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 29

Body lift for removal of abdominal apron of fat

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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.

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

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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.

Abdomen apron

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It sounds like your procedure, if done at this time, will be classified as a panniculectomy.  You may not be an ideal candidate for such a procedure.  The closer you can get to your goal (ideal) weight, the better your result, the better your health, the better your recover will be.  I would recommend, if possible, that you postpone surgery until you get closer to your ideal body weight and your weight loss plateaus for at least 6 months, preferably 12.  If you are not not yet on a physician supervised weight loss program it may be helpful to do so.  

Jeffrey D. Wagner, MD
Indianapolis Plastic Surgeon
4.9 out of 5 stars 30 reviews

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Body Contouring of Abdominal "Fat Apron"

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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
4.9 out of 5 stars 117 reviews

Body lift tummy tuck large abdominal apron

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Congratulations on your weight loss! That the way to go!

Ideally you should be closer to your ideal weight before you undertake surgery.

Sometimes it can be useful to have some surgery when your weight plateaus, but sometimes would only be a limited lipectomy, not completely body contouring surgery.

You really need to see a plastic surgeon to have a proper assessment and decide when would be a good moment for surgery and how much/what type of surgery would be appropriate.

Carmen Munteanu, MD, FRACS
Melbourne Plastic Surgeon
5.0 out of 5 stars 16 reviews

Remove a large apron of fat?

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Plastic surgery is not design to weight loos. I want the best result for my patients, sadly there isn't any magical procedure, you have to be in the best weight possible for us give you the best result.

Also the risk is higher when you're over 30BMI, obviously if you keep asking , you'll find someone willing to do a very aggressive procedure . My recommendation for you is to keep doing the same thing, keep loosing weight until you feel confortable with your weight, and after this together with your plastic surgeon you can plan the best approach on this skin excess. I know this is not what you want to hear, but this is the safer way.

Is there procedure to remove my excess abdominal skin apron?

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Thank you for your question, and congratulations on your weight loss.  I can appreciate your concerns about excess skin and fat hanging from your abdomen.  This is what is known as a "pannus," a common occurrence in overweight patients.  As you lose weight, the pannus will likely hang more and more and get in your way of activities of daily living (as you stated in your question).

Simply removing the pannus is done via a procedure called a "panniculectomy".  It really isn't a cosmetic procedure because it is simply just an amputation of the excess skin and fat.  It is NOT a tummy tuck.  Most people that need or want a panniculectomy just want the excess skin out of the way and they are not concerned with cosmetic body contouring results.  

A large pannus will typically weigh 5-10 pounds, but this will vary significantly.  The largest pannus I have ever removed weighed 24 pounds.  So there really isn't a "safe" limit to the amount of weight you can remove via skin and fat excision.  Large amounts of skin removal must always be done by a board certified Plastic Surgeon who has a good anesthesia and OR team so the surgery can be done safely.

At 400 pounds, you are in a weight category called morbidly obese, and you are still in this category at 330 pounds.  Keep losing that weight.  You've lost 70, so keep up the good work!  You likely need to lose up to 1/2 of your original weight before extensive body contouring is recommended.  In addition, once you reach your goal weight we will want to see you maintain a stable weight for at least 6 months.  If you want to go further than a panniculectomy, I recommend consulting with a Plastic Surgeon who is comfortable with large-scale cosmetic body contouring and speak to them about a tummy tuck (with a possible fleur-de-lis component) versus a full body lift.  Pricing will vary region to region.  A simple panniculectomy might cost you between $3000-5000 in surgeon's fees.  A full body lift will likely approach the $8000-10,000 mark for surgeon's fees.  Remember, anesthesia and facility fees will be an additional cost.

#pannus #tummytuck

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   Congratulations on your weight loss. At your current weight, you are still significantly over your ideal body weight. I would recommend waiting on any type of surgery until you are closer to your ideal body weight.

The only exception I would make is if you are having significant issues with recurring infections or skin breakdown or other issues with your pannus (skin apron)  then you could get a panniculectomy now but wait on any extended abdominoplasty until you have completed your weight loss.

Jack Peterson, MD
Topeka Plastic Surgeon
4.6 out of 5 stars 47 reviews

Treatment of Redundant Abdominal Wall Tissue

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Congratulations on your seventy pound weight loss! Unfortunately, even after this significant accomplishment you would still benefit from additional weight loss before proceeding with massive weight loss surgery.

It's important to optimize weight loss before proceeding with massive weight loss surgery for a variety of reasons. It's also important that your weight be stable for at least six months before proceeding with this type of procedure. When these steps are taken, aesthetic results are better and complication rates are lower.

Based on these considerations, you would benefit from further weight loss. Once this has been accomplished, you would benefit from a procedure that addresses excess skin both anteriorly and posteriorly. This type of circumferential skin resection can dramatically impact aesthetics and quality of life. How much tissue can safely be removed will depend upon your anatomic findings once your weight loss is complete. The cost of this type of procedure varies depending upon a number of variables, but is usually in the $7,000 to $11,000 range in the mid-western United States.

If you're considering this type of surgical procedure, it's important to contact a board certified plastic surgeon with experience in this area. This surgeon should be able to evaluate your anatomic findings and outline an appropriate treatment plan.

How many pounds will I lose after a body lift?

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Great question and one that virtually every patient has - and it is very common and reasonable  - since if you need a body lift you have lost a ton of weight - typically more than 100 pounds - and if you have lost this much weight you are of course interested in how many pounds your plastic surgeon will remove...I wish I could give you a specific or accurate answer - but unfortunately there is a range - the thinner you are the less weight that a body lift will remove - the least I have ever removed is 3 pounds - and the most is 95 pounds - in reality the average amount of the weight of the skin removed is 10-12 pounds...  it is always less weight than you would think!Happy to see you at any point for a consult and to give you a better sense of how many pounds that I could remove!Best of luck.

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.