What is Pannus?

Stephany Seipel

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 example of a pannus.
An example of a pannus.

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.

A surgery called a panniculectomy can be performed to reduce a pannus.
A surgery called a panniculectomy can be performed to reduce a pannus.

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.

A surgical procedure may be performed to remove excess abdominal fat and tissue.
A surgical procedure may be performed to remove excess abdominal fat and tissue.

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.

Surgical scissors may be used to remove skin tags.
Surgical scissors may be used to remove skin tags.

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Discussion Comments


I am a male with a stage 6 pannus that weighs almost 100 pounds. I have lost 300 pounds from 670 down to about 380. We have rigged up a "pannus carriage" for me; kind of like a walker (which I was using anyway since my knees are severely damaged) with a height-adjustable platform. It helps with exercise (simply walking around, which was an incredible struggle before) since I am now no longer trying to lift and push the almost 100-pound belly with every step that hangs to almost my knees.

Surgery is scary, and I would have to lose another 100-150 pounds. Hopefully some of it would be from the omnipresent pannus, which I have to handle with care since it's prone to skin tears with any kind of dropping or falling events, along with incredible pain. I'm still dreaming of being able to have sex again, fit behind a car steering wheel again, and an end to bizarre toilet adventures, although the pannus platform helps with some of that too. It will be wonderful when it is not the major topic of all mobility movement in my extreme morbid obesity damaged life.


Can a 74-year-old woman with heart problems and history of stroke survive this surgery to remove the pannus? Would any surgeon touch her? She can barely move after recovering from a broken ankle. It is painfully obvious that after weeks of sitting (non-weight-bearing orders for recovery of ankle) that she is so weak and hauling her pannus around is becoming next to impossible. She's in physical therapy daily, but I'm wondering if getting rid of this weight will help her walk again eventually. Any thoughts?


I got the Pannus removal four weeks ago and I am so glad I did. I lost 50 pounds due to a lapband, and I still have a long way to go to reach my weight loss goals. I am very pleased with the results once the drains came out. Well worth it!


I wonder how many panniculectomies are performed in the U.S. Since it is a very complicated and long surgery with definite risks, I wonder how insurance companies decide to fund one request and not another.

The article says that insurance will consider the very obese, who have trouble moving around or are getting infections and sores all the time. But do the insurance companies consider if other means have been tried to get rid of the fat? If you have pannus, is surgery the avenue of last resort?


For obese and very overweight people, it must be a real trial to have pannus. First, they must deal with moving around with the extra skin and fat hanging down.

Then, if they decide to have a panniculectomy,they need to lose some weight and stay at a particular weight. On top of that, the panniculectomy surgery is risky, involved and long.

And recovery is painful and slow.

This whole procedure must take a toll on the patient's self-esteem.


My mother-in-law once was obese. She had gastric bypass surgery, and she lost over 100 pounds. Now, though, she has a bothersome pannus.

Complications with her bypass surgery led to an infection that developed into sepsis. She nearly died from it, and she had to spend a month in the hospital. She’s doing much better now, and she has lost so much weight. Because of this, her pannus is quite large.

However, she has to wait while to get a panniculectomy, because her body needs to be fully recovered from the trauma it endured before undergoing another operation. She is eager to get rid of it, but she is afraid to rush in because of what happened with her last surgery.

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