One of the most satisfying procedures in plastic surgery is abdominoplasty. Weight gain/loss, pregnancy, and age related skin laxity are the main reasons why woman may lose her toned tummy. There are three main anatomical components of the abdomen which contribute to deformity; the skin, the fat, and the abdominal wall muscles/fascia. Almost always all the above three components are somehow involved and need to be addressed during a tummy tuck, especially if the etiology is pregnancy and/or weight gain/weight loss.
Abdominal wall muscles/fascia always stretches with pregnancy, and rarely tone back to its pre-pregnancy level. The individual abdominal muscles (going up and down on each side) may remain strong, however they separate away from each other from the midline during pregnancy, and the fascia in between these muscles get thin, and does not hold the intraabdominal pressure as much as when the muscles were close together in the midline. The end result is a loose tone, and abdominal bulge, especially around the belly button and lower abdomen, and the common complaint is “no matter how hard I work-out, do sit-ups, I can’t get rid of this bulge”. By working-out, you can get these muscles individually strong and toned, but unfortunately there is nothing one can do to bring these muscles back to midline/close to each other. This is essentially a very close concept to having a hernia, and is called diasthesis recti (the separation of abdominal muscles), and the only treatment is tightening the fascia by performing an abdominoplasty. Bringing these muscles back together in the midline with tightening the fascia helps tone the abdomen, gives a sexy groove above the belly button (champagne groove), creates an aesthetically pleasing innie belly button, and redefines the waistline.
Loose and excess skin is another always-present problem of a deformed tummy, again mainly caused by stretching with pregnancy, and weight gain/loss. Aging gracefully makes the matters worse due to further losing the elasticity of the skin, and the skin doesn’t snap back as it does in kids. The only way to get rid of the excess, loose skin, regardless where in the body, is to remove it. If it was going to tone back after pregnancy, it would, and if it didn’t, then the chances of skin tightening by itself without help is close to zero. This applies to anywhere in the body. If there is too much loose, relaxed skin on the face, you are not going to fix the problem regardless how many fillers or fancy lasers used, unless the skin is tightened by a well-done facelift. If the skin of the breasts are loose, and breasts are droopy, they will not be toned and lifted by implants, and the only way to fix this would be a skin tightening by a breast lift. The same applies to abdomen. Loose, excess skin has to be removed by a tummy tuck, and no other method (laser, fat freezing, and even liposuction) can fix that problem. Most of the time, the women have numerous stretch marks especially on the lower abdomen along with the loose skin, and most if not all of these stretch marks are removed with a strategically designed incision. So instead of having numerous stretch marks extending up and down, which look like wide, discolored scars, you end up with a well hidden scar below the bikini-line, that no one can ever see unless you are completely butt naked. By placing the incision low enough will also tighten the mons pubis area, and will give you a youthful, tight genital region.
The third component of the abdominal deformity is the excess fat, and this is probably the only problem one can improve by diet and exercise. However, unfortunately the excess fat almost never exists without one or two of the above components (loose abdominal wall and excess skin) accompanying. During a tummy tuck, the fatty tissue below the belly button (aka the blub) is removed. The liposuction is used to further remove the excess fat on the flanks (love handles). Again, if you have an isolated excess fat on your abdomen, especially around the lovehandles, and you have toned abdominal muscles with little or no excess skin, then the diet/exercise will be the solution, and the if that doesn’t work, the most you would need is isolated liposuction. But again, only if the loose skin and stretched muscles don’t accompany the excess fat.
Abdominoplasty is an out-patient procedure. You go home the same day, since the most important thing after surgery is to be active and walk to prevent blood clots. The first night is usually the worst night, and it gets better every day, and within the week, you can return back to work, only if heavy lifting is not required. It is important to wear a spanx type tight garment along with an abdominal binder for few weeks to give extra support and comfort during the healing period. Even though most people think tummy tuck being a major and very painful procedure, it really is not once you pass the first few days after surgery. I personally haven’t heard any of my patients regretting having the surgery. They love their toned tummy, and their happiness reflects on their faces. Their self esteem improves significantly, and they all say that they would do it again in a heartbeat.
To see before and after pictures for tummy tuck, click here.
Our plastic surgery clinic is located in Panama City and Destin, on Northwest Florida's Emerald Coast.