Abdominoplasty or tummy tuck is one of the top five cosmetic procedures for women but is performed much less frequently in men. Because men do not get pregnant, their abdominal skin does not suffer as much loss of elasticity and can ‘snap’ back better after weight loss. Men are also less tolerant of a low abdominal scar than women who may already have had a c-section.
Even though it is far less than women, more men are considering or undergoing tummy tuck surgery than ever before. Some of this is fueled by the large increase in bariatric surgeries which has equal distributions between men and women. Another mitigating factor is that men are increasingly concerned about their appearance and are willing to go to greater lengths to get the best body shape as possible.
There are some significant differences between a male and a female tummy tuck that affects recovery from the procedure. Most importantly, muscle plication is rarely done or needed. In my Indianapolis plastic surgery practice, I have never done muscle tightening in a man. Men do not suffer from rectus diastasis, again due to never being pregnant. As a result, there is no cosmetic or functional advantage to sewing the rectus muscles tighter.
Because the rectus muscles don’t need tightening, undermining of an abdominal skin flap to do so is not needed. This enables just the overhanging loose skin and fat to be removed in a direct cut out fashion. The need for prolonged use of drains is reduced because there is less undermined skin space.
The avoidance of muscle manipulation also impacts one very important aspect of recovery…a significant reduction in pain after surgery. Sewing muscle is the single main contributor to postoperative tummy tuck pain and the restriction in standing up straight right afterwards. The removal of skin and fat causes surprisingly little pain for most people. At best it gives some incisional discomfort but not severe or restrictive pain.
The length of the incision line in men is determined by how much loose skin exists and how far back it goes from the hips…if it does at all. Unlike women, most male tummy tucks require skin and fat removal at least between the front edge of the hips. (anterior superior iliac crests) Most men wouldn’t undergo a tummy tuck if the amount of skin removal would be less than that amount. In some cases, the skin removed may go into the back area of significant weight loss has occurred.
Men should not fear a tummy tuck because of how they perceive it to be done in women. The male tummy tuck is simpler to do and less involved. The lack of a need to tighten the abdominal muscles makes for less pain after surgery and a reduced need for prolonged drain use.
Dr. Barry Eppley
Indianapolis, Indiana