Author Topic: Hernia Repair penniculectomy  (Read 4442 times)

Offline ziggydaddy

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Hernia Repair penniculectomy
« on: February 12, 2012, 09:15:53 PM »
I am 5 years out of  my RNY and am still about 60 pounds over weight. My insurance approved me for a hernia repair and a panniculectomy. I have a insisional hernia from my belly button to my diaphram. I have a partial obstruction of my intestines and have a lot of pain assosiated with it. Im having my surgery on Thursday. The plastic surgon is doing a Fleur de Lis cut and my regular suron is doing the hernia repair. He said he is gonna cut the grissel and bring together my abs then cover them with bio mesh. My question is how will this very from a tummy tuck.

Offline DrBermant

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Re: Hernia Repair penniculectomy
« Reply #1 on: February 13, 2012, 12:06:02 AM »
I am 5 years out of  my RNY and am still about 60 pounds over weight. My insurance approved me for a hernia repair and a panniculectomy. I have a insisional hernia from my belly button to my diaphram. I have a partial obstruction of my intestines and have a lot of pain assosiated with it. Im having my surgery on Thursday. The plastic surgon is doing a Fleur de Lis cut and my regular suron is doing the hernia repair. He said he is gonna cut the grissel and bring together my abs then cover them with bio mesh. My question is how will this very from a tummy tuck.

This should not be construed as medical advice. I am a retired Board Certified Plastic Surgeon.

Pannus Reduction Surgery involves a series of compromises that need to be planned and understood as part of the process. When I was practicing medicine, this type of patient education was critical before scheduling surgery. Panniculectomy comes in different degrees and trade offs such as scars, what skin is removed, how the deeper tissues are contoured, and other issues. While a Fleur de Lis pattern can deal with a greater excess skin around the body, the scar is a major compromise that I never really preferred when I could avoid. If you have not seen examples, the question is why not?  There is a blending between Tummy Tucks, Pannus, and Lower Body Lift Surgery. When possible I also preferred the better sculpture of the lower body lift instead of the vertical scar. Here I show the Loose Skin Managed With body Lift Surgery. but excess tissues comes in so many different degrees, this is something I planned with my patients in front of a mirror to show the limitations of each choice.

Another critical theme was timing of the weight loss. Weight loss before surgery is typically better than after. After Additional Weight Loss there is often a further loosening of tissues.

Not all patients have the option of waiting for optimal sculpture. Complicating factors like infections or partial obstruction of the bowel can change compromises, but this again is education best coming from the doctors who know the patient and are dealing with a consent that should include risks, benefits, and alternate methods of care.

Then there is the documentation of the problem. I preferred my Standard Body Lift Pictures for loose tissues wrapping around the entire body. Getting this set yourself can help with the documentation of the problem. My Standard Body Lift Videos were even better at critically demonstrating the degree of the problem or skill of the solution.

Welcome to our forum. Why not post a standard set of pictures to show others what is bothering you? Good luck on your surgery this week.

Hope this helps,

Michael Bermant, MD
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Michael Bermant, MD
Retired Plastic Surgeon
Surgical Sculptor, Artist, Creative Thinker, Problem Solver
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