A panniculectomy is simply a very large tummy tuck or abdominoplasty. The main goal of a panniculectomy is to remove the large abdominal pannus from the patient usually after massive weight loss. I see these patients in my practice often after some form of gastric bypass surgery (lap band, Roux-en -Y, Fobi procedure, VBG). One difference from the customary abdominoplasty is that the rectus sheath is not always plicated at the same setting. Enormous panniculectomies may require sacrifice of the umbicus due to a very long stalk. Liposuction of the hips is often performed concurrently. Several drainage tubes are placed for at least 7 days to remove fluid under the abdominal flap.