The health risks of having an apron belly – and how to get rid of it

The Private Clinic were contacted by The Telegraph to provide expert commentary on the topic of Apron Belly.

What is it?, What can cause it? and What can be done to reduce the appearance of one?

Consultant Plastic Surgeon and Body Surgery specialist, Mr William Van Niekerk spoke with The Telegraph to share his expertise on the topic.

What is an apron belly?

Colloquially called an apron belly, stomach overhang or mother’s apron, this is a medically recognised condition where excess fat and skin form a flap which hangs down from the lower abdomen. It is properly referred to as an abdominal pannus or panniculus.

“Essentially it’s an overhanging bit of skin at the bottom of the abdomen that has lost its elasticity and cannot shrink back after weight loss,” explains Mr William Van Nierkerk, a consultant plastic and reconstructive surgeon at The Private Clinic of Harley Street. “Usually there is still some stubborn fat associated with it, but not always.”

It’s most commonly seen in women who have carried children or lost a lot of weight, but can also be an issue for men who have undergone significant weight loss.

The condition can vary in its severity from a small sagging overhang of just a few inches of skin, to an unmistakable drooping apron of flesh which can cover the pubic area and reach as far as mid-thigh or even to the knees in serious cases.

What causes an apron belly?

Extreme weight loss

It is not usually gaining weight that causes an apron belly, but losing it. Typically, an overweight stomach will protrude outwards, not downward (although in some cases of obesity you may see both occur together). But after a certain degree of weight loss, the overstretched skin begins to sag and cause an apron or draping effect.

“We tend to see it most commonly in people who have lost a great deal of weight,” explains Van Nierkerk. “Your skin has been expanded by the extra fat, but as you lose it, your skin has to shrink back. Past a certain point of stretching, the skin can be damaged beyond repair. Like an elastic band that has been pulled too far, it can lose its elastic recoil and only shrink back to a limited degree. Thanks to gravity, that skin and whatever residual fat is left in the area is then prone to hang down.”

Although gradual weight loss is safer in general, he says it’s a myth that losing weight very quickly puts you more at risk of an apron developing than losing weight slowly.

Carrying a baby

“You can develop this apron-like stomach to some degree just from going through pregnancy,” says Van Nierkerk. “Some women experience weight gain along with pregnancy, but just the baby bulge and no other real weight gain can stretch the abdominal skin beyond a certain level of tolerance. Just as if the skin had been stretched by fat, it is stretched by the baby bump, and at some point it loses the capacity to entirely shrink back and becomes slack.”

Having a caesarean

Caesarean section scars can exacerbate an apron belly or even create an overhang or shelf of skin in this area, depending on their location and how they have healed. “When you have a C-section, the surgeon cuts through seven layers and the scar tissue can tether the skin to the layer(s) beneath. The scar can act like a barrier, a wall between the skin above and below it.” This horizontal wall across the bottom of your abdomen can cause the skin (and any fat) above it to hang over the scar, creating a small apron that would not be there if the scar was not pulling at the skin. “Even if your body otherwise bounces back from pregnancy well, you can end up with a small lip or overhang of flesh, which can be a source of great frustration,” says Van Nierkerk.

What are the health risks?

The article then goes on to list typical health risks that could arise from having an Apron Belly. These included;

• Excess Abdominal Fat – Studies have repeatedly shown that more fat around the abdomen increases the risk of Type 2 diabetes, heart disease, cancer and even neurodegenerative diseases such as Alzheimer’s and Parkinson’s, among other issues.
• Risk of Infection – A large pannus is likely to cause hygiene issues as it is difficult to keep clean and can be very sweaty and uncomfortable.
• Postural problems – “The apron can also cause discomfort and difficulty moving or exercising, and affect posture causing back pain,” says Van Niekerk. “People don’t realise how heavy these aprons can be, and they can pull you forward and put a lot of strain on the back.”

How to get rid of an apron belly

The article lists a range of great tips to help readers reduce an Apron Belly which included diet and exercise along with non-surgical treatments like CoolSculpting.

However, surgical removal is likely to be the most effective method to get rid of a true apron belly which is typically just excess skin rather than fatty tissue. These can range from surgical removal of just the excess skin, to a full tummy tuck which removes excess skin, fat and repairs any muscular damage to the abdomen.

Surgical treatments for apron belly

Tummy tuck (abdominoplasty)

“A full tummy tuck or abdominoplasty will completely recontour the abdomen and remove any sign of an apron,” says Van Nierkerk. The procedure involves making an incision horizontally along the bikini line, removing any excess skin from above it (as far up the abdomen as necessary) and repositioning the belly button in the new skin. It also repairs any damage to the muscles of the abdominal wall (as many people having this procedure will also have diastasis recti, a separation of the abdominal muscles caused by pregnancy). A similar option is a mini tummy tuck, which involves much the same process and similar scarring, but only removes skin from the area below the belly button.

Brazilian tummy tuck (abdominoplasty with liposuction)

A Brazilian abdominoplasty is similar to a full tummy tuck, however this procedure “includes liposuction and preserves the blood supply to the area during surgery better”, explains Van Nierkerk. This is his preferred method of abdominoplasty where possible as although it is a longer procedure, it is lower risk and patients do not need drains to remove fluid following surgery.

Apronectomy (panniculectomy)

More unusual but more likely to be offered on the NHS than an abdominoplasty is a panniculectomy (also known as an apronectomy). A more basic degree of operation, which focuses just on removing the excess flesh of the apron, it is often offered to people who have lost extreme amounts of weight but still have some to lose and need the excess skin removed in the meantime in order to reduce discomfort and improve movement, says Van Nierkerk.

Apron belly FAQs

Will walking help get rid of an apron belly?

To a degree, yes – in that any form of regular exercise will help you to shed fat all over and to improve muscle tone and posture, which can all lead to an improvement in the appearance of your apron and shrink it somewhat. However, as Van Nierkerk notes, the key feature of significant apron bellies is that they are caused by damage to the skin more so than stubborn fat, and this stretched skin cannot be shrunk by diet or exercise.

[…]

Read full article here

Get in touch

To find out more about treating Apron Belly or our range of body fat reducing and contouring treatments, please contact us on 0333 920 2471 or you can use our online contact form to request a callback.