Benefits and Risks of Combined Hysterectomy & Panniculectomy

A hysterectomy to treat uterine fibroids, organ prolapse, cancer, endometriosis, pelvic pain or adenomyosis doesn’t have to be a dreaded procedure. Now women can simultaneously have hanging abdominal fat and skin removed (in a procedure known as a panniculectomy) to enhance their appearance, without an increased risk of complications. A tummy tuck surgeon can plan the procedure in conjunction with a general surgeon.

“Patients may elect to benefit from the convenience of multiple procedures in a single stage associated with the peace of mind of documented safety,” said Dr. Antonio Jorge Forte, lead author of a new safety study published in the September issue of Plastic and Reconstructive Surgery.

He adds that many women scheduled for hysterectomy also happen to be obese. Especially following the birth of a last child, women may opt to have excess abdominal fat and skin removed in addition to their reproductive organs.

Patient selection is critical for hysterectomy/panniculectomy

The most recent safety study looked at more than 25,000 hysterectomy patients from 2005 to 2012 in the national surgical database. Of these, 174 patients underwent panniculectomy at the same time. Patients undergoing both procedures tended to be obese, have diabetes and have a history of heart or lung disease, which initially skewed some of the data. Triple the risk of blood clot complications (venous thromboembolism) was observed in patients with obesity, diabetes and past history of heart or lung disease who underwent both procedures at once.

Research finds no increased risk of complications

However, when adjusted for similar characteristics, there was no difference in wound complications like infections, venous thromboembolism or other complications 30 days later. Researchers concluded that patient selection is an important part of the process, but for the right patient, the two procedures are easily combined.

Data underscores importance of patient counseling

Patients undergoing hysterectomy plus panniculectomy spent an average of four hours in surgery, compared to two hours for hysterectomy alone. Also, 48 percent of women in the combined group stayed in the hospital for three days or longer, compared to 29 percent of the hysterectomy patients.

“These patients should be counseled to expect to stay longer in the hospital after combined procedures,” said Dr. Forte. He added, “Our findings do not end the conversation about risks associated with combined procedures, but provide more data to help patients and providers make informed decisions.”

Looking for one of the best Manhattan tummy tuck surgeon?

Dr. B. Aviva Preminger is an award-winning Manhattan plastic surgeon who has been recognized by the Plastic Surgery Foundation for her professionalism and commitment to medical ethics. She completed her surgical training at New York Presbyterian Hospital and Columbia University and currently serves on the Board of the New York Regional Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgeons.

As a female plastic surgeon with children of her own, she understands the need for abdominal re-contouring following childbirth and is happy to counsel women considering undergoing a hysterectomy and panniculectomy at the same time. Call 212-706-1900 to book a consultation at her Park Avenue office.