These procedures are customised to address specific problems of abdominal contour, and deal specifically with combinations of excess skin, fatty deposits and midline muscle separation. It covers a spectrum of surgeries ranging from liposuction only, to liposuction + mini tummy-tuck, to full tummy tuck / abdominoplasty. Liposuction is generally reserved for younger patients with elastic skin and moderate fatty deposits. In addition, good abdominal muscle tone is important to ensure a good liposuction result.
MINI TUMMY TUCK
A mini-tummy tuck is performed when problems of excess skin and muscle weakness are restricted to the lower abdomen (below the belly button). This may be the case following pregnancy. This operation is generally done under spinal anaesthetic, as a day case, and initially involves liposuction of the entire tummy area.
Then a variable amount of lower abdominal skin is removed, exposing the muscles, which are then tightened from the belly button down towards the pubis. This gives a very favourable contour to the lower abdomen, and adds longevity to the result. The belly button is not moved in this operation. Most caesarian section scars are removed , although you will be left with a lower abdominal scar somewhat longer than a caesarian scar (but this is well hidden in a bikini)
FULL TUMMY TUCK
A full tummy tuck is done when there is muscle weakness along the full length of the abdomen (from breast bone to pubis), and there is a significant degree of skin excess. In the traditional full tummy tuck, a large area of tummy skin is undermined. All the skin and fat between the belly button and pubic region is removed, the muscles are then tightened from breast bone to pubis, and finally the skin is closed, and belly button repositioned.
A long lower abdominal scar will be present, as will a scar within the belly button. Numerous studies have shown that combining liposuction of the central abdomen during a traditional full tummy tuck may compromise the circulation, and hence is generally avoided, although flank liposuction is considered to be safe.
More recently (2009), a modification of the traditional full tuck was described, and termed a “lipo-abdominoplasty”. This procedure allows for comprehensive liposuction of the abdomen along with a modified / lesser degree of undermining of the tummy flap, but a full repair of the tummy muscles. The indications for a lipo-abdominoplasty are exactly the same as for a traditional full tummy tuck / abdominoplasty. The essential components of this procedure are full abdominal liposuction, elevation of the tummy flap at a more superficial level and in a more limited area, full muscle repair and belly button repositioning. I have done a number of these procedures, and it is now my full tummy tuck procedure of choice! I have also noted easier closure of the tummy, seemingly less discomfort post op, no fluid collections (thus far) and I only leave a drain in place for one night, as opposed to the one week with the traditional surgery previously. That said, it is still a big procedure, takes somewhat longer to perform (due to the concomitant liposuction) and the overall look is similar, although adding the liposuction at the time of the tuck generally negates the need for a possible secondary liposuction in the future. Just to stress that this is not a procedure for significantly overweight patients – your BMI must be below 30 to be considered a suitable candidate in my practice. . This is a major operation, done under spinal anaesthesia, and will require a 1.5 day hospital stay. Complications are fortunately rare, but can be potentially serious, and so patient selection is important. Generalised obesity, cigarette smoking, previous venous thrombosis or poor general health are some contra-indications to a full tummy tuck.
All the above procedures are designed to give the patient an improved abdominal contour, and greater confidence in clothing and swim-wear. Good patient and procedure selection, and a thorough understanding of all the risks and benefits of the various options, should ensure a favourable outcome.