WHAT IS APRON BELLY AND HOW CAN I ELIMINATE IT?

Medically reviewed by Jay N. Yepuri, MD

"Apron belly" describes excess skin and fat that hangs from the abdomen (like wearing an apron). Pregnancy, excessive weight gain, and significant weight loss cause the overhanging skin (also called pannus stomach or an abdominal pannus).

Pannus stomach can cause discomfort and complications like skin infections. Weight loss and exercise may help, but even after weight loss, overstretched skin doesn't bounce back to its original shape. If that happens, noninvasive body contouring or surgery will restore your shape.

Causes

The size of an apron belly may range from a slight overhang to a pannus belly that hangs below the pelvis. In some cases, the skin and fat may hang to the knees (or lower).

Pannus stomach has three causes:

• Pregnancy: The skin that's stretched during pregnancy can lose its elasticity. As a result, it may not return to its original size and shape after delivery. Even after months of diet and exercise, you may still have skin and fat that hangs down (often called mother's apron). About 30% of women have weak, separated abdominal muscles after delivery (diastasis recti), which also contributes to the problem.
• Obesity: Excessive weight gain can cause an accumulation of fat around the abdomen that becomes large and heavy enough to hang down, resulting in apron belly.
• Significant weight loss: Losing a significant amount of weight reduces the fat, but leaves the overstretched skin hanging from the stomach. Pannus belly affects anyone who loses weight but is a common problem following bariatric surgery.

Complications

An apron belly often affects a person's self-esteem and body image. It also takes a physical toll. Depending on the extent of the hanging skin and fat, an apron belly may limit your mobility and cause back pain.

When skin touches skin, the fold rubs together and retains heat and moisture. This skinfold leads to health problems such as:

• Fungal skin infection
• Bacterial skin infection (cellulitis)
• Skinfold dermatitis (intertrigo)
• Skin ulcers

Skin Care

Taking care of the skinfold will help prevent complications. It's essential to keep the skinfold clean and dry. Here are a few tips to help:

• Wash and inspect the skinfold daily.
• Use gentle pH-balanced cleansers.
• Pat dry (don't rub).
• Apply talc-free or cornstarch-based powder.
• Use tummy liners (thin pieces of absorbent fabric to absorb moisture and reduce friction).
• Apply antifungal creams or powders (if recommended by your healthcare provider).

Some people wear a support band (elastic abdominal binder) to hold in their apron belly. However, the band traps heat and moisture, increasing the risk of skin irritation, rashes, and infections.

Lifestyle Approaches

Following a healthy diet and getting regular exercise are essential for losing the excess fat and maintaining your goal weight for the long run. However, there's no way to lose weight in a specific body area like the belly. As a result, you may reach a healthy weight but still have an apron belly.

Strengthening your core muscles, with a focus on the abdominal wall, may improve the appearance of apron belly. Exercise is also the first line of treatment for diastasis recti. Severe muscle separation may not improve with exercise alone.

Treatment

Whether the best treatment is noninvasive body contouring or surgery depends on the extent of your apron belly.

Noninvasive Body Contouring

If you have a small apron belly that doesn't improve with diet and exercise, you may qualify for noninvasive body contouring treatments that eliminate pockets of fat. Some may also tighten your skin.

Body contouring is not intended for weight loss and won't help a significant pannus belly. These procedures use a handheld device placed against your skin. The device sends out freezing temperatures, radiofrequency energy, laser, or ultrasound to break down fat cells.

Cryolipolysis (fat freezing) may help tighten skin, but more research is needed to verify its effectiveness. The other techniques mentioned are known for effective skin tightening.

Abdominoplasty

Better known as a tummy tuck, abdominoplasty removes excess skin and fat and tightens and repairs weak, separated abdominal muscles.

Your plastic surgeon can also remove an apron belly during an abdominoplasty. (Technically, they're doing two procedures: abdominoplasty and panniculectomy.)

Your surgeon may recommend intravenous sedation or general anesthesia for an abdominoplasty. The anesthesia you need depends on the extent of your surgery and your overall health and preferences.

After abdominoplasty, you should plan to take 2-3 weeks off from work. You'll also need to limit strenuous physical activity for 4-6 weeks. Though the initial post-surgery swelling and redness improves in about six weeks, it can take a year for your abdomen to fully heal and optimal results to appear.

The scar runs along the bottom of your abdomen, just above the pubic bone. It should be low enough that's it's concealed by underwear and bikini bottoms.

Health insurance doesn’t usually cover an abdominoplasty because it’s an elective cosmetic procedure. (A procedure you choose to have to improve your appearance.) However, your insurance may cover an abdominoplasty with or without the panniculectomy if it’s medically necessary.

Panniculectomy

A panniculectomy is surgery to remove the overhanging fat and skin. During a panniculectomy, your surgeon only removes the apron belly. They do not repair or tighten the abdominal muscles. (You'll need a simultaneous abdominoplasty if you also need to improve the muscles.)

A panniculectomy is usually performed under general anesthesia. Most people are out of work for about four weeks after the surgery and must limit physical activities for up to six weeks.

It typically takes up to three months for the wounds to heal and the swelling to go down. However, it can take 1-2 years for your abdomen to totally heal and the scars to fade.

Like an abdominoplasty, the incision is in your lower abdomen. so underwear and swimming suit bottoms should cover it. However, the incision size and placement depend on how much fat and skin your surgeon must remove.

Insurance will often cover the surgery if it’s deemed medically necessary. If there is no medical need for the panniculectomy, you may have to pay out of pocket for the procedure.

 

Abdominoplasty vs. Panniculectomy
Abdominoplasty (Without Panniculectomy)	Panniculectomy
Removes excess skin and fat	Yes	Yes
Repairs and tightens muscles	Yes	No
Anesthesia	IV sedation or general anesthesia	General anesthesia preferred
Back to work	2-3 weeks	Up to 4 weeks
Full healing	Up to 1 year	Up to 2 years
Covered by insurance	Only if medically necessary	Usually but must be medically necessary

Summary

An apron belly (pannus stomach) refers to having excess skin and fat that hangs from the abdomen over the pelvis or even lower. It can occur with pregnancy, obesity, and after major weight loss. A pannus stomach can lead to emotional distress, increase the risk of rashes and other skin conditions, and make it difficult to walk in severe cases. 

There are no diets or exercises that can directly target a pannus stomach. Overall weight loss and exercise may help, as can learning to properly care for your pannus stomach. However, most people need noninvasive body contouring or surgery to eliminate an apron belly.

Read the original article on Verywell Health

2023-09-25T18:28:28Z