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CONSULTATION ON FULL TUMMY TUCK OR ABDOMINOPLASTY

Frequently women come in for consultation believing they need a full tummy tuck or abdominoplasty in medical parlance. Just as frequently, however, women are not sure which of the multiple procedures are best suited for them.

The best candidate for a full abdominoplasty is a woman whose weight is stable and is close to or somewhat near ideal weight. The ideal patient has looseness of the abdominal muscles, loose skin above and below the bellybutton, and stretch marks along the lower abdomen. This is ideal because every aspect of the full abdominoplasty or tummy tuck corrects each one of these issues.

At times a woman may show up and have only limited muscle looseness but have sagging skin on the lower abdomen or stretch marks on just the lower abdomen. In this case the so-called mini tummy tuck is offered which does not involve any muscle tightening and only concentrates on removal and tightening of the skin and fat of the area below the bellybutton.

If a patient comes in who is overweight and therefore, not a safe candidate for a full tummy tuck, oftentimes she can be offered the compromise procedure of aggressive ultrasonic liposuction of the upper abdomen with a mini tummy tuck tightening up the loose skin below.

There is also the option of an extended tummy tuck commonly done after massive weight loss where full tummy tuck is combined with extension of the skin tightening around the hips or love-handle region on both sides. This is not quite as extensive as a so-called lower body lift.

There is a unique transumbilical tummy tuck that I offer which I developed 15 years ago. The long incision and scar from hip bone to hip bone is not necessary if the skin tone is good and there is no sagging skin, but the abdominal muscles are loose. In this surgery, the only scar is a 360-degree scar around the bellybutton. The skin and fat are then elevated through this hole off of the abdominal musculature, and all of the muscle tightening is done through this small surgical incision. This gives the tightening and support or so-called “virtual internal girdle” without the long scars in a traditional tummy tuck.

The point of all of these options above demonstrates the importance of seeking a qualified, experienced plastic surgeon certified by the American Board of Plastic Surgery. I believe every patient is unique, and it is important that we have a number of options to offer the patient in order to give them truly custom results. There is an old saying that when “the only tool in your toolbox is a hammer all of the world looks like a nail”. We understand that we must always customize the surgical plan to the need of the patient.

In that same spirit, we also note that over two-thirds of our tummy tuck patients combine their abdominoplasty with other enhancements such as breast augmentation, lift, liposuction or facial surgery. They recognize the benefits of one operation and recovery as well as the time and cost savings. This is what we affectionately call “the mommy makeover”.

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