Traditional Abdominoplasty

A traditional abdominoplasty works best for patients 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 patients 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 patients who have had “massive weight loss” after weight-reduction surgery, such as gastric bypass or lap-band, or in patients 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 woman’s waist, but requires a vertical incision from the breastbone to the horizontal incision across the lower abdomen of a traditional abdominoplasty.

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.

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 to improve circulation and avoid the development of blood clots.  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.

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 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.  These may all lead to suboptimal results, and the possibility of additional surgery to correct.

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.

Duration of Results: The aim 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.

How do I know if I need a full tummy tuck, or a mini tummy tuck?

Patients who have excess skin in their upper abdomen, and/or have separation of their abdominal wall muscles, would benefit from a full tummy tuck to help address these issues. Mini tummy tucks are for those patients with skin laxity and skin quality issues isolated to beneath the belly button.

What is a “mommy makeover”?

This popularized term involves receiving a tummy tuck with a breast procedure, commonly an augmentation, in the same surgery.  Tummy tucks are safely, and commonly, combined with additional plastic surgery procedures such as liposuction, breast augmentation, breast lift, or additional body contouring.

Can I have another tummy tuck?

Whether from changes as a result of aging, or an additional pregnancy, excess skin may redevelop in your abdomen.  It is safe to undergo a second tummy tuck procedure.  If future pregnancies are planned, we would recommend waiting until all of your pregnancies are completed before pursuing surgery.

Can’t I just 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 your trim and athletic-looking stomach.