The Surgeon Minute

Tummy Tuck Variations

Tummy Tuck Variations

It’s been one of plastic surgery’s tried and true operations, but the abdominoplasty (or tummy tuck) underwent it’s own major face-lift when liposuction came along. Now, surgeons and their patients have a variety of approaches that can be selected.

by John Hammarley
and Peter Fodor, MD

It’s More than Just One Operation Option

For decades, there was basically just one approach to abdominoplasty, but the advent of liposuction about 20 years ago changed all that.

Now surgeons have several approaches they can use, depending mainly on the degree of correction needed.

First, what tummy tucks can and cannot do. According to the American Society of Plastic Surgeons, a tummy tuck “removes excess fat and skin and, in most cases, restores weakened or separated muscles creating an abdominal profile that is smoother and firmer.” A flat and sculpted mid-section is a dream for many and the goal of just as many folks committed to exercise and weight control. But sometimes these efforts just can’t get the job done. Some people who carry normal weight and proportion still are nagged by an abdomen that either sticks out or is loose and sagging. Some of the biggest culprits are aging, heredity, pregnancy, other surgeries and big swings in weight gain or loss.

Tummy tucks can’t…

take the place of a good diet and weight loss and/or an appropriate exercise program. Technically, the outcomes of a tummy tuck are permanent, but if you slip back into habits that caused the original issue, the best possible result probably won’t last. For this reason, if you’re planning a substantial weight loss or women who may be considering future pregnancies, it may be a good idea to wait on a tummy tuck.

The surgery also can’t fix stretch marks, even though they may disappear or improve if they are located on the areas of excess skin that will be removed.

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Variations on a Theme

Dr. Fodor points out that liposuction now provides surgeons and their patients several different approaches to tummy tucks — ranging from minimal to maximum tissue removal, and including complete and partial abdominoplasties, circumferential and floating tummy tucks.

Liposuction can be partnered with an abdominoplasty, making a Lipotuck, which includes body contouring around the hips, thigh and buttocks.

You may have heard of the so-called “mommy makeover.” These surgeries include a combination of liposuction, breast reduction or life and sometimes a hysterectomy.

What is involved?

Abdominoplasties, depending on the extent of the surgery, can take from one to five hours. A partial abdominoplasty (mini-tuck abdominoplasty) can be finished in one to two hours. Dr. Fodor says several tummy tuck techniques can be done without having to reconstruct the umbilicus (belly button), but if it’s needed a surgeon will hide the original umbilicus by suturing it into a new hole created by the surgeon.

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Overall, a complete (or full) tummy tuck will include an incision that’s made from hip to hip just above the pubic area. Another incision is made to free the navel from the surrounding skin. The skin is detached from the abdominal wall to reveal the muscles and fascia to be tightened. The muscle fascia wall is tightened with sutures. Surgeons will often employ liposuction to refine the transition zones of the abdominal sculpture. And a dressing and sometimes a compression garment are applied to drain any excess fluid from the site.

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