Abdominoplasty (or tummy tuck) is a surgical procedure that removes the excess skin around the abdomen and corrects other malformations of the abdominal wall. The most common lesions observed on the abdominal wall are skin laxity (alone, or combined with localized fat deposit), striae (stretch marks) and thinning of the muscle wall that leads to hernias in the abdominal area.
These lesions are due to various causes which most often comprise obesity, lack of exercise, multiple pregnancies, frequent weight fluctuations and previous intra-abdominal surgical procedures. Abdominoplasty involves the removal of the excess skin and fat from the abdomen. After the procedure, the size of the abdomen is smaller, the laxity is corrected, the muscle wall is strengthened and any stretch marks that were situated on the removed skin are gone. Therefore, there is a significant improvement of the body image.
Abdominoplasty (tummy tuck) is a procedure that concerns men and women who wish to improve their appearance. The best candidates are men and women with no serious health problems and no serious obesity issues, who have loose and excess skin in the abdominal area. Abdominoplasty is not a method to lose weight, and should always be combined with a balanced diet and exercise to maintain its good result. Skin laxity caused by pregnancies or significant weight loss, diastasis recti (diastasis of the rectus muscles) and stretch marks, combined with skin laxity under the navel, are the principal indications for abdominoplasty.
There are many surgical versions of abdominoplasty. However, all of them have the same goals:
The procedure is performed under general anesthesia, while the patient is in supine position with the thighs bent at 45ο. An incision is made just above the pubic region, exactly at the height of the C-section but much longer. Then the skin and subcutaneous fat are separated, pulled down and their excess is cut and removed. The umbilicus is brought back in a new position. The abdominal wall is reinforced by suturing the rectus abdominis in the midline, and potential umbilical hernias or white line hernias are removed with plastic surgery. After the procedure, a drain is placed on the area and the patient must wear a special abdominal binder.
The doctor will perform the first dressing change and remove the drain 48 hours after surgery. The patient is fully mobilized within the next 48 hours wearing the binder, and can return home. The sutures will be removed 15 days post surgery. The scar that remains is very thin, it looks like a C-section, and may be completely covered by the underwear.
The complications associated with abdominoplasty are rare when the surgery is performed by an experienced plastic surgeon. The most common complications include dyspnea in the first days due to the reduction of the vital respiratory space, accumulation of blood (hematoma) or lymph fluid in the wound (that will require drainage), infection (it can be prevented with antibiotic prophylaxis) and unsightly scars in some patients.
Partial abdominoplasty (mini tummy tuck) is the least extensive abdominoplasty procedure that can be performed in the doctor’s office under local anesthesia. It is only performed in selected cases where the problem is minor and only involves lower abdomen skin laxity (i.e. only under the navel).
With the patient in supine position and under local anesthesia (without analgesia or sedation), the doctor stretches and excises the excess skin. The scar from the incision is very thin and much smaller.
Where a small amount of localized fat also exists, this may be removed with no surgical liposuction during the partial abdominoplasty in the doctor’s office.
No drain is required and the patient is able to return home immediately after the procedure wearing a special binder for 30 days.
Abdominoplasty is often combined with abdominal liposuction, when skin laxity coexists with excess fat under the skin. Liposuction may either be performed during the traditional (full) abdominoplasty, with the patient under general anesthesia, or during a partial abdominoplasty, with the patient under local anesthesia. The combination of the two methods leads to the best results because it improves the general look of the body. Here too, the use of special abdominal binder is necessary.
Non surgical abdominoplasty, or no scalpel tummy tuck, practically refers to the laser assisted abdominal liposuction. The particular technique is for minor problems and may reduce the localized fat of the abdomen, and at the same time tighten the skin, with results equal to those of the traditional abdominoplasty, without the discomfort that the latter involves:
Its advantages are:
Its only drawback is that is ideal for specific body types whereas it involves a very thorough patient selection process.
The use of a binder is also necessary.