Tummy Tuck

What is a Tummy Tuck or Abdominoplasty?

A tummy tuck, also called abdominoplasty, is designed to improve the appearance and tone of the abdomen by removing excess skin and fat, and tightening the muscle contour. It may be performed as a “full” tummy tuck or a “mini” tummy tuck, depending on the patient’s needs. According to The American Society for Aesthetic Plastic Surgery, there were 181,540 tummy tuck procedures performed in 2016, making this the third most popular cosmetic surgical procedure. The tummy tuck is also the most popular procedures that Dr. Dembny performs here in Milwaukee and Waukesha.

What is a Full Tummy Tuck?

A “Full” tummy tuck is the most involved version of this operation. It is used to treat greater abdominal muscle separation that exists in combination with more skin excess and looseness in the lower abdomen. A full tummy tuck is most commonly performed in women who have had children, or those individuals who have undergone significant weight loss The full tummy tuck consists of a longer bikini line incision that extends form hip-to-hip, as well as an incision around the belly button. The abdominal wall muscles are tightened in the mid-line from just below the sternum all the way down to the suprapubic region. The abdominal skin is tightened by pulling it downward, and the excess at the bottom is removed; and a new opening is made for the belly button. To improve the results, liposuction can be combined with with a full tummy tuck when there is some excess fat in the upper abdomen and/or flank (love handle). Your surgeon can discuss specifically how and why a full tummy tuck is the best option for you.

What is a Mini Tummy Tuck?

A “Mini” tummy tuck usually involves removing a smaller amount of skin in the lower central abdomen with a short incision. A true Mini-tummy tuck (as it was initially described) does not involve muscle plication or an incision around the belly button. There are few women who are actually candidates for this operation, as it was just described. Most women who don’t require a full tummy tuck still have loose/excess skin that extends over a larger area than just the suprapubic region; this may often be accompanied by small amounts of excess fat and/or some mild weakness/laxity in the muscle fascia. The small skin excision of a mini-tummy tuck will be inadequate to address these problems. A modified mini-tummy tuck that includes a longer incision, some liposuction, and/or a very limited muscle plication below the umbilicus will be a better option. Your surgeon can discuss the options available to meet your goals.

Who is a candidate for a tummy tuck procedure?

The best candidates for a tummy tuck are men or women who are in relatively good shape but are bothered by a lower abdominal fat deposit and/or loose abdominal skin that won’t respond to diet or exercise. The surgery is particularly helpful to women who, through multiple pregnancies, have stretched their abdominal muscles and skin beyond the point where they can return to normal. Loss of skin elasticity in older patients, which frequently occurs with slight obesity, can also be improved with a tummy tuck procedure as well.

Both the full-tummy tuck and the mini-tummy tuck are contouring procedures; they are not weight loss procedures. A tummy tuck is not generally performed on individuals with a BMI >30 (obese). To obtain optimum results, patients should be at the lowest stable body weight they can achieve prior to surgery. This allows for improved contouring and a better, more stable result. Women who are planning future pregnancies should defer tummy tuck surgery until they are finished having children; this prevents the vertical muscles in the abdomen that are tightened during surgery from separating again during pregnancy. Cesarean-section scars that have not healed well can often be improved during a tummy tuck. If you have scarring from other previous abdominal surgery, your doctor may recommend against abdominoplasty or may caution you that scars could be unusually prominent.

How is a full abdominoplasty performed?

Full tummy tuck operations are performed under general anesthesia. Most commonly, the surgeon will make a long incision from hipbone to hipbone, just above the pubic area. A second incision is made to free the navel from surrounding tissue. With partial abdominoplasty, (mini tummy tuck), the incision is much shorter and the navel may not be moved.

Next, the surgeon separates the skin from the abdominal wall, all the way up to the ribs, to expose the vertical muscles in your abdomen. These muscles are tightened by pulling them close together and stitching them into this new position. This provides a firmer abdominal wall and narrows the waistline.

The skin flap is then stretched down and the extra skin is removed. A new hole is cut for the navel, which is then stitched in place. Finally, a drain is inserted, the incision is closed, and dressings and a binder are applied.

For patients that have some excess fat in the abdomen and/or flanks, in addition to lax skin, liposuction may be used along with a tummy tuck procedure to provide a more comprehensive treatment and improve the contouring result. Frequently liposuction of the flank is done in conjunction with a tummy tuck, to eliminate the ‘love handle’ or ‘muffin top’ that would detract from the rest of the surgical result. And, excess fat in the upper and central abdomen can be removed by liposuction to provide additional slimming in the profile view.