An abdominoplasty, commonly known as a tummy tuck, is performed on individuals who have excessive amounts of loose skin, wrinkles, or stretch marks in the abdominal area. Many times after massive weight loss the excess skin extends over the pubic area and sometimes even onto the thighs. The muscles of the abdomen are tightened on a routine basis as significant weight gain causes the muscles to become weak–this is done at the same time as excess skin is removed.
In many cases, excess fat that lies between the muscles and the skin is suctioned off with liposuction either before or along with the tummy-tuck. This rids the abdomen of fatty bulk and allows the area to appear smoother, flatter, and thus, more pleasing in appearance.
Excess skin, fatty deposits, and weak abdominal muscles can result from weight gain during pregnancy, weight fluctuations, or hereditary causes.
There are three subcategories of abdominoplasty:
- The mini tummy-tuck
- The full tummy-tuck and an extended tummy tuck
- Endoscopic abdominal muscle tightening
A full abdominoplasty tightens the muscle structure and removes excess skin from the upper and the lower abdomen. An incision is made just above the pubic bone in the lower abdomen and the skin is then lifted up to the rib cage area.
Another small incision is made around the belly button itself so it can be freed from the rest of the skin and brought out through another place on the abdomen as the upper skin is pulled downward, tightened, and repositioned.
Essentially all the skin, tissue and fat from pubic bone to above the belly button and in between the hip bones is completely removed. The excess skin is trimmed away, and the upper abdominal skin is brought down to the pubic area and the skin and tissue is stitched together and secured in place.
In an extended tummy tuck, Dr. Frenzel increases the size of the incinsions laterally so that he is able to get rid of all the excess skin and tissue that may extend out laterally. This usually adds about a half hour to an hour to the surgery.
Dr. Frenzel routinely uses pain pump catheters that bathe the abdominal muscles with a constant flow of local anesthesia numbing medicine which significantly improves post-operative pain. These pain pump catheters stay in for about three days after surgery and they allow his patients to have a quicker recovery and a faster return to normal activity.
A mini abdominoplasty removes excess skin from below the umbilicus or belly button. A ‘crescent’ type incision is placed just above or at the pubic hairline. The belly button usually remains unaltered. Muscles can also be tightened in the lower abdomen.
Endoscopic Abdominal Muscle Tightening
Occasionally people have a ‘pouchy’ muscle wall, due to heredity or loss of muscle tone, but they do not have excess loose skin. In these cases, a minimally invasive procedure is used to tighten the muscle structure. A tiny incision is made in the umbilicus or supra-pubic hairline, and a small endoscope is inserted so the surgeon can view the muscles through a special monitor and then tighten them with sutures.
The patient is required to wear a firm compression support garment for about six weeks to achieve maximum shrinkage and a smoother appearance. Physical activities will also be limited.
For more information on the risks, benefits, or cost of tummy tuck surgery, contact the Dallas/Fort Worth surgery office of Dr. Clayton Frenzel.