I have a lot of fat hanging from my lower stomach area. What is this condition called and what can be done? (photo)

The fat hangs down pass my knees and the right side hangs lower and is harder than the left side. I keep getting an infection in the hard area. This is so embarrassing when I sit down or walk.The picture is an example of my problem but my fat hangs much lower.Thanks in advance.

Doctor Answers 3

The Management Of Saggy Abdominal Skin

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The hanging skin that you describe is called an abdominal pannus. It's not unusual for patients with this condition to suffer from chronic infection and inflammation resulting in the hardness that you describe. When this situation arises, patients have a condition called panniculitis. This loose skin is also often associated with chronic back pain and rashes. In addition to these problems, large amounts of hanging skin can cause a significant aesthetic deformity which can lower self-esteem and self-image. For these reasons, it's not unusual for patients to seek consultation with a plastic surgeon when they suffer from this condition.

It's important to realize that no two patients with this condition are ever exactly alike. For this reason, procedures are tailored to patient's specific anatomic findings and unique aesthetic goals.

Although actual pictures of your abdomen would be helpful, your history strongly suggests that you would benefit from an abdominal panniculectomy. Depending upon your physical examination, you might even benefit from extension of this procedure circumferentially. This procedure removes redundant lower abdominal skin. In some cases, it can be extended circumferentially to remove excess back skin and lift the buttocks in an upward direction. In most cases, the umbilicus isn't transposed and the muscles aren't tightened. This procedure is associated with significant improvement in function and quality of life.

If you're considering an abdominal panniculectomy, it's important to consult a board certified plastic surgeon with experience in this area. This surgeon should be able to formulate a treatment plan that addresses your anatomic findings and achieves your aesthetic goals.

Body lift surgery

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The overhanging tissue is termed a pannus.  If you have a rash or inflammation it is panniculitis.  In some areas your health insurance may cover the cost of a panniculectomy. It is very different than a body lift.  With a panniculectomy the skin is excised at the point that it overhangs and then the skin is sewn together.  A body lift elevates the skin and fat off the muscle allowing a profoundly more effective procedure.  Typically the body lift will address the abdomen, the flanks, the droopy buttocks and the lateral thigh.  It is ideally performed when you are at a low stable weight.
Getting approval for a panniculectomy can offset a great deal of costs towards the body lift procedure so it is worth asking your surgeon about that possibility.

Abdominal pannus

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You have an abdominal pannus, which is the term that describes hanging skin and fat.  The hard area you're describing is likely an area of inflammation and scar from recurrent infections that is called panniculitis, though only an examination by your doctor could confirm that diagnosis and make sure it's not caused by other issues such as a hernia. 

The surgery to remove the hanging skin and fat of the lower abdomen is called a panniculectomy.  This is a procedure that's performed to remove the excess tissue of the lower abdomen and eliminate the skin folds that are causing moisture-related problems and infections.  Despite the fact that they have similar scars, it is not the same thing as a tummy tuck (abdominoplasty) and is not performed to improve the appearance of the abdomen.  An abdominoplasty is a much more extensive procedure that works on the upper and lower abdomen, repositions the belly button, and tightens the abdominal muscles, if necessary.  Because an abdominoplasty is performed to improve the appearance of the abdomen, it is cosmetic surgery.

Because a panniculectomy is performed to treat medical problems, it is often covered by insurance but typically requires documentation in your medical records that there are complications (rashes, infections, wounds) related to the hanging skin and fat.  I suggest talking with your primary care physician about the infection/hard area, make sure that the treatment you're receiving is documented in your medical records, and then ask for a referral to a plastic surgeon for a panniculectomy evaluation.

Best wishes.

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.