A 2 ½ year followup on a mother of two who was bothered by hanging skin and fullness in the mons area. She is shown before and again, 2 ½ years after an abdominoplasty with translocation of the umbilicus. Her scar is nicely hidden in the “thong line”
A mother of 6 in her late 40’s who is bothered by fullness and asymmetry ( a difference in size and shape) of her breasts, as well as looseness and bulging of her abdomen. She is shown 13 months after bilateral breast reduction and 6 months after lipo-abdominoplasty. Although her weight has increased by 20 lbs, since her second surgery, she remains thrilled with her improvement.
A mother of 2 in her late 30’s who has had a gastric bypass and has lost 85 lbs. Her case is complicated by having been a recent smoker. She is 5’ tall and 155 lbs, giving her a BMI of 30.27. She was encouraged to not smoke for 2 months before and after her surgery. She is shown before and again, 7 months after an extended abdominoplasty. She had some initial problems with healing in the lower abdomen, but responded to dressing changes and protein supplementation. She is thrilled with her the new shape of her stomach and can now wear normal clothing.
A woman in her early 40’s who is bothered by the appearance of her abdomen, despite having liposuction of the abdomen elsewhere 13 years before. She has also had liposuction reduction of her breasts 15 years before, also elsewhere, and feels that her breasts have regrown. She is especially bothered by “rolls” of the abdomen that show through her clothing. She has not had children. She is 5’6” and 170 lbs and is shown before and again, 7 months aften extended abdominoplasty. She had the excision of more than 4 lbs of skin. We can expect scars to continue to fade over the next 18 months. She is thrilled to be able to wear fitted clothes now, without seeing “rolls” of skin in her abdominal area.
mother of 3 in her late 30’s who is bothered by the appearance of her abdomen after pregnancy. She gained 65 lbs with her last pregnancy and wished to be able to feel comfortable wearing a 2- piece bathing suit again. Many patients mistake the bulging of the abdomen after pregnancy with somehow being overweight. They come in to see me and feel guilty, as if they could correct their problem with further weight loss or exercise. That is certainly not the case here, as she is 5 4 ½ inches and 122 lbs, giving her a BMII of 20.62, and is extremely physically fit. The problem is skin and muscle that was stretched with her pregnancies. Her umbilicus is high, and we need to decide between placing the entire abdominal scar higher, or placing it in the best “thong line” position and accepting a small vertical scar in the lower abdomen that represents the skin that was previously around the umbilicus. In other words, we cut around the outside of the umbilicus (belly button) and leave the belly button attached where it is- after repairing the stretched muscles, the skin is pulled down like a window shade and the excess skin is removed, ant the belly button is popped back up through a new incision. She is shown before and again, 3 years after surgery. The abdominal scar is in the optimal “thong” position, placed 6 ½ cm above where the vaginal lips come together. The small vertical scar is seen just above this and is from the skin that was previously around her umbilicus before the skin was detached and pulled down. She has an excellent contour to her abdomen, and now feels comfortable again in a 2-piece bathing suit.
A mother of 3 in her early 40’s who is bothered by a ”bump” of her stomach after pregnancy, despite diet and exercise. She is also bothered by unfavorable scarring after gallbladder surgery at the age of 21. She had had this revised by a plastic surgeon 12 months before seeing me but was still unhappy with the scar. A subcostal incision is sometimes called a “Kocher” incision and can make an abdominoplasty more challenging. Limited undermining can allow us to maintain the blood supply to the lower abdominal skin. Liposuction of the abdomen can also increase the risk of healing problems with an abdominoplasty. Sometimes a scar can be improved further by releasing and breaking up the scar tissue and fat grafting around the scar.
Lipoabdominoplasty utilizing Power assisted liposuction was used to break up the fat around the old scar using a “Becker” type cannula and judicious liposuction was performed to remove 400 cc of fat from the upper abdomen. Then an abdominplasty was performed with limited undermining to preserve the blood supply to the lower abdominal skin. Fat equalization was performed to break up and smooth the fat under the scar.
She is shown before and again, 4 years after surgery.