A panniculectomy is a surgical procedure to remove a large flap or apron (panniculus) of redundant skin and subcutaneous fat that hangs down from the abdomen covering the pubis and groin. A panniculus can develop with massive weight loss in patients who have had bariatric surgery. A large panniculus can interfere with normal activities such as walking, and lead to serious medical problems. The heavy overhanging tissue can cause chronic skin inflammation under the flap, and subsequently, skin breakdown and infection. The number of panniculectomies performed in the United States is increasing with the increasing incidence of obesity and bariatric surgery. Historically, panniculectomy has been considered primarily a cosmetic procedure; however, for some patients, surgery is the only option if a large panniculus causes debilitating symptoms that do not respond to conventional medical therapy.