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 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.

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.

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.