The tummy tuck, or abdominoplasty procedure, may be one of the most misunderstood plastic surgery procedures to the population at large. People wrongly assume that the procedure has something to do with weight loss, when really, it is all about the abdominal skin and muscles. If fat is present that needs to be removed, then liposuction may be utilized in conjunction to remove it, but this is separate from an abdominoplasty.
In fact, the best plastic surgeons may even tell their patients that a tummy tuck surgery has to wait until that patient achieves an appropriate amount of weight loss. Board certified plastic surgeons Dr. Brooke Seckel and Dr. Sean Doherty of Boston, and Dr. Kevin Smith of Charlotte, discuss on the latest PSC round table.
Ideal Size for a Tummy Tuck
After having upended the misconception that a tummy tuck is a weight loss procedure, patients are even more surprised to hear from their surgeon that they may need to lose some weight before the procedure. Some fat is manageable, and even a good portion of it might be a candidate for removal via liposuction. Ideally, however, a patient should be almost at the best place they can get themselves through diet and exercise alone.
“I think when one is considering any body contouring option, being closest to their ideal weight is extremely important,” shares board certified plastic surgeon Dr. Sean Doherty. “They’re going to do better with surgery, they’re going to do better with anesthesia, their outcome is just going to be better. Having said that, I think the abdomen and waist are areas that have diet-resistant fat, so having liposuction in addition to a tummy tuck is a big part of that. You want to spend a lot of time with your surgeon when talking about an abdominoplasty.”
Relying Too Heavily on Liposuction May Not Be Wise
Liposuction, or surgical fat removal, is one of the crown jewel’s of aesthetic plastic surgery. It works extremely well, and in the right hands, can produce remarkable results. There is a cost, and that “damage” that is done to the areas treated. An expert, board certified surgeon will have great experience at minimizing this damage and getting the most out of a single procedure, but some damage will still occur.
While this damage is normal for liposuction and will heal quickly, it may negatively impact a simulatenous tummy tuck procedure and harm potential results. “When you’re removing fat, you’re also damaging vessels,” explains board certified plastic surgeon Dr. Kevin Smith. “With a tummy tuck, this embarrasses the blood supply to the abdominal skin significantly. What we fear most is to have an incision that doesn’t heal well, or to have that lower abdominal skin fall apart to die. Patients need to know that abdominoplasty surgery is not weight loss surgery.”
Massive Weight Loss Patients and Abdominoplasty
On the other end of the spectrum are patients who have achieved unbelievable results through massive weight loss. They have worked tirelessly to get their weight to an ideal position, but now find that the skin that once held all of that weight will not stretch back. This situation is a good one for a tummy tuck procedure, but only if the skin is localized in the abdominal region. If it’s located on the back, flanks, chest, arms, etc., then a body lift procedure may be a better fit.
“The ultimate treatment is a lower body lift, also called a belt lipectomy,” shares Dr. Doherty. “However, there are some patients where their laxity or their excess, lose skin, is in the front of the abdomen and to the sides. [In that case] a tummy tuck…can be done and an incision from hip to hip would be appropriate for them.”
Problems Solved by a Tummy Tuck
- loose abdominal skin
- stretch marks
- muscle separation following childbirth
If there are localized fat deposits in addition to the above, then a small amount of liposuction may be employed.
A detailed consultation with a surgeon will be a patient’s best bet at forming a unique plan of attack for their unique situation. One thing to know always about the tummy tuck procedure: it is not designed for weight loss, but to enhance the area once weight loss or childbearing has already been attained.