• Men and women who are in good shape but have loose abdominal skin and fat that cannot be corrected by diet or exercise as a result of massive weight gain and loss
• Women who have undergone multiple pregnancies and wish to tighten the consequent stretched abdominal skin
• Older patients who have loose excessive skin due to loss of skin elasticity occurring as a result of obesity.

All candidates must be in good general health to undergo panniculectomy.

• Patients who intend to loose a lot of weight should postpone the surgery
• Women who plan future pregnancies should postpone the surgery as the vertical abdominal skin that are tightened during panniculectomy may separate again after pregnancy.
• Patients who have scarring from previous abdominal surgery
• Patients who do not wish for any type of scarring on the body following surgery as panniculectomy can result in permanent, prominent scarring.

Complications associated with panniculectomy are rare but may include

• Infection, bleeding under the skin flap or blood clots post operatively.  This can be treated with drainage and antibiotics.  The risk of blood clots can be reduced by moving around as soon as the surgery is over
• Seroma
• Wound separation
• Skin break down
• Insufficient healing, which can cause more significant scarring or loss of skin as well as requirement for a second surgery.
• Numbness due to damage to nerves in the abdomen during surgery

Complications can be avoided by following the preoperative and postoperative guidelines charted out by the surgeon.

• Initial check-up and evaluation of patient health by the doctor to determine the extent of fat deposits in the abdominal region and to carefully assess the skin tone. This helps to decide whether partial or complete panniculectomy is required.
• Thorough discussion with surgeon on possible risks, complications, outcome and expectations of the procedure.
• Inform the surgeon of any medications that are being taken.  Avoid the use of certain medications for the prescribed period of time before the surgery, as advised by the doctor.
• Smoking must be completely stopped for at least two weeks prior to the surgery as smoking can give rise to complications and delay the healing process.
• Eat well-balanced, complete meals and avoid dieting before the surgery.
• Avoid overexposure to the sun before surgery, especially to the abdomen
• Inform the doctor of any infection or cold that has developed in which case the surgery would be postponed.
• Arrange for assistance for returning home after surgery.
• Prepare home for post operative recovery by accumulating plenty of ice packs, loose, comfortable clothing, petroleum jelly for incision sites, telephone within reaching distance, hand-held shower head and bathroom chair.
• Do not eat after the midnight before surgery.

• After general anaesthesia is administered on the patient, the surgeon injects the area with a large amount of solution in order to make it tumescent or firm.
• A long horizontal incision is made from hipbone to hipbone just above the pubic area. 
• A narrow cannula is inserted through the incision to perform liposuction to vacuum the excess fat cells.
• The skin is stretched under the new underlying structure and the excess skin removed.
• The skin flap is stretched back into place and sutured.
• A temporary tube is inserted to drain excess fluid from the surgical site which is removed after a few days.

Panniculectomy is an inpatient procedure and may require an inpatient stay of 2-3 days.

• The abdomen will probably be swollen, numb or bruised for first few days accompanied with some pain and discomfort which can be controlled by medication.
• Instructions for showering and changing the dressings are given by the doctor.
• The patient is asked to start walking as soon as possible.
• Surface stitches will be removed in five to seven days, and deeper sutures, with ends that protrude through the skin, will come out in two to three weeks.
• The dressing on the incision may be replaced by a support garment.
• The surgeon will instruct on the best positions for sitting or lying down to help ease pain

• The support garment must be worn for a month.
• Limit strenuous exercise for at least three weeks.
• Three week rest is advised to ensure proper recovery though return to work is possible for some in two to three weeks.
• Avoid lifting more than 15 pounds for six weeks, driving for 4 weeks and sexual activities for 6 weeks.
• Follow an exercise program to reduce swelling, lower the chance of blood clots, and tone muscles
• Follow a balanced diet and exercise regularly.
• Use creams or ointments as prescribed by doctor to reduce intensity of scars.