Abdominoplasty

Abdominoplasty or "tummy tuck" is a cosmetic plastic surgery procedure used to make the abdomen more firm. The surgery involves the removal of excess skin and fat from the middle and lower abdomen in order to tighten the muscle and fascia of the abdominal wall. The best candidates for this type of surgery are patients in good health, but with excess fat in the abdominal area in combination with loose skin and weakened abdominal muscles. It is usually sought by patients with loose tissue after pregnancy, or individuals with sagging in the abdominal region after major weight loss perhaps due to gastric bypass surgery or bariatric surgery.

Abdominoplasty is usually performed under a general anesthesia, which is for the patient’s comfort and safety. An incision is made in the bikini line area, extending outwards on each side towards the flanks. Another small incision is made around the belly button, allowing improved tightening of the upper abdomen. The abdominal muscles are exposed and tightened, flattening the abdomen. Next, the skin of the abdomen is stretched towards the lower abdominal incision. Excess skin and fat is removed, to further flatten the abdomen, while improving stretch marks and abdominal shape. Liposuction is often used to refine the transition zones of the abdominal sculpture. A dressing and sometimes a compression garment are applied and any excess fluid from the site is drained. Finally, the belly button is properly positioned and reshaped before closure.

Mini-Abdominoplasty

For patients with less severe cases of excess abdominal skin and fat, a partial or mini-abdominoplasty may be used. This procedure involves a smaller incision below the bikini line, with no scar around the belly button. The skin and fat of the lower abdomen are detached in a more limited fashion from the muscle fascia. The skin is stretched down and excess skin removed. Sometimes the belly button stalk is divided from the muscle below and the belly button slid down lower on the abdominal wall. Sometimes a portion of the abdominal muscle fascia wall is tightened. Liposuction is often used to contour the transition zone. Finally, at the end of the procedure the flap is stitched back into place. Recovery time is substantially less in comparison with the standard abdominoplasty discussed above.

Related Procedures: Panniculectomy, Trunk lift, Body lift, Thigh lift

Those patients who have undergone significant weight loss may benefit from other body contouring procedures. An abdominoplasty (tummy-tuck) as a component of a lower body lift and can be combined with liposuction contouring, breast reduction, breast lift, or occasionally hysterectomy, depending on the reason for the hysterectomy. A popular name for breast enhancement procedures performed in conjunction with an abdominoplasty is a "mommy makeover." These include the belt lipectomy or lower body lift, brachioplasty (arm lift), thigh lift, panniculectomy (lower abdomen) and mastopexy (breast lift).  A circumferential abdominoplasty is an extended abdominoplasty plus a buttock lift. The resulting scar runs all the way around the body, and the operation is also called a belt lipectomy or body lift and rectifies sagging of the abdomen, buttocks, groin and outer thighs. This operation is most appropriate for patients who have undergone massive weight loss. Brachioplasty arm lift redresses sagging of the upper arms. Medial thigh lift corrects sagging of the inner, outer and mid thigh. The Breast lift procedure, also known as mastopexy, augments and fixes sagging and flattended breasts. The purpose of panniculectomy is to remove a large abdominal panniculus after weight reduction in a patient who has had excessive obesity. This panniculus can be associated with the breakdown of the underside of the panniculus in which case, panniculectomy is indicated.

After the Tummy Tuck

The result of the Tummy Tuck procedure ideally is an abdomen that is tight and flat, along with a waist that is narrow and curvy with more firm thighs and buttocks. The surgery takes about two hours in most cases, and can often be performed as an outpatient procedure at our Los Angeles and Beverly Hills Plastic Surgery Center. A postoperative overnight stay can be arranged where appropriate and necessary. Initially there may be bruising and discomfort. An abdominal binder is used for comfort and wound care for two weeks after surgery; drainage tubes are typically removed within five to seven days. Patients are advised to avoid all forms of nicotine for a month or longer prior to surgery and also during the recovery period.

Because abdominoplasty, or tummy-tuck, does involve more discomfort than many other plastic surgery procedures, patients may wish to consider staying in a cosmetic surgery aftercare facility for a few days, and should plan on taking two weeks off from their usual activities/work. Full recovery takes 3–6 months, with further fading of scars thereafter. Scars may appear red and prominent at first, but with proper care, they heal into a thin, silvery line. Scars are an unavoidable consequence of abdominoplasty surgery, but most patients find clever ways of wearing undergarments or specific bathing suits which help cover any visible scarring.

To review your specific desires for body shaping and contouring, please contact us to setup a specialized consult with Dr. Younai at our Los Angeles and Beverly Hills Plastic Surgery Center. Dr. Younai will walk you through the steps of the procedure you are interested in, as well as discuss a detailed post operative plan with you to ensure you will be comfortable throughout every step of the process.