Last week we talked about who is ready for Cosmetic Surgery after weight loss surgery. If you have not read that installment, read it first. Today we are talking about one of the most common procedures desired after weight loss and that procedure is the tummy tuck or abdominoplasty.
After massive weight loss, either surgical or diet, many people have excess skin in the upper and lower abdomen. This is not only unsightly but can cause to infections, rashes, and leads to the problem of where to put it in clothing etc. In a few cases, insurance may even cover the removal, but in most instances, it is considered Cosmetic and remains uncovered. When covered by insurance, usually only the lower hanging skin is removed and this skin and fat is called a pannus. The procedure is called a panniculectomy and is meant only to remove the skin that is hanging and prone to infection. It is not meant to be a cosmetic procedure.
In a true tummy tuck, the entire abdomen is addressed. The skin in the upper and lower abdomen is addressed and the underlying muscle is tightened. The idea is to regain the appearance and shape that was lost with weight gain.
There are two common types of tummy tuck. The first is the full tummy tuck that is probably the most common. The incision is across the lower abdomen and around the belly button. I like to keep the incision as low as possible to conceal it below garments and swimwear. The belly button stays where God put it but the skin and fat is elevated, pulled down and removed. Before re-attaching, the muscle is tightened in the middle of the abdomen to flatten the stomach and get rid of any laxity in the connective tissue. The upper skin is then pulled tight and sewn to the lower skin. Finally, the belly button stalk is located and a new opening is created in the overlying skin and it is sewn in place. A plastic tube drain is placed in the space under the skin and it stays in place until this space stops producing fluid....about a week. During this time I advise patients to stay bent over a little until the skin stretches. A garment is also worn for several weeks.
For people that already have an incision in the middle of the upper abdomen, an anchor abdominoplasty or Fleur Des lis tummy tuck may be more appropriate. This can tighten the waist as well. Here is a video that demonstrates the procedure.
Anchor or Fleur Des Lis tummy tuck
The second most common type of tummy tuck is the lipoabdominoplasty or Avelar abdominoplasty. In this technique, the fat is removed with liposuction until the skin becomes loose. The incisions are made in the lower abdomen and around the belly button, the skin is pulled down and removed. A tunnel is made to allow tightening of the underlying connective tissue and a drain is placed. I could not find a good video for this procedure....guess I need to make one!!
It just depends on your specific needs and wants when choosing a technique. Many cosmetic and plastic surgeons try to make everyone fit into one procedure. Find one that can offer choices and be sure to look at before and after pictures AND be sure they are the Doctors work and not someone elses!!
Come see us at Total Body Surgical Cosmetic Surgery to investigate all of the options. Don't miss out on our special pricing on a number of procedures. Press the tabs below to see them.
Next week...the arm reduction. Thanks for reading!!