, sutures the patient and installs temporary drainage tubes to remove any excess fluid that builds up inside the abdomen. He also will send the patient home with post-operative care instructions as well as prescription medications for the pain and swelling.
A panniculectomy will usually make patients more comfortable and improve their mobility, but the surgery is not risk-free. Individuals might experience bleeding, infections, blood clots and excess fluid buildup. It also leaves scars on the abdomen.
Panniculus vs Pannus
Despite the popular belief that the pannus and the panniculus are the same things, the two are actually two different things. Pannus is a medical term that refers to layers of fibrovascular tissue or granulation tissue that are abnormal. A pannus may grow in a tumor-like fashion, such as over a joint surface in a patient who has rheumatoid arthritis. When this happens, the pannus can erode the patient's bone and cartilage. Other common places where a pannus may grow include on a prosthetic heart valve or over the cornea.
Many people call the fatty tissue in the lower abdominal area a pannus, but the reality is that it is called a panniculus. This medical term refers to the dense layer of fatty tissue that contains subcutaneous fat and is often the result of obesity. It may also be noticeable after a pregnancy or after someone loses a large amount of weight. Sometimes, a panniculus is mistaken for a hernia or tumor, but the reality is that it's the result of loose tissue.
How To Get Rid of Pannus
Getting rid of a pannus (not a panniculus) depends on where it is. One of the most common types of pannus is the one that causes inflammation for rheumatoid arthritis patients, for example. An RA patient who has pannus-related inflammation can make some changes at home to relieve some of the symptoms.
- Changing the Diet – Eating more fiber, fruits, and vegetables can relieve the symptoms of pannus inflammation. It is also a good idea to avoid too many carbs or foods that are high in sugar or caffeine content.
- Exercising Regularly – When RA patients do not move enough, the joints become stiff and inflamed. RA pannus makes that inflammation worse. RA patients should exercise several times a week to reduce symptoms.
- Quitting Smoking – Smoking, including vaping, exposes the body to toxins that can trigger pannus inflammation and cause pain for RA patients.
- Reducing Stress – Stress is everywhere, but it is important for RA patients to do what they can to relieve the stress, such as meditation, music, or spending time with loved ones or pets.
- Sleeping More – Insomnia leads to a reduction in the body's ability to keep infections and inflammation at bay. RA patients who sleep 8-10 hours per night are less likely to deal with pannus-related pain than other patients are.
Many people mistakenly search for "pannus removal" when they mean "panniculus removal," which can lead to misinformation. Read on to learn about panniculus removal.
How To Get Rid of the Panniculus
A panniculus can develop for a number of reasons. Typically, it occurs because someone gains weight and then loses it rapidly, such as what happens after someone has bariatric surgery. Other times, someone develops a panniculus after a pregnancy. Regardless of why you have the excess fatty tissue on your lower abdomen, there are several things you can do to combat the problem and feel more comfortable in your skin.
As you lose weight, you'll need to start doing what you can to target specific parts of your body. If your lower abdomen develops a panniculus, which you may also hear referred to as an "apron belly," you'll need to do specific exercises. To start lifting the abdomen, add sit-ups or crunches to your workout routine. Swimming, walking, and lifting weights can also help you to tone the area and lessen its appearance.
If your panniculus is at least one inch of fat but not much more than that, you might be a good candidate for a cryolipolysis procedure. Cryolipolysis uses targeted lasers to freeze and eliminate the fat cells that cause the panniculus. This treatment may not be an option for people who have more than an inch of fat left in the lower abdomen, so additional weight loss may be required. Typically, results can take up to 6 months to appear but are lasting results once they do become apparent. Cryolipolysis does not require any surgical cuts and has very few complications. Fewer than 1% of people report any complications, and those that did had minor ones, such as redness and mild swelling.
Some people have enough excess skin and fat cells after large weight loss that their doctors recommend a panniculectomy. A panniculectomy removes the excess skin that covers the genitals and upper legs. Because it is a surgical procedure, candidates must meet certain requirements, especially if they want their insurance providers to pay for it. Good candidates do not have uncontrolled cardiac or lung diseases, do not have uncontrolled diabetes, and are nonsmokers. Weight must be stable for at least six months and must be in good health. Most insurance providers require the abdominal apron to interfere with daily activity in order to pay for it.