When the doctor and patient decide a circumferential panniculectomy is the preferred treatment of choice, the plastic surgeon may make an incision around the lower half of the body. The doctor can then remove excess skin that might also hang over the hips and buttocks, which further impede proper hygiene, the ability to walk comfortably, and the chance to finally wear fashions that actually fit nicely. The first step will likely be liposuction, to remove any lingering fatty deposits on the back and the lower belly. The skin will be pulled loose from the muscle wall. Thus, the skin can be pulled tight, without disturbing belly or back muscles. After the skin is pulled taunt, the excess epidermis will be removed and the incision closed. In most cases, the patient is still able to go home the day of the procedure.