Post-partum moms or men and women who have lost significant weight are the most common candidates for an abdominoplasty, also known as a “tummy tuck.” Rejuvenating the abdominal area both aesthetically and functionally involves three areas—extra skin in the upper abdomen, lower abdomen or both, extra fat, and lax muscles. Often, two areas of the abdomen are affected. One is the rectus abdominus (sit up) muscles and the other is the oblique muscles. Together with the abdominal fascial layers, they help hold back the intra-abdominal contents and diet-sensitive fat. Pregnancy or significant weight gain leads to both the muscles and the skin stretching, usually resulting in stretch marks. These conditions cannot be treated by weight loss and exercise alone. Muscles do not shrink, and skin can only be expected to minimally recoil after weight loss. Surgically tightening the muscles and removal of excess skin and fat will result in a smooth, flat tummy.
Everyone’s abdomen is different. The location and amount of loose skin and changes to tissue under the skin will be assessed at consultation. Some women need muscles called diastasis recti repaired because they have separated during pregnancy creating a bulge. If there are excess rolls and fat around the midsection and back, advanced body contouring with liposuction will be recommended, but liposuction alone is not generally a viable substitute for patients who need a tummy tuck.