MALE ABDOMINOPLASTY
The ideal male body shape is considered to be trim and athletic-looking, with broad shoulders and chest, a flat abdomen, and a narrow hip to thigh area. As men age, their abdomen can undergo significant changes: the development of excess skin, abdominal bulges, and stretch marks. These changes lead to the loss of a defined, narrow waist.
An abdominoplasty, or “tummy-tuck,” allows for the correction of age-related changes, contours the body to add definition, and improves shape. With several types of abdominoplasty available, Dr. Castillo individualizes a procedure to address a patient’s greatest concerns in order to restore their physique.
SURGERY CONSIDERATIONS
Traditional Abdominoplasty
A traditional abdominoplasty works best for males suffering with extensive excess skin, loose abdominal wall muscles, prominent abdominal bulges, loss of waist contour, or stretch marks below the belly button. This type of abdominoplasty places an incision on the patient’s lower abdomen from one hip to the other hip, while reshaping and repositioning the belly-button.
Mini-Abdominoplasty
A mini-abdominoplasty is best performed in men suffering with mild to moderate skin excess, muscle laxity, or stretch marks below the belly button. This procedure does not reposition the belly button, and has a shorter scar than the traditional abdominoplasty.
Fleur-de-Lis Abdominoplasty
The most powerful of the abdominoplasty techniques, a Fleur-de-Lis (FDL) abdominoplasty is best performed in men who have had “massive weight loss” after weight-reduction surgery, such as gastric bypass or lap-band, or in men who have lost considerable weight through a diet and exercise regimen. These patients tend to have excess skin and fat in both a vertical and horizontal dimension. An FDL can remove this excess skin, and significantly narrow a man’s waist, but requires a vertical incision from the breastbone to the horizontal incision across the lower abdomen of a traditional abdominoplasty.
SURGICAL TECHNIQUES
Traditional Abdominoplasty
An incision is carried from one hip down towards the lower abdomen and back upward to the other hip, made as low as possible to be concealed by an undergarment or swimsuit. If there is extensive excess skin, the incision may need to be extended towards the patient’s back. This incision is then used to reach the patients abdominal wall musculature. The excess skin and fat of the abdomen is then lifted towards the patient’s rib cage and breastbone. When the belly button is reached, it is dissected from the surrounding skin and fat, so that it may be repositioned later in the surgery. The abdominal muscles are then tightened to narrow the waist and flatten the stomach. The elevated skin and fat is then stretched downward, and the excess removed. A “new” belly-button is then made through a small incision in the now tightened skin. Drains may be placed underneath the skin to prevent the accumulation of fluid until final healing has taken place.
Mini-Abdominoplasty
This procedure is similar to a traditional abdominoplasty, except the incision is shorter, located along the lower abdomen, but not from one hip to the other. The belly button does not need to be cut free of the surrounding skin, and only the muscles of the lower abdomen are tightened. The skin is similarly stretched downward, with the excess removed. Drains may be placed underneath the skin to prevent the accumulation of fluid until final healing has taken place.
Fleur-de-Lis Abdominoplasty
An FDL mimics the traditional abdominoplasty with a lower abdominal incision being used to gain access to the patient’s abdominal wall muscles. It differs from the traditional abdominoplasty by making a vertical incision down the middle of the abdomen to allow extra skin from a horizontal dimension to be removed. After making all of the incisions, and elevating the skin, the abdominal wall muscles are tightened and the skin redraped. The skin is pulled tight in both the vertical and horizontal directions, while any excess is removed. Drains are placed underneath the skin to prevent the accumulation of fluid until final healing has taken place.
RECOVERY
After surgery, the abdomen will feel tight, and you will be slightly bent at the waist. Over the next several days you will gradually be able to stand up straighter. We encourage walking every day, including the day of surgery, as a precautionary maneuver. When sleeping on your back at night, place additional pillows under your lower back and legs to take tension off of the incision in your lower abdomen.
Your incisions will weep a small amount of fluid daily, and we ask that you maintain your incisions covered with gauze. You will also be wearing a compression garment to assist with swelling after surgery.
Abdominoplasty usually requires prescription pain medication after the procedure to ensure comfort. These medications can lead to constipation, so we ask all patients to take stool softeners to avoid unnecessary straining when going to the bathroom.
Any drains placed during surgery will require you to maintain a logbook where you record how much fluid comes out of the drains in a 24 hour period. These measurements are important, as they will determine when the drains can be removed.
Full recovery will take weeks to months, depending on the type of abdominoplasty, with return to work dictated by how well you are feeling, and the typical duties required of your job.
RISKS
We believe in being preemptive to avoid any risks associated with surgery, but occasionally the following may occur:
Bleeding/Hematoma – A small amount of bleeding is common after surgery, but if severe enough, another operation may be required to stop it. Bleeding can also form a collection, termed a hematoma, which presents as a swollen, painful, bruised, and tense abdomen. These require drainage to prevent secondary problems.
Seroma – A fluid collection may form under the skin after an abdominoplasty and may require drainage. This can typically be performed in the office.
Infection – Abdominoplasty carries a small risk of infection, but if one occurs, it may require oral, or intravenous, antibiotics.
Poor Cosmesis – Despite proper technique, a skin or contour irregularity may occur. The incisions may have poor healing, or a wound may develop, leading to the possibility of additional need for surgery.
Blood Clots: Abdominoplasty can result in the development of blood clots in the legs. These clots can travel to the lungs where they can be fatal. Precautions before, and after, surgery are taken to avoid blood clots from forming.
Skin Laxity: As much skin is removed during surgery as safely possible. Once the swelling from surgery has resolved, there may be some skin laxity present.
ADDITIONAL INFORMATION
Duration of Results: The goal is to make a tummy-tuck a once in a lifetime procedure. While removal of the extra skin and fat is permanent, what remains is diet and exercise sensitive. The best long-term results occur when patients maintain a healthy weight, without significant fluctuations.
Stretch Marks: Most stretch marks below the belly button can be safely removed during an abdominoplasty. Stretch marks above the belly button cannot usually be removed. Additionally, due to the increased stretch on the skin, some stretch marks may be wider after surgery.
FAQS
Can I achieve a flat stomach through diet and exercise?
Despite best intentions, a proper diet and exercise regimen may not give you a firm, flat stomach. With weight fluctuations or with aging, the skin of the abdomen may loosen, and crunches cannot fix this.
How long will my results last?
An abdominoplasty is usually a one-time procedure. By limiting weight fluctuations as part of a healthy lifestyle, you will be able to maintain a trim and athletic-looking stomach.
Can a tummy tuck be combined with other procedures?
Yes. Tummy-tucks are excellent at removing excess, loose skin and tightening underlying muscles, but limited in their ability to remove unwanted fat. Liposculpting can be added to a tummy-tuck to obtain an even further improved contour to the chest, stomach and hips.