Panniculectomy surgery is to remove hanging skin and fat from the lower abdomen to create a smoother abdominal shape. A panniculectomy differs from a tummy tuck in that the abdominal muscles are typically not tightened during a panniculectomy. Common reasons to have panniculectomy surgery If you develop excess skin and fat in the lower abdomen, some of the most common causes are: Age Hereditary Pregnancy Prior surgery Massive weight loss