Tummy tuck, also known as abdominoplasty, is a procedure designed to tighten and flatten the abdominal region. Unfortunately, not all of us have the slim, six-pack muscled abdominal contour that we see frequently on television and in magazines. In real life, there are many factors that work against that. These can include: pregnancy with the related stretching of the abdominal wall tissues, stretch marks, weight gain, weight loss, significant sun exposure and abdominal surgery with related scars. These can all conspire to loosen our abdominal skin, fat and muscles. It may not look pretty. If this is causing you concern, a tummy tuck may be a possible option.
The best candidate for a classic abdominoplasty is one with loose, redundant skin and fat especially in the lower part of the abdominal wall below the belly button. If one has tight skin and just some fullness of the abdomen, liposuction alone may be the best option. But if the skin is loose or hanging or if you have stretch marks, one of the tummy tuck techniques may be recommended.
Typically, a classic abdominoplasty (tummy tuck) has three parts to it. First is the removal of extra skin and fat in the lower abdomen. Next, is the tightening of the deeper muscle layer. Finally, the third part usually involves liposuction (liposculpture) of the side areas. The side areas are sometimes referred to as the love handles (I like that term better than the medical term “flanks”). All three aspects mentioned are part of a typical abdominoplasty in my practice although obviously each abdominoplasty is tailored to the individual’s needs.
The repair of the muscle layer is designed to tighten that part of the abdominal wall that gives it its maximum strength. Especially after pregnancy, the abdominal wall muscles and their covering (the musculfascial complex) can stretch out. Approximately one third of women who have been pregnant, the muscle layer does not return to its pre-pregnancy tightness. This stretched out separation of the two main sit up muscles is known as diastasis recti of the rectus abdominals muscles. Oftentimes we can repair this with internal stitches to reposition the muscles to improve abdominal contour. Occasionally, more stitches can be placed elsewhere within the muscle layer to improve tightness of the abdominal wall.
In addition to the classic abdominoplasty mentioned above, another frequently performed type of abdominoplasty is a lower abdominoplasty. This is sometimes referred to by plastic surgeons as a mini-abdominoplasty or mini-tummy tuck. This option is effective for certain body types with only mild skin looseness in the lower abdomen. It involves the removal of skin and fat in the lower abdominal region, but less than the classic technique noted above. Additionally, there is typically liposuction of the central abdomen and love handle regions. Occasionally the muscles are tightened with this technique. At your consultation, we would discuss the pros and cons of both methods and which may be best suited for you.
A compromise in getting a better tummy appearance is the necessity of a scar. The scar is placed in the lower abdominal region along the bikini line and in most cases there is a small scar around the umbilicus. Fortunately, over time, scars fade although this can take up to a year or longer. Most individuals can get back to work within one to two weeks and back to full activity including sit ups in about six weeks.
As with all cosmetic surgeries, healing takes time with abdominoplasty. In most cases, one would require one to two weeks off from work following surgery of this magnitude. Some discomfort is expected and in some cases a drain is used for a week. A girdle type of garment is also worn for several weeks following the procedure to help support and reduce swelling following abdominoplasty. In the correctly selected individual, an abdominoplasty can yield a most pleasant change in one’s contour.