A mother of 3 in her late 30s who is bothered by “belly flab: and fullness of her hips. She had a breast reduction with us when she was in her early 20s, and before having children. She is 5’ 9” and 142 lbs and is shown before and again, nearly 6 months after a floating lipo-abdominoplasty combined with liposuction of the hips and back rolls.
Discussion: her abdominal wall fat was slightly thicker than desirable with a caliper pinch of 4 cm. Her umbilicus is a little high and we can “float: it down and reattach it at a lower level along with tightening of the abdominal muscles and perform liposuction of the abdomen. This works when the umbilicus is a little high and the upper abdominal skin is not too loose.
Another option when the umbilicus is high is to detach it from the skin, pull the skin down like a window shade, and bring it back out in the normal location through a new opening. The old opening can be closed as a small vertical scar in the lower abdomen. However, the blood supply to the skin around that vertical scar area is not sufficient to safely allow liposuction at the same time. So this was a useful combination in her unique case but would not work for everyone.
Liposuction was also performed on the “muffin tops” and “back rolls” to improve her contour.
A mother of 3 in her mid-40s is bothered by the bulging of her abdomen in fitted clothing. She is 5 ‘ 3” and 160 lbs and is shown before and again, 5 months after an abdominoplasty as an outpatient. Exparel was placed during the surgery to limit her pain and need for narcotics afterward. Progressive tension sutures were used to decrease the risk of seroma. She is thrilled by her improvement and loves being able to reach into her closet now and not worry if the clothing is going to hide her abdomen.
A woman in her later 50s who is bothered by bulging and excess skin of her abdomen. She has had 3 children and has also lost 60 lbs following a gastric sleeve. She’s shown before and again 4 months after an extended lipo-abdominoplasty. She happily reports that she wore a 2 piece bathing suit on a recent cruise, which is the first time she has worn a bikini since she was a pre-teenager! Scars will typically continue to fade and improve for 2 years after surgery and there is typically some swelling of the abdomen that takes 6 months to go away.
Details: A mother of 1 in her mid 40’s who is bothered by the bulging of her abdomen, especially in fitted clothing. She has always been bothered by the fullness of her abdomen, even when younger and before pregnancy, but especially now after her pregnancy. She is shown before and again, 18 months after lipo-abdominoplasty. Her fatty layer of the abdomen was too thick and was reduced with liposuction at the time of her abdominoplasty to give a better contour.
Details: An Asian mother of 2 in her early 40s who is bothered by the bulging of her abdomen in fitted clothing and in a bathing suit. She is also bothered by back rolls and “muffin tops”. She is shown before and again, 5 ½ months after abdominoplasty with liposuction of the flanks and back rolls as an outpatient. Exparel was used to limit postoperative pain.
Details: An early (6-week) follow-up on a mother of 3 in her mid 40’s who was bothered by bulging and looseness of her stomach in fitted clothing.
She is shown just before and again 6 weeks after an abdominoplasty. Exparel was used during surgery to block the pain receptors and allow her surgery to be done as an outpatient. Her scar is hidden in a “thong” position. Scars will typically get redder and thicker for 6 weeks and then fade and improve over the next 2 years or longer. There is typically swelling in the abdomen that continues to improve over the next 6 months. She is already thrilled with her improvement
A woman in her later 40s with laxity of the abdomen after significant weight loss. She has a gastric bypass 20 years before and lost more than 100 lbs. She is now a runner and was bothered by the looseness of the skin. She also has a history of hypertrophic scarring and has required Kenalog injections for her scars in the past. She already has a scar on the upper abdomen. She is shown before and again, 11 months after surgery. She just completed the Chicago marathon! We chose a Fleur de Lis abdominoplasty that has a vertical component in the upper abdomen to better tighten her skin. She wore EMBRACE scar therapy devices after surgery and is using topical silicone to help her scars, which are continuing to slowly fade.
A mother of 1 in her middle 40’s has always been bothered by the fullness of her stomach but finds that after her pregnancy this is bothering her even more. She Is bothered by bulging and rolls of her abdomen in fitted clothing and would like to be able to wear a 2 piece bathing suit.
She is shown before and again, 10 months after lipo-abdominoplasty. In her case, we were able to perform liposuction of the abdomen at the same time as the abdominoplasty to thin the area even more. Scars will typically continue to fade and improve over the next 1-2 years and it is placed where is hidden by a thong, which allows her to wear most clothing and bathing suit styles.
A mother of 2 in her early 50’s who is bothered by her abdomen following her 2 pregnancies. She describes it as “ a lump of blob” and does not like the roll of skin and bulging above the waistline of her pants and in fitted clothing. She is 5’5” and 145 lbs. She is shown before and again, 6 ½ months after abdominoplasty.
Last four photos: Our patient is now seen one year after her surgery. Scars have continued to fade and improve, and will typically continue to do so for another year or more.
Discussion: Scars typically get redder for 6 weeks and then begin to soften and fade over the next 2 years or more. Sharp eyes will notice a small vertical scar in the lower abdomen- this was the original aperture or opening around her umbilicus ( belly button) that is pulled down like a window shade after the muscles are tightened. It is better to have the longer scar low and in a thong position with a small vertical slit if needed, instead of having the entire scar higher on the abdomen. She is thrilled with her new shape and size. Exparel was used to limit her reduce pain and limit need for narcotics after surgery.