Explore Plastic Surgery

Like all structures on the body, things change with age, gravity, and the general wear and tear of life. Nowhere is this more apparent than on the female abdomen. Puberty, pregnancy, and weight change all play potential havoc with the smooth flat abdomen that most women have in youth. Pregnancy is the biggest culprit here, stretching the skin through expansion and contraction and leaving scars from c-sections.

The c-section scar itself may lay flat as it shrinks and heals but the overlying skin excess and loose skin often falls over this scar, resulting in an unsightly bulge of the lower abdomen. Often stretch marks extend upward from the scar and around the bellybutton as well. Unfortunately, no amount of dieting and exercise will shrink this skin excess and many women can attest to that observation.
Abdominoplasty, otherwise known as a tummy tuck, will get rid of this problem but a traditional or full tummy tuck may be a bigger procedure than many women desire to undergo. The length of a full tummy tuck scar (hip to hip) may be excessive given the amount of lower skin excess. In addition, a full tummy tuck requires the belly button to be repositioned at the skin level resulting in a scar around it. Despite my best efforts at making belly button scars, I find most of them to be somewhat visible and not completely normal in appearance.

An alternative approach is a more limited version of an abdominoplasty, known as a mini-tummy tuck or for a better visual understanding, a Bikini Line Tummy Tuck. With this approach, the length of the resulting scar is shorter but, more importantly, it stays very low. (hence the name Bikini Line) It stays low because the amount of skin removed is less and the cut out is below the belly button level. This allows the initial incision of the cut out to be put as low as possible and does not place a lot of tension on the final skin closure which can cause it to be pulled up higher. (as occurs in a full tummy tuck) In addition, no scar results around the belly button since as it is repositioned lower from underneath the skin before the final skin closure.

While not every woman who has overhanging skin and fat on their abomen is a candidate for the Bikini Line Tummy Tuck, about half of the women that I see are. Women that are close to a good body weight with a small amount of lower abdominal skin excess, with or without a c-section scar, are ideal candidates. A flat abdomen, a normal-appearing belly button, and a resulting scar that will fit inside

Dr Barry Eppley

http://www.eppleyplasticsurgery.com/

http://www.ologyspa.com/

Clarian North Medical Center, Carmel, Indiana

Clarian West Medical Center, Avon, Indiana

Indianapolis

I often call a tummy tuck, medically known as an abdominoplasty, as the ‘facelift’ of the body. It is a dramatically effective procedure that makes a change in the mid-section of the body that no amount of exercise or weight loss can ever do. While it is not a simple and quick recovery, the long-term benefits are enormous for most patients. The analogy of a tummy tuck to a facelift is a good one, because the surgery is all about layers. Removing and moving different layers of the abdominal wall to get the desired effect.
Whatever you don’t like about your stomach and waistline area, what you are seeing is a function of the three layers; skin, fat, and muscle. Each patient’s problem’s is composed of different contributions (excess or looseness) of these three layers. Knowing the contributions of each goes a long way in picking the right tummy/waistline solution.
If ones stomach area or waistline is full but the overlying skin is not loose, for example, then this problem is better treated by liposuction and you probably don’t need a tummy tuck. If, however, the stomach skin is loose, has stretch marks, sticks out, if you have had children, then some variation of a tummy tuck is probably in order. A tummy tuck deals with all three layers of the problem; removing loose skin, excess fat (even in areas where skin is not removed), and tightens the muscle. This three-layer approach produces the best result as all problem layers are adjusted.
Tummy tucks come essentially in two varieties; a mini- or limited tummy tuck and a maxi- or full tummy tuck. The fundamental difference between the two is in the amount of skin removed. If the cut-out of skin and fat is done below the belly button, this falls into the mini-tummy tuck variety. In this more limited operation, a new belly button does not have to be created, at the price of cutting out less skin. In the full tummy tuck, the cut-out of skin and fat goes above the belly button. A new belly button hole is needed to bring out the original stalk of the belly button. In either case and for most patients, liposuction is done around the waistline and into the back removing fat from areas that the cut-out does not reach. This is an extremely valuable companion procedure as you need to think of this operation as a 270 degree result, not just a 180 degree (or frontal only) effect.
Dr Barry Eppley
http://www.eppleyplasticsurgery.com/
http://www.ologyspa.com/
http://www.eppleytummytuck.com/
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis

Full or Limited Tummy Tuck ??

