The Surgeon Minute

A Guide to Improving Your Abdomen with Plastic Surgery

A Guide to Improving Your Abdomen with Plastic Surgery

Plastic surgery plays an important role in helping post-pregnancy and post-weight loss patients restore their abdomen and their confidence. The most popular surgical procedures for improving the contour of the midsection are a tummy tuck and liposuction. While both procedures offer dramatic improvement to the abdominal area, they are very different in terms of what they accomplish. To complicate matters further, there are three different styles of tummy tucks: the mini, the full and the extended version, and all of them are routinely combined with liposuction.

To help you decide which procedure or combination of procedures may be right for you, board certified plastic surgeon Dr. Craig Colville breaks broken down the decision making process into three steps.  

#1 List Your Goals

This is where you need to get specific. It’s pretty common to refer to your entire midsection as your “trouble area,” but the trouble needs to be pinpointed a little further in order to determine the best method of improvement.  

A more in depth understanding of your abdomen’s anatomy can help you with this step. According to Dr. Colville, your torso is shaped by four distinct elements. The outer layer is the skin.  Below the skin is subcutaneous fat, and below the fat lie the abdominal muscles. The fourth element involved in determining your abdominal contour is everything else below the muscle. Colville refers to it as the, “inside,” which includes subcutaneous fat, intestines and other organs.  

Returning the abdomen to ideal contour.

Elements that shape the torso:

  • Skin
  • Fat
  • Muscle
  • Inside: Everything below the muscle

Take the time to describe your concerns based on which element or elements they involve, and where specifically on your midsection the problems are. Do you have excess skin or stretch marks? Do you have excess fat around your belly button? Love handles? Are your abdominal muscles separated as a result of pregnancy?

#2 Understand What Each Procedure Will (& Will Not) Accomplish

Now that you have a list of what you want the surgeon to address in the operating room, it is time to find out which procedure will check all the right boxes.  


When a woman is unhappy with her abdomen, it is rare that liposuction alone will be the answer. This is because liposuction does not address excess skin. Removing fat through liposuction when excess skin is already present can actually add to the problem, especially in the front of the abdomen.  In other areas, such as the love handles where the skin may be thicker and not saggy to begin with, liposuction may be a great standalone option.

Problems with the abdomen.

Traditional Tummy Tuck

The separation of abdominal muscles is common after pregnancy. When these muscles separate, the foundation of a tight, youthful stomach is gone and no amount of ab exercises will bring it back. During tummy tuck surgery, Dr. Colville brings the muscles back together, restoring a firm foundation. Next, he removes excess skin and redrapes the remaining skin, providing a youthful contour.

Mini Tummy Tuck

In some cases, a patient will have very little excess skin. If you’ve got a few tummy wrinkles below your belly button, a mini tummy tuck may be all you need. In these cases, a smaller incision can be used to address the muscles below and remove the abdominal wrinkles.

Extended Tummy Tuck

Dr. Colville refers to the extended tummy tuck as, “going around the corner.” Instead of an incision that extends from the beginning of one hip to the other, the incision in these patients extends further – around the side of the hip, allowing Collville to remove excess skin on the sides as well as the front of the abdomen. When the abdomen sags in the front and on the sides around the love handles, the extended tummy tuck may be necessary to achieve maximum improvement of contour.

#3 Consult with a Board Certified Plastic Surgeon

Once you have done your homework, it is time to make an appointment with a board certified plastic surgeon. While you may already have a procedure in mind, it is important to bring an open mind and your list of goals to the appointment, so your surgeon can share all of the possible solutions available.

“The first thing I do is sit down and put all the pens and paper aside, and just talk to them a little bit, find out a little bit about them, and then find out what bugs them,” shares Dr. Colville.

Abdomen patient - Dr. Colville.

Next, he examines the area to determine the safest and most effective way to achieve the patient’s desires. “If we can pinch it, and grab it a little bit, while they are standing, and it moves up and down a little bit, I think they are going to get a much bigger and better result with removal, than just pure suction,” explains Colville.

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