When an abdomen has been stretched out of shape after pregnancy or weight loss, not often do the muscles snap back to where they started. This looseness of abdominal muscles creates a situation that a perfect diet and exercise regimen will never fix. The only way to restore an abdomen to it’s pre-baby or weight loss state is with the tummy tuck procedure.
A tummy tuck, also known as abdominoplasty, addresses three important aspects of the abdomen – the underlying muscle layer, the outer excess skin and the overall contour of the waist/hip region. The end result is a shapely waist and a flat stomach. The trade-off is a scar, which will ideally be hidden beneath the bikini line.
Surgeons have many options when it comes to individualizing the procedure, a necessity with the amount of variation that exists from patient to patient. The right surgical plan is key to achieving a beautiful, undetectable result. Board certified plastic surgeon Dr. Jason Cooper of Jupiter, Florida specializes in abdominal surgery for a beach loving, bikini wearing South Florida population. Here, Dr. Cooper walks us through some of the tough questions that arise during the tummy tuck planning process.
What Goes on During a Tummy Tuck?
A traditional tummy tuck is also known as a full tummy tuck. In a full tummy tuck, the incision typically begins at one hip and stretches across to the other hip. In addition, a second incision is made around the belly button. The skin is elevated, and the plastic surgeon addresses what is known as rectus diastasis. This is the term used to describe the separation of abdominal muscles that often occurs with pregnancy or weight gain. After the muscles are returned to a tight, flat position, the skin is pulled taut. The excess skin is cut away, and a new incision is made for the belly button.
In a mini tummy tuck, a smaller incision is made in the lower abdomen. Less skin is removed, and the belly button typically slides down in position a centimeter or two.
Do I Need a Full Tummy Tuck, or Could I get a Good Result from a Mini?
Full Tummy Tuck Addresses:
- Loose, excess skin located both above and below the belly button.
- Separated or bulging abdominal muscles.
Mini Tummy Tuck Addresses:
- Small amount of excess skin found below the belly button only.
- Separated or bulging abdominal muscles.
Everyone likes the idea of a smaller scar, and for this reason, mini tummy tucks are very appealing. Determining if you are a candidate for a mini tummy tuck can be a confusing process.
According to Dr. Cooper, it all comes down to excess skin and where that excess skin resides in the abdominal region. “When there’s a small amount of skin below the belly button, oftentimes a mini tummy tuck can achieve excellent results and is all that’s needed,” he explains. “You can tighten the muscles through a mini tummy tuck. You can still repair the entire diastasis from the area just underneath the breast all the way down to the pubic area. When there’s a significant amount of excess skin both above and below the belly button, a conventional tummy tuck is recommended.”
Decision: Liposuction or No Liposuction with Tummy Tuck?
Yes to Lipo: Excess fat in abdomen or flanks
No to Lipo: Patient has little or no excess fat
“Whenever I get asked a question about liposuction in conjunction with tummy tuck, I really need to evaluate the patient on an individual basis,” says Cooper. “Is there excess subcutaneous fat, or is this just skin that’s in excess? Sometimes I use liposuction to create a better contour while doing a tummy tuck. There are other patients who really don’t have a lot of excess fat.”
Patients often forget that liposuction isn’t just about removing fat, but recontouring bodily regions. When Dr. Cooper opts for liposuction, he often removes fat in the flanks, adding important curves to the waistline. This technique has more to do with adding shape and contour to a waist that would otherwise appear boxy than with strict fat removal.
Decision: Drains or No Drains?
Techniques and technologies have allowed for truly drainless techniques in modern tummy tuck procedures, but the advances do not take into account unique patient situations. At this time, it’s up to a skilled surgeon to determine which technique would best optimize the results and recovery for patients. In many cases, this may involves drains.
Drains: Most Full Tummy Tucks
No Drains: Some Mini Tummy Tucks
“Drainless tummy tucks have recently come to the fore as an option because most patients after the surgery do need drains, and they often don’t like them,” explains Dr. Cooper. In his practice, Cooper is selective when deciding who will be a good candidate for a drainless tummy tuck, and who would benefit the most from a recovery that involves drains.
“A woman with a lot of excess skin and subcutaneous tissue, even in conjunction with liposuction, is not going to be a candidate for a drainless tummy tuck,” says Cooper. “On the flip side, a woman who has a small amount of skin, who is a mini tummy tuck patient, may be an excellent candidate for a tummy tuck without a drain.”
Whether it is a mini tummy tuck or a full, patients who undergo abdominoplasty share their happiness at electing to go forward with the procedure. Even with a small to large scar across the bikini line, the benefits of having restored a loose abdomen and developing contour far outweighs the scars’ presence. For most of waking life the scars will remain hidden, but a patient’s new contour will shine through clothing, providing a new sense of self-confidence and relief.