Body Gallery

A mother of 3 in her early 60’s who has lost significant weight after an endoscopic gastric sleeve 2 years before. She is bothered by the “pouch” of her abdomen that makes it difficult to wear fitted clothes. She is shown before and again, 6 months after an extended abdominoplasty.

A mother of 2 in her early 30’s who is bothered by bulging and laxity of her abdomen. She is 5’3” and 146 lbs and is shown just before and again, 6 weeks after an abominoplasty. Exparel was used to limit her postoperative need for narcotics. Progressive tension sutures were used to decrease her risk of seroma. Scars are typically at their thickest and reddest at 6 weeks and will then begin to fade and improve over the next 2 years. Her abdominal incision is placed low, in a “thong” position, where it is hidden by most clothing styles. There is typically still significant swelling in the abdominal skin a the 6 week mark that takes 6 months to fully resolve. Having said that, she has an excellent contour already, and tightening of the loose abdominal muscles have given her a nice waistline.

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, 4 ½ 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 the tightening of the muscle wall but it remains deviated to the right. Despite this, she has had an excellent correction of her abdominal contour and loves being able to wear fitted clothes and t shirts now.

Update: Our patient is now seen at 8 months. All swelling has resolved and the scars continue to fade and improve.

A mother of 2 in her mid 50’s who has lost 80 lbs with diet and exercise. She is bothered by the “rolls of skin which make it difficult to tuck in her skirt”. Her impetus for losing weight was to be more fit to be able to play with her grandchildren. She is shown before and again, 9 months after an extended abdominoplasty with the removal of 8 lbs of skin. Although the best results with abdominoplasty are with patients who are thin and have not had decreased elasticity of the skin from significant weight loss, she has a significant improvement. Her scar is hidden in a “thong” position.

A woman in her late 30’s who has lost more than 120 lbs with diet and exercise and is bothered by the appearance of her abdomen, She is currently 5’ 7” and 200 lbs, giving her a BMI of 31.32, She is shown just before and again, 17 months after an extended abdominoplasty with the removal of more than 5 ½ lbs of skin. We could provide additional tightening of the upper abdomen with a midline excision ( a fleur de lis pattern) but she does not wish to have a visible scar in this area. She is thrilled now to fit better in her clothes.

A mother of 4 in her early 50’s was bothered by the appearance of her abdomen which she describes as a “loaf of bread” when she is leaning forward. She finds it difficult to wear fitted clothing and is also bothered by the wrinkled appearance of the skin. She is shown before and again, 6 months after an extended abdominoplasty. She is thrilled by the new appearance of her abdomen, and is able to reach into her closet and grab some clothing without worrying about how it will hide her abdomen. Her scar is placed in a “thong” position where it is hiddent by most clothing styles.

A mother of 2 in her early 50’s who is bothered by the appearance of her stomach.  She has had two treatments elsewhere with cool sculpting, but did not see any improvement.  This is not surprising.  She does have excess fat of the stomach wall, but her main issue is stretching of the abdominal muscles and skin from pregnancy, neither of which are treated or improved with cool sculpting.  When she first saw me her BMI was 33 and I had her lose 25 lbs with diet and exercise to get ready for her surgery to bring her BMI down below 30.  Abdominplasty is not procedure for patients who are significantly overweight.  Fat that is inside the abdomen, around the intestines (omental fat) can make it difficult to tighten the abdominal wall.  I tell my patients that you cannot put 40 lbs of potatoes in a 20 lb bag.  Not only will the muscles stretch back out, but there would be a much greater risk of having a blood clot from increased pressure on the abdominal veins, as well as difficulty taking deep breaths because the diaphragms are at the bottom of the lungs but at the top of the abdomen and would not be able to descend normally.

She still has a thicker layer of subcutaneous fat over her abdomen, and chose to have a “lipo-abdominplasty” which combines liposuction of this fat at the time of the abdominoplasty.  The technique is modified to limit the undermining of the abdominal skin to better preserve the blood supply.  In her case, an “extended  lipo-abdominoplasty” was performed to give better tightening of her sides.  A “high lateral tension” pattern was used which has visibly  improved her upper thighs.   She is shown just 7 weeks after her surgery.  There is typically significant swelling in the lower abdomen that takes 6 months to fully resolve.  And the scars around the umbilicus and in the “thong line” are at their thickest and reddest at this time, and gradually improve over the next 2 years.  Even so, she has a dramatic improvement in her contour.  Her waistline is narrower and her stomach is flatter from the muscle tightening.  The abdomen has a beautiful contour from liposuction of 1050 cc from the abdomen.  And the skin is dramatically tighter after the excision of 5 ½ lbs of skin.  Her umbilicus (belly button) was deviated to her left side by uneven stretching of her pregnancies.  I have brought it back to the midline using our plumb-line technique with differential tightening of the abdominal muscles.

She is thrilled with her early result and is happy to be able to head back to the gym now.

A mother of one in her late 50’s who is shown just before and again, nearly 10 years after an extended abdominoplasty with the removal of 4 ½ lbs of skin. A “champagne groove” has been fashioned in the midline of the abdomen and a hollow sculpted around the umbilicus to give her abdomen an even more beautiful shape.

A woman in her mid 50’s who has lost 148 lbs after a gastric bypass more than 15 years before through an open upper abdominal midline incision. She had had Coolsculpting treatment of the abdomen 3 months before coming to see me, but didn’t report any improvement. Of course cryolipolysis is s treatment for fat, and her problem is excess skin, so the lack of improvement is not a surprise. It is always important to make the diagnosis before selecting a treatment.

Our patient is now seen 18 months after her abdominoplasty. The scars have continued to fade.

A mother of 2 in her early 50’s whose children are grown and who is now ready to do something for herself. She has lost 20 lbs with diet and exercise but is still bothered by the appearance of her abdomen in clothing. She feels that her breasts are too full and droopy after children. Her case is interesting for a few reasons. She has a large scar in her right upper abdomen ( a right subcostal incision or sometimes called a “Kocher incision” ) from an open gallbladder removal in the past. This can make the abdominoplasty more challenging by potentially interfering with the blood supply to the abdominal skin during an abdominoplasty.
She also has ‘fat pockets” in her anterior axilla which bother her in an evening dress. They can be treated at the time of a reduction mastopexy with liposuction. I generally to not perform the abdominplasty and a breast reduction at the same time-it is too much surgery for most patients and difficult early in the recovery of an abdominoplasty when a patient needs to use her arms to get in and out of bed.
She is shown 2 years after her abdominoplasty, and 21 months after her reduction mastopexy and liposuction of the axilla. I like to place the abdominoplasty scars low, in a “thong line” position where they can be hidden by most clothing styles. Her scars are quite good, but are easily hidden by her two piece bathing suit. She reports that her abdomen feels much stronger now when she does Yoga, and she never thought she would feel comfortable wearing a bikini again!