Contouring of the stomach and hip area is a common request. Many post-partum women long to get rid of that ‘babyroll’ and get particularly frustrated when, despite diet and exercise, fail to make any headway. At this point, they seek out a plastic surgeon. When seeing this kind of patient, I reassure them that no amount of effort on their part can get rid of excess skin, fat, or stretch marks over the lower abdominal area. And the type of surgical procedure that they should chose is based on an understanding of their problem.

The shape of the abdominal area is determined by three types of tissues; how much skin, how much fat, and how loose is the underlying abdominal muscles. Each woman’s stomach shape is determined by differing proportions of these three components. In the post-partum patient, the amount of loose skin and its residual elasticity provides the key to the right type of tummy tuck. (adominoplasty)

The classic or full tummy tuck removes the most skin and gives the tightest result. It results in a hip-to-hip low scar, the cut out is carried above the bellybutton (which remains attached to the muscles like a mushroom), the muscles are tightened in a midline vertical fashion, and the skin is then pulled down and sutured to form a low-lying scar. A new hole for the bellybutton is made and it is then pulled through. Liposuction to thin out the upper abdominal is not commonly done as it may interfere with the blood supply to the skin. While producing the best result for many patients, it is a big operation, requires 7 to 10 days of drains, and will take 3 to 4 weeks to fully recover. This operation is best used in women with a lot of skin excess.

The mini- or limited tummy tuck also leaves a low scar but it is shorter than for a full tummy tuck. This is because the cut out of skin stays below the belly button, also meaning that no scar will result around the belly button at the end. Liposuction is liberally used on the upper abdomen since no skin undermining is done. The muscle tightening is usually done only on the lower half from the bellybutton to the pubis. The skin is then pulled down and the bellybutton ‘floats’ downward so that is an inch or so lower than before. A drain is still used but only remains in 3 to 5 days.

Over the years, I have changed the ratio of full to mini-tummy tucks that I do. These days I do more mini-tummytucks than before. In many patients the results are not significantly less, I can more more aggressively use liposuction, and their recovery is quicker. My incidence of seroma formation is also less.

Dr Barry Eppley
www.eppleyplasticsurgery.com
www.ologyspa.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis

“I want to get rid of my Baby Belly”

It is an almost every day occurrence that I hear from women how they are unable
to get rid of their belly skin and fat after pregnancy, despite eating healthy and exercising.
No matter how well they eat and exercise, that layer of fat on their stomach just above and below the belly button, is something that they struggle with. This frustration eventually brings them into office to seek a solution that they cannot do on their own.

Unfortunately, eating right and exercising will not make skin tighten or go away. Even the newer non-surgical skin-tightening devices (such as Thermage) will not significantly tighten skin and are rarely worth the cost. Liposuction, while great at taking away fat, does not tighten skin either and make actually make it look worse with less fat underneath.

For postpartum paunch due to lax muscle and skin, some form of an abdominoplasty (tummytuck) is the surgical solution of choice. There are different techniques for different stomach conditions. A woman may be trim but the skin is loose. These patients may only need a limited procedure called a mini-tummytuck. This results in a smaller scar, with no scar around the bellybutton. In women with larger paunches, a full abdominoplastty is required with a scar from hip to hip. Since tummy tuck scars are a big issue for women, the incision can be designed to lie within their underwear or bathing suit lines.

Tummy tuck surgery gives dramatic results, but there can be a significant recovery period. In full tummy tucks, it can take as long as four weeks for total recovery. For women who have had Cesarean section, that scar is essentially removed during the tummy tuck and a new, often less, noticeable scar will result.

Dr Barry Eppley
www.eppleyplasticsurgery.com
www.ologyspa.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis