A mother of 1 in her early 50’s who had a “mini-abdominoplasty” elsewhere in 2008 but was still bothered by the rolls of her abdomen. She would like to be able to wear pants with a belt. She is shown before and again, 10 ½ months after an extended abominoplasty. She absolutely loves not having the rolls of excess skin in her lower abdomen and still reaches down frequently to touch this area with her hand and smile. She tells me that she can just get dressed now and doesn’t worry about the clothes that she is wearing or whether they will hide this area.
Often patients come in and ask for a “mini-abdominoplasty”- they want the minimum of surgery but still want a maximum result. I find that it is better to find out what is bothering a patient, make the diagnosis and then come up with the best procedure to treat the diagnosis. As in this case, she asked her first plastic surgeon for a “mini-abdominoplasty, but her treatment plan was incorrect. In fact she really needed an “extended” abominoplasty to contour the sides better.
A 59 year old mother of 4 who was dissatisfied with the appearance of her abdomen despite a vigorous exercise program. Looseness of skin and abdominal wall muscles after pregnancy is not improved with exercise. She is 5’4 and 135 lbs and is shown before and again 11 months after abdominoplasty (“tummy tuck”). Notice the beautiful, sculptured quality of her abdomen with the creation of a “champagne groove” in the midline with liposculpture, and an attractive hollow created around the umbilicus (naval) by contouring the fat at the time of surgery. One can also notice a tightening of her upper thighs, which were “pulled up” as the abdominal skin was pulled down in a “high lateral tension abdominoplasty”, with no surgery being done separately on the thighs. The bulge in her abdomen from the separation of the abdominal muscles is shown in the side view to be nicely corrected after her surgery. A gratifying result for this patient who works hard to maintain her appearance. The scar is still slightly pink in spots, but will typically continue to fade over the next 12 months, and is placed in a “thong line”, where it can be hidden by most one or two piece bathing suits.
A 54 year old woman with 4 children shown before and more than 8 months after abdominoplasty. She is 5’2 14 inches and 129 lbs. The looseness of the skin and the abdominal wall muscles that was present after the stretching with her multiple pregnancies is corrected following her surgery. She is happily shopping for new bathing suits for the first time since she was a teenager!
A 45 yo woman is shown before and 6 weeks after an abdominoplasty. Her case was made more difficult by having had liposuction of her stomach 10 years previously by a non-plastic surgeon. This did not properly address the looseness of skin and muscle following her babies. She felt that this had made the appearance of her abdomen worse. She had a bulge of fat in her mid abdomen following the liposuction but the majority of the irregular “cellulite” appearance following the liposuction was in her lower abdomen and was able to be corrected with her abdominoplasty, which tightened the skin and muscles which had been loosened by her pregnancies. The fat bulge was also corrected at the same time. This is fairly typical of cases that I see where the diagnosis of loose skin and loose abdominal muscles from pregnancy was not properly made before her initial surgery. The scar from her abdominoplasty is covered by her underwear. The scar around her umbilicus is at its most noticeable at this, her 6 week visit. These scars typically fade over the next 2 years.
A 37 yo woman who underwent gastric bypass in 2005 and has lost over 100 lbs shown before and 5 months after an extended abdominoplasty. Her case is made more difficult because she had undergone a previous gall bladder removal through an incision in her right upper abdomen, and this scar can sometimes complicate the blood supply. Her preoperative height and weight are 5’5″ and 173 lbs. She has maintained this stable weight for 2 years.
46 yo female with one child. 5’2″ and 179 lbs shown before and 5 months after an extended abdominoplasty. An extended abdominoplasty fits in between a standard abdominoplasty and a lower body lift. When a patient has enough laxity on the sides, a standard abdominoplasty leaves excess skin along the flanks. A lower body lift continues the incision completely around the trunk. An extended abdominoplasty “extends” the incision further posteriorly without the added time and expense of a lower body lift. An excision of additional skin along the flanks and back can always be added later, but many patients can meet their goals without this additional surgery. The scars shown at 5 months will typically continue to diminish and fade for up to 2 years.
36 yo 5’7 1/2″ Male who reduced his weight from 258 to 174 lbs with diet and exercise. He continued to have loose abdominal skin and muscles despite a vigorous exercise regimen. He is shown before and 10 months after abdominoplasty.