Body Gallery

A mother of 3 in her early 30’s who is bothered by the appearance of her abdomen. She had hyper emesis through her pregnancy which caused her to develop a large umbilical hernia She would like to be able to wear a 2 piece bathing suit again, as well as fitting better in fitted clothing. She is shown before and again, 2 1/1 months after surgery. She is already wearing a 2 piece bathing suit. Scars are at their reddest and thickest at 6 weeks after surgery and then typically fade and improve over the next 2 years. Her scar has been hidden in a “thong” position where is can be hidden by most clothing styles. Patients typically have swelling of the abdomen after surgery that continues to improve for the first 6 momths. She is already thrilled with her early result.

A mother of 3 and a medical professional who is in her mid 40’s and who was bothered by skin hanging over her pants and the stretch marks of the skin. She had a painful umbilical hernia as well. She is shown before and again, 3 years after an extended abdominoplasty with a correction of her umbilical hernia by general surgery at the same time. She is 5’5” and was 150 lbs before her surgery. 1089 gms of skin were removed at the time of surgery (454 gms in a pound, so 2.4 lbs).
Since that time she has become active in fitness competitions and has lost additional weight, now being 136 lbs. She shared some photos from her recent competition and gave us permission to share these. She told us that she received many compliments from her fellow contestants on her abdomen and also on the placement of her abdominoplasty scar. They were amazed that it was low enough to be able to hide it with a thong!. I feel it is important to place the abdominoplasty scar in a thong position where it is low enough to be hidden by yoga pants or hip hugger pants, but high enough on the sides to still be hidden by a French-cut bathing suit. The umbilical stalk is kept short to try and keep the scar around the umbilicus hidden on the inside.

A 39 yo mother of 3 who was bothered by a “roll” of abdominal skin as well as by the appearance of the abdominal skin and bulging of the abdomen after pregnancies. She is shown before and again, 2 years after an extended abdominoplasty. A hernia of her umbilicus was repaired by general surgery at the same time. EXPAREL was used to decrease her need for narcotics after surgery. Progressive tension sutures were used to decrease her risk of seroma formation. Her scar is placed low, in a “thong” position. She is thrilled with the dramatic improvement of her stomach, and is happily wearing a 2-piece bathing suit again!

A mother of 2 in her early 50’s who is bothered by laxity and rolls of the back around her bra area. She had a breast augmentation/ lift elsewhere 20 years before, and an abdominoplasty elsewhere 10 years before. She was seen by another plastic surgeon who had recommended liposuction but I did not feel that this was likely to be helpful in her specific case as the skin calipers showed just 3 cm of pinch in her back, the same as the skin thickness in her abdomen. This is a normal pinch and because this grasps a double layer of skin shows that the actual thickness of the skin and fat is just ½ that or 1.5 cm. Her issue is laxity of the skin, not excess fat and can be demonstrated by a “lift” maneuver. When the skin is manually lifted the rolls go away. The only way we know to reliably tighten loose skin is to take out a piece- in this case the incision is carefully hidden under the bra strap. A “bra-line back lift”. The results as seen here at just 6 week after surgery are dramatic. The scar will continue to fade over the next 2 years but is hidden under the bra. She is already thrilled with her new contour. EXPAREL was used at her request and she did need to take any narcotics after surgery. Tattoos are blurred for her privacy.

A mother of 3 in her mid 30’s who is bothered by the appearance of her abdomen after pregnancy. She has an umbilical hernia and bulging of the abdominal wall as well as excess skin.
She is shown before and again, just 6 weeks after an abdominoplasty. Her umbilical hernia was corrected by general surgery at the same time. Her abdominal wall muscles that were stretched from her pregnancy was repaired during the abdominplasty and the excess skin was excised. A “champagne groove” was fashioned in the fat above the umbilicus and a beautiful hollow was sculpted around the umbilicus. EXPAREL was used to limit her need for narcotics and pain medication after surgery. Her scar is placed in a “thong” position where it is low enough to be hidden by a thong or by yoga pants or most clothing styles. There is typically still swelling of the abdomen that will resolve over the next 6 months. And the scars are at the reddest and thickest at 6 weeks and will now begin to fade and improve over the next 2 years or longer. She is thrilled with her early improvement.

