I recently underwent a surgical procedure called a panniculectomy. Sometimes confused with a tummy tuck, a panniculectomy is a non-cosmetic procedure designed to remove a person’s abdominal apron, apron belly, or mother’s apron — known medically as an abdominal pannus or panniculus. An abdominal apron is a hanging collection of skin and fat that extends beyond the bikini line and hangs down to or past the mons pubis.
Basically, it’s a (sometimes super-sized) saggy tummy, y’all. It’s the “belly” part of a VBO. Some people call it a FUPA, although there’s a lot of debate about whether that’s accurate. (Some people…like Beyonce… say the “mummy tummy” is the foop, and some people say the actual chubby pubic mound is the foop. Feel free to draw your own FUPA conclusion.)
Whatever you call it, a panniculectomy is the surgical removal of that… hanging belly flap. Some people have this procedure done after massive weight loss and end up with a flat tummy. But it’s not a tummy tuck—it doesn’t tighten up any muscles and, if you’re fat like me, you might not end up with a flat stomach at all.
So, if you don’t always end up with a flat stomach after a panniculectomy, and it’s not a purely cosmetic procedure, why in the freaking world would anyone voluntarily undergo a massive surgery like I did? Glad you asked.
My decision to have a panniculectomy was twofold.
First and most importantly by a million miles, I had medical reasons for seeking this procedure. In the last twenty years, massive up and down changes in my weight and the c-section births of three children turned my formerly adorable little round belly roll into a very large, very heavy pannus. With each child, my skin lost some elasticity and my abdominal apron grew, eventually turning into a Grade 3 panniculus—which means it extended to the mid-thigh. The MID-THIGH, people. It was becoming A. Whole. Thing.
Over the last two years since my daughter was born, despite losing a substantial amount of body weight, my panniculus was going nowhere. That baby was here to stay, hanging on for dear life, making my lower stomach muscles work hard for the money. For the first time, my lower back was beginning to feel the strain, too. The weight of my freaking panniculus laid against my legs, making exercise extra tough, and some things, like riding a bike, very awkward and uncomfortable.
I started seriously considering a panniculectomy a few months ago when I got a yeast rash under my apron belly that would not let up. My skin was cracked and bleeding. It took weeks and multiple prescription medications to clear it up. I felt disgusting, and I was in serious pain.
That’s when I decided I’d look into having the hanging skin removed—because massive surgery couldn’t be worse than dealing with that ever again.
I would be lying if I didn’t admit that I was also interested in the way a panniculectomy would change the way my body looked.
Clothes aren’t designed to accommodate a large pannus. Finding clothing that fits properly when your body is out of proportion according to clothing manufacturers standards sucks. I love fashion, but I’ve felt excluded from it for years. Nothing freaking fit like I wanted it to fit when I had to try to accommodate my apron belly. Pants are made for legs…and legs don’t typically have a twenty-pound roll of flesh just chilling in the thigh area.
I am very comfortable being fat. I love my body. It’s served me well for thirty-seven years. I think I’m really beautiful, and if I wasn’t physically uncomfortable, I never would have considered lobbing part of my body off. But I won’t pretend I’m not pretty damn excited about how differently clothes fit me now, and how much more confidently I move through the world.
The surgical approval process was kind of a breeze for me, honestly.
There were less than two months from the time I told my primary care doctor I wanted to look into the panniculectomy process and the day a skilled surgeon went ahead and lobbed off my abdominal apron.
I am incredibly lucky because my insurance agreed to cover one hundred percent of the cost of the procedure. The estimate I received from the hospital for the whole kit and caboodle was $60,817—but my responsibility was $0. I recognize the immense privilege that insurance coverage like mine affords me. I wouldn’t want to discuss this without acknowledging that when I was deciding whether to do this procedure, I didn’t have to consider the cost. That’s not the case for everyone, and I totally get that.
The actual panniculectomy was not as bad as I thought, either.
As far as pain is concerned, I am only a week post-op right now, but I feel pretty good. I took my pain meds exactly as prescribed for the first three days, including setting alarms for overnight doses, and I felt literally no pain at all. Not even any discomfort. Addiction runs in my family, so when my pain medicine ran out at the end of the third day, I opted not to ask my surgeon for more (as she had instructed me to do if I needed it.) I’ve continued to take OTC NSAIDS on schedule since, and my pain has been next to nothing. I’m uncomfortable now and then, but I have been up and moving since just a couple hours after surgery without a problem. It’s not exactly a vacation, but it’s fine.
My body does look like a science experiment, though.
My surgeon ended up removing NINETEEN POUNDS from my lower abdomen. No, I’m not kidding. I was carrying a flap of fat and skin around my waist that weighed almost as much as my toddler. I feel very confident that removing it was the best thing for my body and my mind—and my wardrobe. Oh! And I cannot WAIT to go bathing suit shopping next spring. My chunky bod is going to be rocking all the styles that never worked well for my when my apron was, ya know…aproning.
The incision involved runs from hip to hip, and I have two surgical drains—silicone grenade-looking pouches with long silicone tubing coming out of each end of my incision. I have to wear an abdominal binder for support and to help reduce swelling. It definitely looks like someone chopped part of me off—because she did!
I’m still a fat girl after panniculectomy, and that’s perfectly fine with me!
Lots of people end up with flat tummies after panniculectomy, but since I am still fat, I did not end up with a flat tummy or anything even remotely close. My formerly round, saggy belly is now a round, high belly. I am ecstatic with my results, but I’m still round and chubby—as I knew I would be! I can’t stop looking in every mirror I pass, even though I know my body is still not society’s ideal. It’s my own ideal! I have been joking that I am shaped kind of like Lady Glitter Sparkles from the Trolls movie. You know Danny Devito as The Penguin in Batman Returns? He and I are rocking similar body types.
Right after surgery, I looked in the mirror and described myself as “a meatball on a toothpick.” But I wasn’t mad about it. I am an ADORABLE meatball on a toothpick! The day after surgery, I even FaceTimed my best friend just to show her how cute I look in my new pajamas.
I am thrilled.
My body feels more like my home now. It’s a little bit closer to how I remember it before the last few years of my life changed things, and I am enjoying that feeling. I can’t wait to fully heal.
I know I will get some crap from the fat community for choosing this procedure, but honestly, I don’t care. It’s not like I am telling anyone else to get a panniculectomy, and I am not saying that my body is worth more now that it has a little less fat. But I am saying that my doctor, my surgeon and my insurance all agreed that I had medical and aesthetic reasons for choosing to remove close to twenty pounds of fat from my abdomen. It was the right choice for me, and I have no regrets.
If you think a panniculectomy might be right for you, the best place to start is at your regular doctor’s office. They can help you assess your body and determine if removing your abdominal apron would be medically beneficial to you.