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Panniculectomy/After Weight Loss Skin Removal Procedure Overview

It takes incredible dedication and willpower to lose a significant amount of weight. After losing all of that weight, the last thing anyone wants is for their new slim and trim body to be hidden by pockets of loose skin. Unfortunately, this is often the case. Skin tends to stretch if an individual is overweight for an extended period of time, so when the weight is eventually lost, the excess skin remains.
The best option to look great following extreme weight loss is to simply remove any excess skin with a panniculectomy. Dr. Leo Lapuerta is an expert in skin removal surgery in Houston, Katy, and Pearland, Texas, with over two decades of experience helping patients unveil a sleek and beautiful new appearance following weight loss.

  • Review from K. P.
  • Source: Google
  • May 16, 2018
Dr. Lapuerta, Brandi, Residents and staff were all wonderful. I had a big surgery that included thigh lift, arm lift and mini tummy tuck all at the same time. Everyone kept me informed, up to date with my progress, and comfortable. My surgeries went very well, minimal pain and left me with absolutely no regrets. His handy work with the scalpel has me feeling more like my old self Great bedside/office manner explains things in detail and tells what will happen next I would recommend !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

What is Panniculectomy Surgery?

Individuals who lose a significant amount of weight are often left with loose and hanging skin. Many look to Dr. Lapuerta, one of Houston’s board-certified plastic surgeons, for after weight loss surgery to complete their transformation. This surgery is a combination of procedures that remove loose skin while tightening the underlying tissue and muscles. It is a common surgery for individuals who lose 100 pounds or more and is especially common among bariatric weight loss patients.

Panniculectomy Candidate

The ideal candidate for skin removal surgery is anyone who has lost a significant amount of weight and is left with loose and hanging skin. The excess skin may not be aesthetically pleasing and may cause irritation, rashes, back pain, and an unpleasant odor. Candidates should no longer be trying to lose weight and have maintained the same weight for somewhere between six months and a year.

If the patient is still trying to lose additional weight or is susceptible to gaining back the weight they lost, they will be advised to hold off on the procedure in order to get the best possible results. Patients should also be in good overall health and have realistic expectations about the outcome of the surgery.

Prior to the procedure, Dr. Lapuerta will partner with the patient to devise a goal and a treatment plan on how to reach that goal, making sure the patient is well informed so they know exactly what to expect during every step of the process.

Conditions Treated with Plastic Surgery After Weight Loss

Weight loss patients will consider after weight loss surgery to correct or enhance one or more of the following conditions:

Deflated and Sagging Breasts

After weight loss, it is common for women to lose volume from their breasts. This can lead to deflated and sagging breasts, often with nipples that point downward. Skin removal surgery can lift the breasts, restoring them to look more youthful and perky.

The surgeon will remove excess skin in a breast lift, tightening the remaining skin to reposition the breasts. The patient may also choose to have breast augmentation if they liked the larger size or fuller shape of their breasts pre-weight loss.

Hanging Skin on the Abdomen

The abdomen is a common storage site for excess fat, so the skin around the tummy can be very stretched out and loose following weight loss. By removing excess skin, patients can proudly display a firm and taut abdomen.

The surgeon may recommend a panniculectomy or abdominal surgery for patients that have excess hanging skin, which causes irritation. They may not be at their ideal weight even though they have lost a significant amount. The result is skin that hangs down and rubs against other skin, causing a rash, irritation, or even open wounds. After the surgery, the patient will enjoy fewer skin issues. This procedure may also be done in conjunction with liposuction and a tummy tuck.

Excess Skin on the Hips

The hips are a problem area for many patients. Not only can the hips have hanging skin following weight loss, but oftentimes patients are unable to shed stubborn pockets of fat on the hips. Panniculectomy surgery can remove both excess skin and pockets of fat on the hips.

Many times, a patient will choose to have a lower body lift along with panniculectomy and abdominoplasty to treat the entire area after weight loss. The surgeon removes excess skin along the hips along with underlying fat. They will smooth the remaining skin and stretch into place for a taut look in body contouring.

Excess Skin on the Buttocks

Get firm and tight buttocks following weight loss with skin removal surgery. Not only will the procedure remove any excess skin, but it can also lift the buttocks and add needed volume. This area is often treated with the hips, thighs, and knees in a lower body lift. It begins in the back, but the surgeon will reposition the patient during the surgery to treat the buttocks and front of the thighs. If the lost weight results in a sagging or unflattering bottom area, the patient may wish to have implants to give them a more rounded look in their buttocks.

Loose Skin Around the Knees and Inner Thighs

Look and feel great wearing shorts, skirts, or dresses by eradicating any loose or hanging skin around the knees and inner thighs. Those who were severely obese and lost a significant amount of weight may notice their loose skin hanging down. Embarrassment or self-consciousness may restrict their clothing choices. A lower body lift after weight loss, which includes the knees and inner thighs, can give them a new sense of self-confidence.

Hanging Skin on the Arms

Even after losing weight, hanging skin can make slim arms look chunky. Remove hanging skin on the underside of the arms (often called “bat wings”), allowing patients to flaunt their toned arms. This procedure is often performed as part of an upper-body lift to address excess skin in several areas.

