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!!
Literally every state has an issue with people being over weight and in many states.....severely. All we need do is walk down the street to see how bad it is. The question is what to do about it?? This question deals with numerous issues that are difficult to quantify. We are victims of our own prosperity and it is rapidly spreading around the globe. We now have readily available food. Our activity levels continue to decline. The food is processed in ways that may be detrimental to our bodies. Bad habits are passed on to our children and this is perpetuating the problem. Obesity is becoming an issue globally. Many will say "so what", I am fat and hurting nobody, why should you care?? What we see is the rising cost of the care that is required as we get older and fatter. When people are young, their bodies can compensate for their weight by producing more muscle to haul the excess weight around. They can produce more insulin so blood sugars don't rise. Young hearts can beat more efficiently to send oxygen to the excess. BUT, as we age, our skeleton is not capable of carrying all the excess and begins to fail. Our pancreas cannot keep up and the fat causes insulin resistance. Arteries become clogged with fat causing atherosclerosis, starving the heart, losing efficiency. We then have joint breakdown, hypertension, coronary disease, adult onset (type II Diabetes), and the inability to increase activity. These chronic problems are an expensive drain on the medical system and it effects all of us. Not to mention all of the man and woman power we lose as a nation.
