Tummy Tuck (Abdominoplasty)

Anything from pregnancy, extreme weight loss, aging, or just plain genetics can create a protruding belly that can’t be fixed with diet and exercise. It’s a combination of loose skin, excess fat, and loose abdominal muscles that leads to a stretched-out abdomen. As we age, we lose the proteins that make our skin tight and elastic, while pregnancy and weight gain can stretch out the skin in a way where it can’t bounce back. Fatty deposits throughout the abdomen can also be very hard to remove, especially after pregnancy. Athletic-looking stomachs are defined by the tightness of two vertical abdominal muscles, and pregnancy can damage those muscles, causing them to droop and separate – a condition called rectus muscle diastasis – making it nearly impossible to gain an athletic stomach. Thankfully, a tummy tuck, also known as an abdominoplasty, can address each of the components that cause a protruding belly to give you a flat, athletic stomach.

Abdominoplasty Topics

History of the Tummy Tuck

Like most plastic surgery procedures, the procedures that acted as precursors to the abdominoplasty were focused on removing physical deformities, rather than improving the abdomen aesthetically or minimizing the look 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. The particular patient was a medical student, and dermolipectomy succeeded in reducing his abdomen, which hung all the way down to his thighs. By 1899, the modern abdominoplasty was performed in Johns Hopkins by a gynecologic surgeon, Dr. Kelly. At this point, however, the belly button was usually completely removed during a tummy tuck, leading to an unnatural look. By the early 1900s, surgeons had 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 70s, 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, the abdominoplasty can fully customize its results.

Full Abdominoplasty

A full tummy tuck is performed by creating 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. A small tunnel is then created by lifting the skin off the abdominal muscles, and the two vertical rectus muscles will then be sewn together from the breast bone all the way down 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. The skin and a small amount of remaining fat is then pulled down tight and a new hole is made for the belly button. The incision will then be closed with dissolving sutures.

Usually, liposuction on the flanks (love handles) and lower back is performed with the abdominoplasty to maximize the fat reduction results and create a very contoured waistline.

Mini Abdominoplasty

Some patients might have pockets of fat and loose skin that are more localized to their lower abdomen below the bellybutton. These patients are the perfect candidates for a mini abdominoplasty, a variation of the tummy tuck that has a smaller incision and leaves the belly button untouched. For the mini tummy tuck, the perfect candidate should be in relatively good shape, with their problematic areas situated below the bellybutton. 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 very specialized type of abdominoplasty designed for abdomens with significant rectus muscle diastasis and limited amount of loose skin: The Modified Endoscopic Assisted Abdominoplasty. In this is innovative variation of the tummy tuck, your muscles are tightened and fat is removed using only small incisions above the pubic area and in the bellybutton. This procedure uses a small camera called an endoscope, which allows for an unprecedented view under skin. This allows the abdominal muscles to be accessed and tightened through small incisions. Patients with muscle diastasis and a small amount of excess skin are good candidates for this procedure.

Reverse Abdominoplasty

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.

Abdominoplasty Recovery

Your tummy tuck will take about 3-4 hours to complete, and will be performed in our fully-accredited surgical facility. This procedure can be done with an epidural and sedation for a quicker recovery. Pain catheters are placed deep in the abdomen to help limit pain after the procedure. It’s an outpatient procedure, and you will be able to go home the same day. We recommend taking two weeks of time off work, with six weeks of avoiding strenuous activity. You will be given medication to help with pain and be given compressive garments to prevent swelling.

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.

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