Tummy Tuck

Patients with or without massive weight loss (MWL) frequently seek surgical solutions for rejuvenating the abdominal area.  After childbirth, the abdominal muscles and skin stretch dramatically, and then never contract back to their original state.  Obesity followed by weight loss is another cause of stretched skin and muscle, which also never recovers despite MWL from diet and exercise or bariatric surgery.  No matter what the cause of the skin excess and muscle laxity, there is no amount of sit-ups, work-outs, creams, lotions, or any other non-surgical technique that works for rejuvenating the abdomen.

In a small minority of cases, where there is no skin excess, sometimes we can simply do liposuction only.  However, in the vast majority of cases (>95%) of the patients I see need an abdominoplasty to adequately treat the problem.  An abdominoplasty (tummy tuck)  is the surgical removal of excess skin or fatty deposits from the abdomen, along with the repositioning of the belly button and suturing of the abdominal muscles into a tighter formation.  This bodily enhancement procedure is designed for those who wish to have a flatter and tighter stomach. 

Reasons for Considering an Abdominoplasty:

  • Inability of dieting and exercise to improve the abdomen area.
  • Excessive accumulation of skin following weight loss.
  • Loss of skin elasticity or diastases (loose abdomen muscles) due to pregnancy.
  • The removal of unsightly skin and fat deposits as well as the proper alignment of the abdomen muscles to produce a more flattering look.

Panniculectomy or Abdominoplasty?

What is the difference between these two terms?  Panniculectomy - a procedure sometimes covered by insurance for medical reasons - is not a cosmetic surgery operation.  It is not designed to achieve aesthetic results.  Rather, it is designed to simply remove the excess hanging "pannus" or skin in the front of the abdomen to relieve symptoms such as back pain, rashes, or other problems.  It does not involve relocation of the umbilicus or tightening of the abdominal wall muscles.

Abdominoplasty involves first performing a panniculectomy, and then performing additional procedures including cosmetic relocation of the belly button and tightening of the abdominal wall muscles to achieve a flatter abdomen.

Video

This video shows some intraoperative film of an abdominoplasty in a MWL patient.  In the non-MWL patient, abdominoplasty is simply a smaller version of the same procedure (Note: graphic content).


 

General Procedure

Not all patients are candidates for this type of surgery.   If your body mass index (BMI) is over 30, your results will be less than optimal.  If your body mass index is over 32, you are not generally a candidate for abdominoplasty (only for panniculectomy).  If your BMI is over 35, you are usually not a candidate for any such procedure because weight loss must be achieved first.  Abdominoplasty surgery lasts anywhere from one to five hours, depending on the desired look and the patient’s unique physiology.  To begin the procedure, an incision is made just above the pubic bone area.  This incision goes horizontally across the lower abdomen and sometimes around to the back.  The skin is then stretched away from the muscle tissue, and excess skin is removed.  The abdomen muscle tissue is tightened to provide a firmly contoured stomach and well-defined waistline.  Finally, the incision is closed; and the skin is stitched back into place.  Sometimes the procedure requires an additional incision around the navel in order to provide the best results.

Recovery Process

Generally, post-operative instructions call for plenty of rest and limited movement in order to speed up the healing process and recovery time.  As the body recuperates, the patient can expect some swelling, pain, and discomfort.  Medication can be prescribed to relieve any pain caused by the procedure.  The stitches will be removed shortly after the surgery depending on the procedure(s) involved.  Normal activities can generally be resumed within two weeks.  For abdominoplasty - if the sutures are placed to tighten the abdominal wall - we don't want the patient to lift over 20 pounds for 6 weeks afterward.  It may take up to a year for the body to completely adapt to the new abdominal configuration.  With proper diet and exercise the striking results of the surgery will be long lasting.