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Procedure to Remove a Large Apron of Fat

I'm overweight, but have lost weight going from 400lbs. to 330. I'm 24 years old with good blood pressure, and no diabetes nor other health problems.

The better I get around my ribs, across my chest, and in my arms, the bigger my lower tummy gets. Lower body exercise is getting harder because of this apron of fat hanging. It even changes how I sit.

I want to get rid of it, but it's kind of heavy. How many pounds, or in general, how much can I remove from my body safely? How much would a procedure this large cost?

Doctor Answers 17

Procedure to remove apron of fat on tummy

The procedure done to remove the apron of fat that hangs down beyond your abdomen is called a panniculectomy. A panniculectomy leaves a scar across the lowest part of your abdomen. This surgery is often covered by insurance when specific criteria are met, for example how low the apron hangs down.

A panniculectomy is not the same thing as a tummy tuck, which is called an abdominoplasty. With an abdominoplasty, the muscles going down the abdomen are tightened with sutures and the belly button position on the abdomen is moved. This gives a tighter flatter appearance to the abdomen which a panniculectomy does not. Abdominoplasty is a cosmetic procedure and is not ever covered by insurance while a panniculectomy is done for medical reasons and lifestyle improvement so often is a covered procedure.

Relatively speaking, there is actually not that much weight lost with a panniculectomy. But it will feel like a large weight removed to you because of the difference in balance. The lifestyle improvement is life-changing.

If you are a candidate for the procedure, as determined by a plastic surgeon, the procedure is common and safely done.

Las Vegas Plastic Surgeon
4.5 out of 5 stars 7 reviews

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Body Contouring of Abdominal "Fat Apron"

Thank you for your question.  You are to be congratulated on the 70 lb weight loss.  At 330 lbs you are still too heavy to be ready for this type surgery, but researching what you will need to do is a good idea.  There are several approaches.  Removing the apron alone is called a panniculectomy.  This helps relieve the  rubbing of skin, but usually is not a good solution for contour.  An abdominoplasty works well for smaller amounts of weight loss, but a lower body lift generally gives the best restoration of contour in persons like yourself with a substantial weight loss.  Keep up the good work.  Change is possible.

Mary Lee Peters, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 95 reviews

Apron of fat on tummy

A large abdominal pannus ( the technical term) can often be a source of frustration for folks who have worked so hard to lose weight, only to be left with a big apron of fat on the tummy. Fortunately, I have found that insurance companies are becoming more understanding in the realization that it can be quite debilitating for patients.  Ask your plastic surgeon about your options. Hope that helps.

Joshua Korman, MD
Mountain View Plastic Surgeon
5.0 out of 5 stars 7 reviews

Procedure to Remove a large apron of fat

Hello and thank you for your question. The simple procedure is called a panniculectomy and may very well be covered by insurance. If not the cost for that in San Antonio is $7000. I have removed as much as 50 pounds.
Peter Fisher M.D. 

Peter Fisher, MD
San Antonio Plastic Surgeon
5.0 out of 5 stars 15 reviews

Body lift for removal of abdominal apron of fat

Congratulations on your substantial weight loss - way to go!! You're young, and other than your obesity, you appear to be fairly healthy. This bodes favorably for you in the long run. I'm afraid, though, that at this stage you are probably not yet an ideal candidate for a panniculectomy, the procedure that removes the apron of fat (pannus) at the lower abdomen, or a total body lift, which removes a "belt" instead of the apron only found in the front. Both of these operations that we are addressing are not operations done specifically FOR weight loss, but rather, are done AFTER massive weight loss has occurred. In regards to your question, though, usually due to the large size of the pannus, substantial weight loss can do achieved. This procedure ususally costs several thousand dollars, and may vary in cost, depending on how much time is taken in the Operating Room, as well as if other procedures are to be done concurrently. I understand that it is getting harder to deal with the pannus, and that it interferes with daily activities and exercise. My only reply to that is: KEEP AT IT!!! YOU CAN DO IT!!! Continue to lose more weight, continue to watch what and how you eat, and continue increasing the activity level in your life. When it's the right time, a panniculectomy or total body lift will work wonders for you, and the quality of your life will be immensely improved. Good luck.

Abdominal contouring after massive weight loss

Congratulations on your weight loss  progress. There are several options for improving your contour and minimizing symptoms such as skin infection or heaviness after massive weight loss. I usually suggest that you are close to your target weight prior to surgery in order to achieve optimal results. The surgical options include extended abdominoplasty or lower body lift. If your symptoms become too severe prior to reaching your target weight you may benefit from removal of the skin and fat apron, a procedure known as panniculectomy. These operations are quite involved and costly. I suggest you search for a board certified plastic surgeon who has significant experience and do not focus solely on price.

Panniculectomy versus abdominoplasty vs body lift


Thank you for the question.  There are a variety of body contouring procedures available to improve the appearance of the abdomen and waist after significant weight loss.  These body contouring procedures are not designed to be a weight reduction treatment rather they are designed to improve the appearance of the body part in question.  In general there are three levels of waist contouring procedures from least involved to most involved in terms of cost, down time, and recovery.  These are panniculectomy: removal of just the overhanging skin of the abdomen.  Abdominoplasty: full tightening of the abdominal area including abdominal wall and belly button rejuvenation.  And finally a lower body lift which is an abdominoplasty in the front and a buttock lift in the back.

All the best,

Dr Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 111 reviews

Best procedure to remove a large apron of fat????????????

Congratulations on losing the weight.  An abdominal pannus can be very debilitating and cause hygiene issues as well as difficulty with ambulation.  So far you have lost 70 pounds and you are continuing to lose weight.  If that is the case, do not have your surgery until you have reached your goal weight.


The other piece of this picture is that you are still morbidly obese at 330 pounds.  I would encourage you to get closer to a normal body weight.  You may be able to reach this with true lifestyle modification, but you may also need some help.  Bariatric surgery has excellent outcomes compared to lifestyle changes alone.  Should you remain in the morbidly obese category, I would encourage you to explore the option of weight loss surgery.

Procedure to Remove a Large Apron of Fat

If you are still losing weight, it would be best to continue with your regimen until you have reached your maintenance weight.  After your maintenance goal is reached you can schedule a consultation with a board certified Plastic Surgeon for a panniculectomy (removal of excess abdominal apron fat).  Unlike a cosmetic abdominoplasty (tummy tuck) this procedure removes the lower hanging excess of fat and skin and makes it easier to move about and exercise and will help you stay motivated on your healthy lifestyle program.

Thomas Guillot, MD
Baton Rouge Plastic Surgeon
5.0 out of 5 stars 6 reviews

Panniculectomy to remove excess abdominal apron

I would suggest a panniculectomy.  This procedure removes excess skin and fat of the anterior abdominal wall.  The conditions you describe, I hope, should be covered by most insurance plans; however, your insurance may require you to lose more weight based on your height.  This number is your BMI.  Not having seen your pictures, I would guess your surgical specimen would weigh between 50 and 80 pounds.  For your case, I would suggest this procedure be perfomed in a hospital.  Good luck with your weight loss journey.  Sincerely, Dr. Katzen

J. Timothy Katzen, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 78 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.