The Surgeon Minute

A Low Scar Abdominoplasty

A Low Scar Abdominoplasty

If you ask any woman how she feels about her stomach, more often than not, the answer is not positive. The abdomen is inarguably one of the least-loved body parts for any woman, especially moms. Pregnancy, weight gain and loss, age, and genetics all take a toll on the muscles and skin of the belly.

Abdominoplasty, or a tummy tuck, is a surgical procedure that lifts and tightens the loose skin and muscle in the abdomen. Currently one of the top five most popular cosmetic surgery procedures in the US, tummy tucks are life-altering. However, many patients who want or need one are reluctant to get one due to the scar.

Dr. Richard Zienowicz of Providence, RI practices a technique called the low scar abdominoplasty which makes it possible for women to have the smooth, flat stomach of their youth with a scar that can be completely hidden. Now, that’s what we call revolutionary.

Bring on the Bikini

A tummy tuck is hands down the best option for restoring a smooth, flat, and toned tummy. While liposuction can certainly remove any excess fat, it does nothing for the sagging skin and loose muscles that are a problem for most women, particularly after pregnancy or any kind of weight loss.

The technique that most surgeons use for a tummy tuck has them making an incision right above the belly button. They then raise the abdominal pannus, which is that dense layer of fatty tissue in the lower abdominal area, and then pull everything down and close. The result may be a flat stomach, but it invariably leaves a scar so high that, “you need to wear a large bathing suit. It’s not a bikini. It takes away the possibility of wearing a bikini for life,” explains Dr. Zienowicz.

What about putting the scar where you want it? In the low scar abdominoplasty, Zienowicz places the incision low in the pubic area so that it can be easily hidden in a bikini bottom or in low riding underwear. He then raises up the abdominal pannus, pulls everything down and cuts off the excess. The technique is called tailor tacking and it’s been used for years in breast surgery and in facelifts.

Low scar abdominoplasty results.

 

The technique is ideal for the vast majority of women, except for those who have had:

  • massive weight loss
  • huge pregnancies
  • multiple huge pregnancies

Low Scar Abdominoplasty = High Patient Satisfaction

If the technique is so easy then why don’t more surgeons do it? According to Dr. Zienowicz, they weren’t taught how to do a low scar abdominoplasty. Technically, this technique is slightly more difficult than a straight forward tummy tuck because the surgeon does have to have the assistant retract the abdominal pannnus while he or she works beneath this tissue, but it’s not prohibitively more difficult.

Low scar abdominoplasty before and after.

Scarring is hands down the biggest worry and the single greatest deterrent for most patients when it comes to getting any kind of surgical cosmetic procedure. No one wants a scar. By putting the scar in a place where it can be easily camouflaged, the low scar abdominoplasty reduces scar concern which greatly increases patient satisfaction. In fact, a huge part of Dr. Zienowicz’s current tummy tuck practice is doing revision surgery on patients who previously had a tummy tuck using the old or standard technique and who have been left with a high scar that makes them unhappy. With the low scar technique, he is able to bring their existing scar down so that these patients can wear whatever clothes they want.

A low scar tummy tuck procedure.

His interest in a low scar technique came about when early in his practice he had a tummy tuck patient who, after she healed from surgery, went and had her incision tattooed because it was high, and she wanted to in some way hide it. This taught him an important lesson. “I prefer the low scar abdominoplasty because it conceals the scar far better for women than traditional techniques do,” he shares. Innovation, thy name is plastic surgery.

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