BODY CONTOURING

Abdominoplasty

My goal is not only to address the changes associated with weight loss or pregnancy, but to take it one step further—giving my patients the abs they never had…

The Procedure In

Detail

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.

Surgical Notes

Abdominoplasty - Tummy Tuck

Anesthesia

General

Length of Surgery

2-3 hours

Outpatient / Inpatient:

Inpatient

Adjunct Procedures

Liposuction

Recovery

2-3 weeks

Dr. Lee's Priorities &

Technique

When performing abdominoplasty (tummy tuck) Dr. Lee makes a very low incision, to hide it below a bikini line, to the point where any C-section scar is removed with the procedure. A common complication of abdominoplasty is the scar eventually migrating into a visible part of the abdomen. The location of Dr. Lee’s scar mitigates this risk. Loose abdominal skin is lifted up and pulled tight. Once the correct tension is realized, all excess skin is removed, and a new incision is made for the belly button. Dr. Lee gives careful consideration to creating an aesthetic belly button–one that is rounder or more vertically shaped to look youthful.

Dr. Lee uses a progressive suture technique that takes extra time but minimizes the tension of put on the scar by distributing the resulting tension over the whole abdomen. The incision is placed deep into the fascia to hold the location. In the majority of cases, repair of the core muscles (diastasis recti) is done. Often these muscles separate during pregnancy and create a pooch or bulge of the tummy. Restoring the anatomy to its correct position through this “internal girdle” not only strengthens the core but makes the abdominal contour more aesthetic. Variations exist on the traditional tummy tuck procedure. These will be discussed at consultation after a physical exam. Different scar patterns and approaches serve some patients better than those performed in a traditional abdominoplasty.

A CONVERSATION WITHDR. MICHAEL LEE

What is involved in a “mommy makeover”?

The term ‘Mommy Makeover’ refers to a combination of procedures that focus on the areas most affected by pregnancy. It’s definitely not a cookie cutter operation, but rather a highly individualized surgical plan related to a woman’s body, the changes that have taken place and what results she is seeking. We are talking about advanced body contouring that until now was not thought possible in one operation…from the removal of excess skin, to literally redefining a patient’s body to the size, shape, look, and feel they want. It’s one of the most satisfying aspects of aesthetic surgery for me because it allows a patient to be less self-conscious and see herself as a woman again.

Who is a candidate for a mini tummy tuck?

Some women, albeit a distinct minority can have a mini tummy tuck. If patient has great skin tone and loose skin confined to the area below the belly button, the skin can be removed with a smaller incision. In a mini tummy tuck, there is no repair of the core muscles or the belly button.

What can be accomplished with diet, exercise and some of the new non-surgical treatments for tighter abs?

A thousand crunches will not put separated muscles back together or eliminate excess skin. There are skin tightening devices that will subtly tighten some abdominal or flank skin over time, but they are no substitute for surgical removal of skin and muscle repair resulting in a flat, smooth tummy.

Will a tummy tuck eliminate my stretchmarks?

It all depends on the location of the stretchmarks. If they are concentrated below the belly button, there is a possibility they can be eliminated as part of skin removal during a tummy tuck. Stretchmarks are essentially scarring in the skin itself. If they cannot be removed as part of the skin excised during a tummy tuck, there are fractional lasers that may slightly improve the overall appearance of the marks and stimulate new collagen in the dermal layer.

How soon after childbirth can a woman schedule a mommy makeover?

Generally speaking, there are benefits to waiting at least one year to determine how the body will respond over time and signal what will not “rebound.” Having said that, I routinely see women 6 months post-delivery for a consultation so they can schedule their surgery at the 12-month mark.

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