Abdominoplasty Gallery

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.

More on this patient in the blog!

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. 

A woman of color and mother of 3 in her late 50’s who is bothered by the size and appearance of her breasts as well as the bulging of her abdomen.  Her BMI was 32 and I had her reduce her weight to a BMI of 28 or less.  There is typically fat around the intestines (“omental fat” ) that fills  the space created from the pregnancies and prevents tightening the stomach wall if a patient is overweight.  I tell patients that you “can’t put 40 lbs of potatoes in a 20 lb bag” and if we operate at the higher weight there is not only a greater risk of a blood clot because of pressure on the large veins in the abdomen, but more pain and a greater likelihood of the muscle wall stretching back out again.  So I prefer my abdominoplasty  patients to have a BMI of 28 or less. ( the exception being a bariatric patient who has lost 100 lbs or more and can sometimes be accommodated up to a BMI of 35)

She is shown 5 months after breast reduction, and 2 months after lipo-abdominoplasty.  This is an early result and swelling will typically diminish and improve over the next 4 months, and the scars will continue to soften and fade.  She is already thrilled with her early result!

A mother of 1 in her mid 40’s who has always been bothered by fullness of her abdomen, even when younger, but now this is worse since her pregnancy.

She is bothered by bulging in fitted clothing and would also like to be able to wear a 2 piece bathing suit.  She had an external laser treatment to reduce fat in her stomach somewhere else but said this was painful and didn’t work.  Sh has also had cool sculpting to her inner thighs, again, without improvement.

She is shown before and again, 7 months after a lipo-abdominoplasty along with liposuction of her medial thighs.  Her weight is up 10 lbs since surgery ( now 5’4” and 150 lbs) but she maintains an excellent contour of the stomach.

Discussion.  Her abdominal skin has excess fat with a caliper pinch of 4.5 cm  I find 3 cm or less to be more idea.  Liposuction can be done separately as another procedure but in some cases can be cautiously added at the time of the abdominoplasty to thin the layer more and give a better result, as we did here.  Despite a significant weight gain she has maintained her contour in the abdomen.

A nurse and mother of 2 in ther later 30’s who had polyhydramnios with her second pregnancy and became quite large.  She has an umbilical hernia, a ventral hernia and a large diastasis of the rectus muscles.  She is frequently asked if she is still pregnant.  She is shown before and again, 6 months after abdominoplasty combined with umbilical hernia repair.