A mother of 2 in her late 40’s who lost 40 lbs following her pregnancies and is bothered by excess skin and bulging of her abdomen. She is shown just before and again, 5 months after an extended abdominoplasty. Her umbilicus is brought back to the midline while repairing her diastasis and bulging of the abdominal muscles by means of a “plumbline” suture. EXPAREL was used to limit her need for narcotics after surgery. She is just back from a cruise, where she was able to wear a bikini, and loves the new appearance of her stomach.

A mother of 3 in her early 50’s who is bothered by bulging and rolls of the abdomen> She has had previous laparoscopic gallbladder surgery. She is 5’6 and 146 lbs. Her photos are shown before and again, 11 months after surgery. Her case is made more challenging by a higher position of her umbilicus. In a normal abdominoplasty when the skin is elevated up to the rib cage and then pulled down like a window-shade and removed, the skin that was around the umbilicus is completed removed and falls below the abdominoplasty scar. But in this case, when the abdominal skin is elevated and pulled down like a window shade, the slit of the scar from around the umbilicus sits higher and is closed as a small vertical ( up and down) scar, allowing the abdominoplasty scar to stay low, in a “thong” position where it is hidden by most clothing styles. An alternative procedure when the umbilicus is high is an umbilical “float” where the umbilicus is detached at its base and pulled down slightly lower-but this does not work as well when the upper abdominal skin is also loose because the “sheet” of skin is not able to be pulled as tight.
In cases such as here, it is better to keep the abdominoplasty scar in the “thong” position where it is low enough to be hidden by yoga pants and bikini bottoms, and accept a small vertical slit scar that shows, rather than putting the entire scar higher where it cannot be hidden.

A mother of 3 ( including twins) in her early 40’s who is bothered by bulging and loose skin of her abdomen. She would like to be comfortable wearing fitted clothing. She is 4’10” and 124 lbs and is shown before and again, 11 months after an extended abdominoplasty. She has severe stretching of the abdominal wall from her pregnancies and her umbilicus is deviated to her right. An attempt was made to bring it closer to the midline with differential tightening of the muscle wall. She has had an excellent correction of her abdominal contour and loves being able to wear fitted clothes and t shirts now. The fat has been sculpted in the abdomen to give her a midline groove and a hollow around the umbilicus. Her scar has been placed in a thong position.

An unusual case of a nurse in her late 50’s with lipodystrophy of the flanks. She is 5’2” and 292 lbs, giving her a BMI of 53.40. Her maximum weight was 450 lbs and she has had a panniculectomy of the abdomen in 2001 and a gastric bypass in 2006. She was referred by her orthopedic surgeon because the flank skin oscillates when she moves and causes a disturbance of her gait.

She is shown before and again, 3 months after a posterior-lateral thigh/buttock lift with the removal of more than 10 lbs of skin from each side, for a total of more than 20 lbs. Despite her high risk for surgical complications with her highly elevated BMI, she healed uneventfully. Although our main goal was a functional improvement in her gait, which was achieved by her surgery, she also has a significant improvement in her appearance as well.

A medical professional in her late 50’s who had a gastric bypass 12 years before and has lost 70 lbs. She has had an abdominoplasty with buttock lift and liposuction of the medial thighs by another plastic surgeon 5 years before but remained unhappy with prominence of the mons pubis that was not addressed at the time of her abdominoplasty as well as laxity and asymmetry of the medial thighs. Her mons remains too wide and is unnaturally prominent in her clothing. The thighs are asymmetric and the skin is loose.
She is shown before and again, 8 months after revision of her mons and lower abdomen with liposuction, as well as secondary liposuction of the medial thighs and knees combined with a medial thigh lift. She can stand with her legs closer together now without the skin touching and the thighs now match more closely in her leggings. An excision of the mons was marked but not required at the time of surgery.