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Abdominoplasty
Also referred to as a "tummy tuck", abdominoplasty is a procedure that minimizes the abdominal area. In abdominoplasty, the surgeon makes a long incision from one side of the hipbone to the other. Excess fat and skin are surgically removed from the middle and lower abdomen and the muscles of the abdomen wall are tightened. Women and men who have loose abdominal skin and fat that is concentrated in the abdomen can benefit from abdominoplasty. Sometimes these conditions are inherited, or substantial weight loss may cause abdominal skin to become flaccid, and abdominoplasty can also tighten muscles that have been separated and weakened by pregnancy. The procedure may improve the appearance of stretch marks somewhat, especially those located below the navel.

Individual factors and personal preferences will determine the specific technique selected to smooth and flatten the abdomen. Generally, a horizontal incision is placed just within or above the pubic area, and if there is loose skin above the navel, the surgeon may make a second incision around the navel. Skin is then separated from the abdominal wall. To tighten the abdominal wall, the surgeon brings loose underlying tissue and muscle together with sutures. Abdominal skin is pulled downward, and the excess abdominal skin is removed. A small opening is made to bring the navel through. The position of the navel remains unchanged. Skin of the lower abdomen that contains stretch marks may be removed as well. Any remaining stretch marks may be somewhat flattened and improved, but do not expect a dramatic change in their appearance.

The length of the horizontal incision, which extends laterally toward the pelvic bones, depends largely on the amount of skin to be removed. The contour of this incision will vary somewhat according to the structure of the abdomen and the style of bathing suit or undergarments preferred. A plastic surgeon will try to keep the incision within bathing suit lines, if possible. Some patients have loose skin above the navel, and in such cases, the surgeon may make a second incision around the navel so that the redundant skin above it can be pulled down. The procedure may include tightening of the underlying abdominal muscles using sutures.

Variations to the Common Abdominoplasty Technique

There are many variations both to the design of the incisions and the abdominoplasty technique. In some instances, it may be possible to avoid an incision around the navel. When the amount of loose skin is minimal and the excess fat deposits are located below the navel, a short horizontal incision is all that is necessary, and this procedure is called a partial (or "mini") abdominoplasty.

Sometimes liposuction may be used alone, or in conjunction with abdominoplasty, to remove abdominal fat. Endoscopic abdominoplasty is another technique for minimizing scars and may be useful when patients have only a mild degree of excess fat and muscle laxity. A plastic surgeon can discuss the particular method that they recommend for achieving the best result in a particular case.

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