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!