Abdominoplasty (Tummy Tuck)

The typical patient that presents for abdominal contouring complains of extra skin, extra fat, a stretched or loose abdominal wall, stretch marks, and/or poor lower abdominal skin quality.  These conditions are often results of pregnancy or weight loss.  Some patients complain that they can’t see their belly button and others that their clothes don’t fit properly.  The abdominoplasty or tummy tuck procedure addresses all of these issues.

The abdominoplasty is completed through an incision made across the lower abdomen in an area that is usually covered by undergarments, typically at a level similar to a c-section scar.  Through this incision, most of the abdominal wall is exposed.  With pregnancy, the paired ‘washboard’ or rectus abdominus muscles typically separate from each other (horizontal excess) and lengthen (vertical excess).  Sit-ups and other exercises may strengthen the muscles but no amount of sit-ups can bring the abdominal wall back into its normal, unstretched postion.  During the abdominoplasty operation, these muscles are plicated, or tightened, with sutures.  The rectus muscles are visibly closer together and have better form.  This achieves a flatter and tighter abdominal wall.

Next, the excess skin and fat is removed.  Usually, this results in removal of all of the skin and fat from just above the belly button down to the incision.  This discarded skin tends to contain most or all of the stretch marks and often is inelastic and of poor quality.  The upper abdominal skin, which is usually of better quality, more elastic and without stretch marks, is stretched to the lower incision.  Finally, the belly button is recreated in an ideal position.

With the use of a pain pump, pain after surgery is significantly reduced and in some cases eliminated.  Abdominoplasties are often combined with other procedures, such as liposuction of the lower back or thighs, or a breast augmentation and/or lift.  Depending on the type of work, most patients are ready to return with 1-2 weeks.

If a patient has some excess but not enough to warrant an abdominoplasty, he or she may be a candidate for the Titan procedure.  The Titan is a laser procedure designed to heat the deepest layer of the skin which causes skin tightening.  It will not be as dramatic as surgery but is a nice alternative for someone with more modest laxity.