By Christopher Chung, M.D.
Chief Medical Officer

Searching for the best solution for removing fat and excess skin from your abdomen? You’re not alone—every year, thousands of people choose a surgical solution to help achieve their ideal body shape. But knowing which procedure is right for you can sometimes be confusing.

For most people, two options offer the best solution for removing excess skin from the abdomen: Sono Bello’s AbEX procedure, or a traditional panniculectomy. However, key differences could impact a patient’s choice between the two.

Understanding the difference between AbEX and a panniculectomy can help patients better understand what goes into each procedure, and what to expect when making the decision.

Why Choose Surgical Abdominal Contouring?

Abdominal contouring surgeries can be ideal for helping individuals looking to change the appearance of their midsection.

There are several reasons that anyone, even someone with otherwise normal body weight or proportions, may develop a protruding, loose, or sagging abdomen:

1. Significant increases or decreases in weight

2. The regular effect of aging

3. Body changes from pregnancy

4. Hereditary predisposition

5. Effects from prior surgery

For many people who experience significant weight changes over time (whether through natural causes or through liposuction), abdominal fat and excess skin can still pose problems and can be unpleasant for someone trying to achieve their ideal body shape.

This is why many people choose abdominal contouring—to tighten loose skin and achieve their desired abdominal look. However, the procedure they choose can have a big impact on the overall result.

AbEX vs. Panniculectomy: Understanding the Differences and Which Option is Best For You

AbEX procedure and a traditional panniculectomy both target the same area of the body—the abdomen—but that doesn’t mean they accomplish the same goal. In fact, there are key differences between each procedure.

The most immediate difference is that AbEX is specifically focused on contouring the abdomen through the application of micro-liposuction alongside excess skin removal. A panniculectomy, however, does not include contouring, and only focuses on removing excess skin around the abdomen.

What Is AbEX?

AbEX is an abdominal body contouring procedure that combines liposuction and skin resection, with a particular emphasis on the patient’s aesthetic endpoint.

The major focus is on providing the patient with their ideal flat, tight tummy in just one visit, without the use of general anesthetic.

There are two main components to the AbEX procedure:

Liposuction: for volume reduction. This is the process of removing fat from sections of the abdomen using minimally invasive, micro-laser liposuction. A Sono Bello board-certified/eligible surgeon performs this fat removal process.

Skin removal of the excess abdominal skin. This skin resection can be custom-tailored to the needs of the patient. Skin removal with the AbEX procedure can range from minimum (same amount as done in a “mini-tuck”) to maximum (same amount done in a traditional tummy tuck with repositioning of a new belly button).

The major benefit of the AbEX procedure is that it combines liposuction and skin resection and uses only localized anesthesia for maximum safety.

Because AbEX does not require general anesthesia or deeper sedation, patients experience fewer complications, less downtime, and a faster recovery process.

What Is a Panniculectomy?

While AbEX may combine both liposuction and skin resection into one procedure, a traditional panniculectomy is exclusively focused on removing only the excess skin. Typically, a panniculectomy is performed using a wedge resection and only addresses the abdominal skin itself.

Panniculectomy is often done for medical reasons. For example, if someone has intertrigo (skin infection/irritation from skin overhang), then panniculectomy can be done to remove the excess skin hang.

How Does Panniculectomy Differ from a Tummy Tuck?

If you’ve explored your options for abdominal contouring procedures, you may have seen another procedure called a “tummy tuck,” also known as abdominoplasty.

Though the terms are sometimes confused, there are some key differences:

A panniculectomy specifically focuses on removing sagging or excess skin on the abdomen after weight loss.

A tummy tuck takes this one step further by repairing loosened, stretched, or split abdominal muscles, and is usually more extensive than a panniculectomy.

What these two procedures have in common, however, is that neither includes liposuction of abdominal fat. That’s where AbEX can be a powerful better alternative to a tummy tuck or panniculectomy, in that it removes both abdominal fat and excess skin in one procedure.

AbEX vs. Panniculectomy: How Do They Compare?

Although both AbEX and a panniculectomy provide the removal of hanging skin and fat from the lower abdomen, the major difference between the two is that AbEX includes liposuction alongside excess skin removal on the abdomen, compared to panniculectomy being exclusively focused on resection of that excess skin.

The difference really comes down to the overall goal of each procedure. With panniculectomy, there is much less emphasis on the aesthetic endpoint, and instead, this procedure is a more ‘medically’ focused skin resection.

AbEX, on the other hand, places much more emphasis on the aesthetic endpoint, combining liposuction with skin resection to provide abdominal contouring custom-tailored to the patient’s desired look.

If a patient is specifically interested in both removing fat from the abdomen and removing excess skin, then the AbEX procedure may provide a more complete solution than a traditional panniculectomy.

Recovery Time & Process: AbEX vs. Panniculectomy

Because the AbEX procedure uses only localized anesthesia under gentle minimal sedation, recovery is often significantly shorter than with a traditional panniculectomy (which usually requires the use of general anesthesia).

And, because (unlike a tummy tuck) the AbEX procedure does not include adjustments to stomach muscles, patients can expect a much faster recovery. Typically, AbEX patients return to normal activities in 5-7 days and resume full normal activities, including working out in 2-4 weeks, compared to 4-6 weeks after a panniculectomy.

Who Is a Good Candidate for AbEX vs. Panniculectomy?

The ideal patient for an AbEX procedure may not be the ideal patient for a panniculectomy, and which procedure is right for a patient could come down to their specific circumstances and their goals for the procedure.

Generally, someone who is not interested in fat removal in addition to skin resection, or who does not have a specific aesthetic goal for their abdomen, may want to consider a panniculectomy. This is especially true for someone who has recently undergone massive fluctuations in weight, for whom excess skin is posing a medical problem.

For individuals specifically focused on the aesthetic result of the procedure, AbEX may be a better solution. Because AbEX combines the fat removal process of liposuction with skin resection in one procedure, patients can much more effectively achieve their desired tight, toned, and slim results with a much faster recovery time.

How to Determine Which Procedure is the Right Choice

For patients still struggling to choose between the AbEX procedure or a traditional panniculectomy, it may be helpful to consider a few important questions:

Are you interested in removing fat as well as excess skin? The AbEX procedure combines both liposuction and skin resection, while panniculectomy includes only skin resection.

Do you want to avoid general anesthesia? While most panniculectomy procedures require general anesthesia, the AbEX procedure uses only local anesthesia and allows patients to remain comfortable but awake.

Are you aiming for a specific aesthetic look? The AbEX procedure is a highly targeted aesthetic procedure, and the amount of fat and skin removed can be custom-tailored to your desired body shape. The panniculectomy is a medically focused procedure and may not result in an aesthetically pleasing outcome.