Loose Skin on the Neck

Loose skin hanging under the neck, known as a “turkey neck,” can be very common following weight loss. A panniculectomy helps patients look their best by removing excess skin on the neck. This loose skin ages a person’s appearance – while the surgery helps restore a more youthful look. A neck lift can also include liposuction to remove any excess fat that adds a “double chin” to the face. The surgeon will remove excess skin and attach the remaining skin in place to add definition to the face.

Combination Surgeries

The goal of after weight loss skin removal surgery is to reduce the amount of loose skin that collects and hangs on the body and to lift the body part so it appears tighter. Multiple areas of the body may need to be addressed, depending on the needs of each patient. Most surgeons will group body parts together and stage them across multiple surgeries. Doing so helps reduce the risk of complications, such as blood loss and infection. Examples of this grouping include:

Upper Body

An upper body combination skin removal surgery usually includes liposuctionbreast lifttummy tuck, and arm lift.

Lower Body

A lower body combination surgery after weight loss usually includes liposuction, butt liftthigh lift, and lower body lift.

What to Expect During Panniculectomy Surgery

Skin removal surgery is performed under general anesthesia in an accredited surgical facility. Dr. Lapuerta’s office features an on-site accredited surgical facility and operating room, giving his patients convenient access to a cutting-edge facility. Generally, the procedure can last up to five hours, but the duration of the surgery varies based on which area(s) of the body are being treated. Every attempt is made during surgery to minimize scarring as much as possible.

Each procedure is performed slightly differently based on the area, but in general, the surgeon makes incisions in the skin. They will remove excess skin and tighten what’s left by stretching it back in place. If a breast lift is included in your surgery after weight loss, the surgeon will reposition the breast tissue and remove extra skin. The nipple and areola may need to be repositioned.

The surgeon may insert a drain to remove fluid and to help with healing. Liposuction may also be included in the surgery if any excess fat is located in the areas you want to treat. For many people who have experienced significant weight loss, it’s still possible to have a few trouble areas where fat tissue resides that they can’t get rid of through diet and exercise. Liposuction can help remove this fat to give you the shape and definition you want.

Panniculectomy Recovery

Panniculectomy recovery following surgery can be a slow process. Patients are usually required to spend the night in the hospital so they can be monitored, and there will be some swelling, bruising, and discomfort immediately following surgery. Patients will likely need assistance around the house during the first few days following surgery, but they should be able to return to work after about a week. Patients should avoid exercise or strenuous activity during panniculectomy recovery for at least a few weeks. A full recovery from surgery will take about 2-3 months.

While the post-surgical results can be life-changing for many weight loss patients, scarring is an unfortunate part of this process. Patients should adhere to a healthy lifestyle so that the results achieved through the surgery are not compromised, as gaining weight can reverse the outcome of the procedure.

When to Consider Surgery After Dramatic Weight Loss

You may want to consider plastic surgery after weight loss if you are currently at your ideal weight and in good health. If you have a lot of loose skin and lack self-confidence in swimwear or other revealing clothing, you can talk to Dr. Lapuerta about your options.

How Much is a Panniculectomy?

The panniculectomy cost varies, especially if the patient opts for a combination surgery. A variety of different factors will play a role in determining the final cost, such as the number of procedures performed (abdominoplasty, liposuction, thigh lift, etc.), the number of surgical settings, length of the patient’s hospital stay, anesthesia, and more. On average, patients can expect the panniculectomy cost to be at least $7,000-$15,000.

To get a more precise panniculectomy cost estimate, contact Dr. Lapuerta for a surgical consultation. During a consultation, Dr. Lapuerta will examine the patient, look at their medical history, and discuss the best treatment method to achieve their desired results. Once a treatment plan is agreed upon, the patient will be provided with an updated panniculectomy cost estimate.

Schedule a Consultation for a Panniculectomy in Houston, TX

If you’ve recently lost weight, you may be proud of your accomplishment but afraid to show off your new look because of sagging and loose skin. You can gain that confidence you want to wear what looks good by having plastic surgery to remove excess skin and tighten it in areas of significant weight loss. Dr. Lapuerta isa triple-board-certified plastic surgeon with more than two decades of experience in helping patients to reach their goals. He can help you look and feel your best after weight loss. To learn more or to schedule an after weight loss skin removal surgery consultation, contact Dr. Lapuerta today.


  • Recovery Time
  • 1-3 Weeks
  • Average Procedure Time
  • 2-6 Hours
  • Post-op Follow-up
  • 1 Week
  • Procedure Recovery Location
  • In & Outpatient


Common body parts that may need skin reduction surgery include the abdomen, buttocks, upper thighs, breasts, arms and neck. The breasts and abdomen are among two of the most popular areas addressed. A large majority of individuals will address the breasts (with a breast lift), and the tummy (with a tummy tuck) in a single surgery. As you lose weight, you will notice which areas are most concerning, and you can begin discussing cosmetic surgery with your plastic surgeon.
Most plastic surgeons require patients to be at or near their goal weight before moving forward with this surgery. However, this isn’t always the case. Sometimes, removing the loose skin is all it takes to accelerate the loss of the final pounds—especially if the loose skin is getting in the way of exercise and mobility.
In most cases, no. Insurance companies consider this surgery to be cosmetic, and they usually do not cover any of the surgical expenses. However, each surgical case is different and may have a special circumstance. Our billing coordinator works to provide accurate estimates and thoroughly checks the benefits of each provider.
Leo Lapuerta Plastic Surgery