Background: Tummy tuck surgery is one of the most common of all body contouring procedures and can create some dramatic waistline changes. The operation is designed to reverse some of the tissue expanding effects caused by pregnancies and/or weight loss. While it can be tremendously effective at this purpose, its main effects are largely limited to the area of tissue excision. What lies beyond this zone is less significantly changed as it is pulled closer to the location of the suture line.
While the severe stretching effects of pregnancy affect women’s abdominal areas differently, some women develop a tremendous amount of stretch marks and loose skin. Large amounts of weight gain, small body frames and thin skin all lends themselves to the development of such abdominal skin damage. In these cases stretch mark radiate outward from the belly button like the rays of the sun. The redundant skin can be so significant that the loose and thinned out tissues can be stretched and pulled out like a piece of taffy.
Case Study: This very petite 36 year-old Hispanic female had two children that left here with a ‘wrecked’ abdominal area. She was very thin and had little subcutaneous fat but the loose skin on her abdomen was considerable. She had stretch marks from the pubic region all the way up to just below her lower ribcage.
Under general anesthesia, a full tummy tuck was performed from hip to hip removing a large abdominal skin segment that measured 18 inches in the midline. The skin was so loose that no skin undermining was needed of the upper abdominal skin flap other than to free up the tissues around the umbilicus. With such little tissue undermining, no drains were used due to the small dead space at closure. She was so thin than no liposuction was needed around the perimeter of the tummy tuck zone to reduce tissue fullness.
With extensive abdominal tissue damage as exemplified by a large number of stretch marks, only those stretch marks within the outline of the excised tissues will be removed. Stretch marks will remain with many mid- to upper abdominal marks being pulled down lower closer to the incision line.
Highlights:
1) The extent of tummy tuck surgery due to stretched out abdominal tissues depends on how large the zone of damaged tissues emanates out from the belly button area.
2) Large amounts of loose and damaged abdominal skin can often be removed during tummy tuck surgery with limited tissue undermining.
3) The quality of a tummy tuck result is influenced by the scar’s location, amount of pubic hairline distortion, appearance of the new umbilicus and whether dog ears are present at either end of the horizontal scar.
Dr. Barry Eppley
Indianapolis, Indiana