Anything from pregnancy, extreme weight loss, aging, or just plain genetics can create a protruding belly that diet and exercise cannot correct. A combination of loose skin, excess fat, and stretched abdominal muscles can lead to a sagging abdominal wall and an unsightly bulge. As we age, skin elasticity declines, and pregnancy or weight gain can stretch out the skin in a way where it simply can’t return to its former tautness. Fatty deposits throughout the abdomen can also be challenging to target, even if you maintain a healthy lifestyle. The two vertical abdominal muscles that create a sleek contour for the abdomen can pull apart over time, and pregnancy can permanently damage those muscles, causing them to droop and separate – a condition called rectus muscle diastasis. This separation makes it impossible to have the same waistline that you once did. Thankfully, a tummy tuck, also known as an abdominoplasty, can address all of the problems that contribute to a protruding belly to give you a flat, taut abdomen.
History of the Tummy Tuck
Like most plastic surgery procedures, the procedures which act as precursors to an abdominoplasty focus on removing physical deformities rather than improving the abdomen aesthetically or minimizing the appearance of scars. 1890, French surgeons Dr. Demars and Dr. Marx caused a sensation by performing a “dermolipectomy,” a procedure to fix a protruding belly button and to remove excess skin and fat. Their patient was a medical student, and dermolipectomy succeeded in reducing his abdomen, which hung down to his thighs. By 1899, Dr. Kelly was performing the modern abdominoplasty at John Hopkins. At this point, however, the belly button was usually wholly removed during a tummy tuck, leading to an unnatural look. By the early 1900s, aesthetic medicine developed techniques that could save the belly button, and as the decades went on, new suturing techniques and incision placements led to more discrete scarring. By the 1970s, the location of the tummy tuck incision was moving in concert with the popular swimsuit styles of the time.
As time went on, the abdominoplasty evolved in a way that focused on creating the most aesthetically pleasing results: inconspicuous scars, flatter stomachs, and narrower waists. Today, with the recent addition of the liposuction procedure and the development of different variations, each abdominoplasty can be fully customized in a number of ways to suit unique body shapes and abdominal anatomies.
The traditional tummy tuck creates a horizontal incision in the lower abdomen. The placement will vary with each patient, but your Aesthetx surgeon will customize your tummy tuck incision to make it as discreet as possible. Dr. Zeidler and Dr. Berkowitz use a technique developed by a Brazilian surgeon, called the Saldanha abdominoplasty. Also known as a “lipoabdominoplasty,” this technique provides the most dramatic reshaping results.
First, complete abdominal liposuction is done to get rid of fatty deposits. Then an incision is made to remove the excess skin between the belly button and the pubic region, making it as low and discreet as possible. Then the two vertical rectus muscles are sutured together from the breast bone to the pubic bone. The belly button, which is left attached to the abdominal wall, is cut out and separated from the rest of the lifted skin. Next, we pull the skin and a small amount of remaining fat down tight and make a new hole for the belly button. Lastly, we close the incision with dissolving sutures.
Usually, liposuction on the flanks (love handles) and lower back are performed with the abdominoplasty to maximize the fat reduction results and create a contoured waistline.
Some patients might have pockets of fat and loose skin that are localized to their lower abdomen below the belly button. These patients are the perfect candidates for a mini-abdominoplasty, a variation of the tummy tuck that uses a smaller incision and leaves the belly button untouched. The ideal candidate for the mini tummy tuck is in relatively good shape with a problem area situated below the belly button. Like a regular abdominoplasty, a mini-abdominoplasty can remove excess skin and fat. However, a mini-abdominoplasty only lifts skin and fat to the level of the belly button.
Modified Endoscopic-Assisted Abdominoplasty
Dr. Zeidler and Dr. Berkowitz routinely perform a modified endoscopic-assisted abdominoplasty designed to address significant rectus muscle diastasis on patients who have only a small amount of excess fat and loose skin. It requires only small incisions above the pubic area and in the belly button. This procedure uses a tiny camera called an endoscope, which allows your surgeon to work under the skin without creating large incisions. Through small incisions, the muscles can be stitched together and reinforced to create a narrower middle. Additionally, pockets of stubborn fat can be removed and skin can be tightened somewhat. These approaches combine to refine the waistline and strengthen the core. Patients with muscle diastasis and a small amount of excess skin are good candidates for this procedure.
For patients who experience fullness in the upper part of their abdomen, a reverse abdominoplasty can remove excess skin and fat by creating incisions underneath the breast, also known as the inframammary folds. Skin and fat above the belly button are then pulled up and removed, and the muscles can be tightened. For patients with fuller breasts, these incisions can be completely hidden, and in general are not noticeable even when wearing a bikini.
Your tummy tuck will take about three to four hours to complete, and we perform this surgery in our fully-accredited, state-of-the-art surgical facility. Many patients are comfortable with an epidural and sedation, which allows them to experience a fast recovery. Catheters are placed deep in the abdomen to minimize any discomfort after the procedure.
Because the abdominoplasty is an outpatient procedure, you will be able to go home the same day as your surgery. You will leave with specialized compression bandages in place that will help to prevent swelling and support your body as you heal. Most of our patients take about two weeks away from work, and are able to return to most daily activities after this initial time of recovery.
Aesthetx is renowned for extremely informative and in-depth consultations. To schedule your private consultation for an abdominoplasty or to learn more about the procedures, contact Aesthetx by visiting HERE or calling (408) 559-7177.
Q. Will I Lose Weight Form a Tummy Tuck?
A tummy tuck is not a weight-loss treatment, but you will lose a small amount of weight from the procedure. Although body contours will improve significantly with the removal of excess skin and fat, most patients lose only a pound or two.
Q. How do I know if a tummy tuck is right for me?
A good candidate for a tummy tuck is in good general health. Though the procedure has come a long way, it is still a surgery that requires the body to heal, and you need to be in relatively good health to do so properly. Our patients that choose abdominoplasty are close to their ideal weight but have a “problem area” in their stomachs.
Q. Will I Need Drains For Recovery?
We will discuss with you whether drains will be necessary or not, depending on your customized procedure. The need for drains varies with the type of tummy tuck techniques we perform. We do use progressive tension sutures which can often reduce the amount of time that drains are necessary or alleiviate the need for drains altogether in some cases.
Q. Are Sutures Removed After Abdominoplasty?
No, sutures will dissolve on their own.
Q. How Long Will I Need to Take Off From Work?
Most of our patients will need to stay home for two weeks after a tummy tuck unless their job requires strenuous activity. We will monitor your recovery progress after surgery and advise you when you can safely return to your job.
Q. When Can I Resume My Exercise Routine?
Patients who are recovering from a tummy tuck should not start any exercise for at least three weeks. At this time you can resume cardio workouts with more strenuous activity after six weeks.
Q. Will a Tummy Tuck Prevent Pregnancy? What Happens if I Become Pregnant?
An Abdominoplasty will not prevent a woman from having more children. However, carrying a child will stretch the skin and put pressure on the abdominal wall, which may cause a reversal of results from the surgery. For this reason, we advise that women wait until after their childbearing years to have an abdominoplasty.