This popular procedure is performed to re-shape the abdomen for cases in which there is significant: "Looseness" of the abdominal muscles (common in women following multiple pregnancies) Loose skin along the lower tummy making simple liposuction potentially counter-productive (if improving "looseness" is the aim) Poor scarring of the skin and/or stretch marks in the lower abdomen

Pre-Operative Patient

The procedure involves the tightening of the tummy muscle and skin with the removal of fat through an incision in the lower tummy. Additional "fine-tuning" makes the result look more youthful and natural. These "fine touches" show the difference between the novice or "Dr Quickie" surgeon and the fine Tummy Tuck surgeon. They also take time. Short operations tend to include few of these additions.

Types of Tummy Tuck Surgery

• The amount of skin and fat at the start (and its location)
• The patient's preference with regards to bathing wear and/or undergarments
• The location of scarred or stretch mark-laden abdominal skin (if any)

"Standard" Procedure

This technique involves a "side to side" incision in the lower abdomen allowing the removal of large amounts of abdominal fat and skin. It addresses abdominal wall laxity as well as fat and skin excess in both the upper and lower abdomen. The typical patient presents with unsightly fat and skin in the upper and lower abdominal wall. Abdominal wall tightening can be performed in both the upper and lower abdomen. The closure is placed such that a standard bathing suit or undergarment will hide the scar.

The "Mini" Tummy Tuck

This procedure is designed for those patients with less abdominal skin and fat who are interested in a smaller scar. Often this scar can be completely hidden in the pubic hair. The locations of the fat and loose muscle/skin are crucial here as the procedure addresses only fat and abdominal laxity below the belly button. Skin excision here is very limited. This is the cost of the smaller scar. Fat removal can be augmented via liposuction and abdominal tightening can be performed below the umbilicus only. Very few patients seem appropriate for this operation as it frequently "under-corrects." The doctor recommends them very infrequently for this reason.

"Modified" Abdominoplasty

The abdominoplasty procedure can be modified particularly in cases in which patient preferences extend or omit parts of the surgery. Some young women for example are thinking of future pregnancy and opt not to have their tummy muscles tightened. Lack of a muscular repair means less pain, but does not define the waistline as nicely. Modified surgery varies and therefore does not have a standard incision pattern.

Extended Abdominoplasty

In the age of the gastric-bypass, sometimes the tummy tuck has to be extended to address the looseness that strays outside the borders of the traditional operation.
 
 

The Operation Itself

• Liposuction - This can be used during an abdominoplasty to improve the appearance of the tissues outside of the area of the tummy tuck. This surgeon does no liposuction in the area of the wound during the procedure. Abdominoplasty problems are frequently related to healing and infection. This risk may be decreased when liposuction is not performed in these areas. This surgeon has had no large wound healing complications for over ten years of tummy tuck surgery. Few surgeons can honestly report this.
• The Umbilicus "Belly Button" - A formal Umbilicoplasty makes the post-operative "belly button" look far more youthful with a natural-appearing curve partially hiding the scar and providing for a more natural look. See the "Actual Patient Images" at the link below for a demonstration. Other surgeons don't perform this nice little addition to the operation. It is not performed in the "Mini" operation, as the umbilicus is not "moved." It is an option in moderate or larger operations.
• The operation takes this surgeon between three and six hours to perform. It is performed under general anesthesia. This surgeon does not do a "quickie" tummy tuck and the results speak for themselves. Dr Di Saia's major revision rate is extremely low.

Tummy Tuck Results

• Women who repeatedly lose and gain large amounts of weight may not be the greatest candidates. Keeping one's weight in good control (plus or minus a few pounds) absolutely helps improve the longevity of the result.
• Not all women can expect a "flat" tummy when all is said and done. Depending upon the integrity of the abdominal wall it may not be advisable to make the "internal tightening" too tight. The idea is to strengthen and not weaken the final result. Too much tightening in weak tissue can result in an unpleasant outcome. The doctor makes them as tight as he can.
• Individual patient healing varies to an extent. Smokers tend to heal more poorly than non-smokers. Diabetics and those on steroid medication may also have less reliable wound healing.
• Abdominoplasty not infrequently lends itself to improvement by considering "touch up" or "fine tuning" procedures a year or so after the operation. The liposuction or small skin excisions relate to the way in which the patient healed after the first operation as well as predictions about this healing made by the surgeon.