Background: Weight loss creates a lot of external body changes that is usually most manifest in the trunk region. In the anterior abdominal region the deflated skin hangs often hangs over the waistline tethered by the belly button attachment. How mucb skin overhangs the waistline depends on how much weight loss one undergoes and what one looked like before the weight loss.
The tummy tuck is the standard treatment in the weight loss abdomen. Depending upon how much skin needs to removed the length of the horizontal can range from hip to hip or can extend completely around the waistline in a circumferential manner. When the extent of the tummy tuck matches the magnitude of the loose skin present, the abdominal contour change can be dramatic.
Case Study: This 23 year-old Hispanic female lost 60 lbs through diet and exercise over a one year period. (185lbs down to 125lbs) This left her with a central mound of loose skin that was mainly restricted to the anterior abdomen.
Under general anesthesia, a full tummy tuck as performed through a wide horizontal excision of skin with umbilical transposition. It was not necessary to extend the tummy tuck incision further back into the flanks areas.
At one year after her surgery, her abdomen was reasonably flat. Her tummy tuck scar healed beautifully, being barely detectable even in her darker skin. She still had a fair amount of stretch marks but these were expected since they were outside the zone of the skin excision pattern.
Many weight loss tummy tucks produce good scars. The the skin closure, even though it is under tension, heals favorably because of the loss of skin elasticity from the weight gain/loss on the dermal architecture of the skin.
Highlights:
1) Large amounts of weight loss causes unsightly loose skin on the abdomen.
2) A full tummy tuck removes much of the loose abdominal skin but can not remove all the stretch marks.
3) The stretched out abdominal skin heals well and creates a good tummy tuck scar.
Dr. Barry Eppley
Indianapolis, Indiana