A tummy tuck or abdominoplasty is a really excellent procedure for reshaping the abdomen to correct changes from pregnancy or weight loss. It is important to understand the difference between a tummy tuck and liposuction. Liposuction is for the correction of excess fat; a tummy tuck is for the correction of loose skin. If there is no significant skin looseness, then liposuction by itself can be a wonderful correction. If there is some mild looseness present, a mini tummy-tuck with or without liposuction can often be effective. If the skin is significantly lax due either to pregnancy or to weight loss, then tightening of the skin, with or without tightening of the underlying muscles, will be required. Liposuction is also an excellent ancillary procedure to a tummy tuck, both to help shape the abdomen attractively and to remove extra tissues along the side and flank areas.
MINI-TUMMY TUCK
A mini-tummy tuck can be a very useful procedure when there is mild looseness present. A long horizontal incision along the lower part of the tummy is generally required, but there is no incision around the belly button. A mini-tummy tuck will correct looseness which is located below the belly button, but it can not correct looseness which is present above the belly button because the belly button is fixed in position. In some patients who have a high navel and a little bit of looseness above the navel, the navel can be floated downward about an inch or so and obtain some limited tightening in the supra-umbilical area. A mini-tummy tuck is a good correction for limited looseness, but it is not a replacement for a full tummy tuck. The patient’s appearance is much improved when standing, but there is still some looseness when the patient is sitting. As a result of this, the mini-tummy tuck, while useful, is often not the ideal correction.
FULL TUMMY TUCK
A full tummy tuck uses the same long horizontal lower abdominal incision as a mini tummy tuck but also includes a small circular incision at the margin of the navel. The tissues are elevated all the way to the border of the rib cage. The skin is pulled downward like a window shade, and the excess is trimmed off at the bottom. The navel is brought out through a tiny incision like a boutonniere, and the correction is complete.
Sometimes the abdominal muscles are stretched as well as the skin. These are the so-called rectus muscles, the “six-pack” muscles that run up and down the center of the abdomen. The rectus muscles should be right next to one another, but the muscles can separate in the middle, leaving a gap. This can occur when there has been a lot of pressure from inside the abdomen as with pregnancy or with intra-abdominal weight gain. The muscle gap is called a diastasis, and when that occurs, the tummy is no longer flat. The loose muscles mean that there is always some bulging present. Correction of this gap during a tummy tuck is straightforward. The muscles are stitched together in the midline, and you get a flat, tight abdomen. The skin is treated the same as with an abdominoplasty without the muscle tightening.
RECOVERY
The major consideration in recovery is whether or not the muscles are tightened. Clearly when the muscles are tightened, the recovery is longer than when the procedure just involves the skin and underlying fatty tissue. Recovery from an abdominoplasty usually requires 10 days to 2 weeks, although this varies from person to person. If the muscles are tightened, you cannot do strong abdominal exercises such as sit-ups for six months. The results, however, can be truly amazing.
ADDITIONAL INFORMATION:
The links below provide authoritative sources for additional information on abdominoplasty (tummy tuck). There is a lot of information here, and it is reliable. You can email Dr. Friedenthal at drfriedenthal.com or phone him at 1-415-752-2066 for further information and assistance.
American Society of Plastic Surgeons (ASPS) – With Animation Videos
American Society for Aesthetic Plastic Surgery (ASAPS)
Canadian Society for Aesthetic Plastic Surgery (CSAPS)