Now that two-thirds of U.S. residents are overweight or obese, a whole new language has sprung up to describe various fatty body parts. One term you may have heard and, like me, wonder what it meant is “FUPA.” In the vein of college or urban humor (read: funny if you’re in the mood, not funny if it applies to you), FUPA means “fat upper pubic area” or “fat upper pelvic area.” Since both men and women can have FUPAs, sometimes the “P” in FUPA is said to refer to specific genitals of either sex.
The medical term is “panniculus.” It’s derived from the word “pannus,” which refers to a flap, or apron, of hanging tissue. Unwanted tissue can grow over corneas, joint cavities (in rheumatoid arthritis) and artificial heart valves. When a pannus is present on the lower abdomen, it's called a panniculus.
People afflicted with a panniculus are either overweight (usually obese), or their abdomen has shrunk several sizes post-pregnancy or after weight loss. The tissue itself is made up of skin and fat and is graded by degree of severity:
- Grade 1: the panniculus reaches the pubic hair but not the genitals
- Grade 2: the panniculus lies over the genitals down to the thigh crease
- Grade 3: the panniculus reaches down to the upper thigh
- Grade 4: the panniculus hangs down to mid-thigh level
- Grade 5: the panniculus reaches the knees
Yes, in severe cases this apron of skin and fat can reach the knees and beyond. Search Google on the terms “pannus” and “panniculus” and you’ll see.
If you enjoy slightly raunchy humor, you can tune in to various FUPA songs and dances on the Web. Just know that those with a panniculus—especially beyond grades one and two— won’t be amused. Problems stemming from hanging abdominal skin and fat can range from annoying, such as difficulty fitting into clothes, to altering the quality of ones life, such as inability to have sex. Beyond those issues are even more serious problems such as hygiene difficulty (leading to skin infections), chronic infection of the panniculus itself, and, for some, the inability to walk.
Obese people
with a large panniculus should seek medical care. This can be a case where a metabolic specialist will recommend surgical removal, or a “panniculectomy.” Most doctors wisely refuse to perform surgical fat removal, except in the case of liposuction for patients who are at or near their ideal weight. But when a massive panniculus presents danger to an obese person’s health, a plastic surgeon or general surgeon may be called in and a panniculectomy may be in order.
For those who have lost a great deal of weight, a panniculus can be both troublesome and frustrating. There’s almost nothing worse than achieving a challenging weight loss goal and having redundant skin marring an otherwise new, healthier self. The good news is that with the rising popularity of bariatric surgery, plastic surgeons are becoming more and more adept at post weight loss body contouring, including panniculectomy.
In this case, where the panniculus is comprised mainly of redundant skin, the plastic surgeon will remove the excess and take care to preserve blood supply to the remaining skin and wound. (Abdominoplasty, which also involves tightening the stomach muscles, is a different procedure, often appropriate for post-childbearing women.) Liposuction may also be used to banish any remaining pockets of fat.
Panniculectomy results in scars, naturally, and to ensure optimal healing the scars may not be placed in the most advantageous locations. However, most patients are happy to trade the excess skin for this lasting evidence of surgery.