Abdominoplasty – Patient 168

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.