Background: A tummy tuck, or abdominoplasty, is one of the great plastic surgery body contouring procedures. It can do for many patients what no diet and exercise program can…get rid of loose skin and fat along the waistline. While there is always the trade-off of a scar (and a significant recovery), the results usually justify those significant trade-offs.
Like most every other plastic surgery procedure, a tummy tuck can be done multiple ways. The amount of loose skin and fat removed can be adjusted through either a more limited resection of tissues (limited or mini-tummy tuck) and a more complete or full tummy tuck. What differentiates these two variations is the amount or length of horizontal scar that is needed to complete the tissue resection. Mini-tummy tucks remove tissues below the belly button and result in a shorter horizontal scar and no scar around the belly button. A full tummy tuck includes a resection of abdominal tissues that extends to just above the belly button, ultimately resulting in a longer low horizontal scar and a scar around the new belly button.
Case Study: This 32 year-old female, who is serving in the military, wanted improvement in her abdominal region. After the delivery of her twins a year ago, she has been unable to get her tummy back in any reasonable shape. She had a very large amount of abdominal muscle looseness (laxity) which accounted for a significant amount of her tummy protrusion. She also had loose skin with an extreme number of stretch marks around her belly button and throughout her entire lower abdomen.
In discussing her tummy tuck options, she was what I call in my Indianapolis plastic surgery practice a ‘tweaner’. This means she could have either a smaller or a larger procedure, in this case being either a mini- vs. a full tummy tuck. She had enough loose skin and stretch marks to justify a full tummy tuck to get all of them out. But by doing so, she would have a scar that went past her hips. With a mini-tummy tuck, her scar would be less but a significant portion of her stretch marks would remain. With her tummy tuck option, her abdominal muscles would be sutured back together. Which one is best for her? As you can see, her approach will make a big improvement but each one has trade-offs.
Because she did not want a longer scar, she was willing to accept much of stretch marks to remain. She opted for the mini-tummy tuck which included liposuction through the entire abdomen and into the flank (back) areas. She had a drain for a week and wore a binder for two weeks. She returned to her service duties in three weeks and exercise four weeks after surgery.
Case Highlights:
1) The decision between the two tummy tuck options in the ‘tweaner patient’ is a balance between much scar one can tolerate vs the amount of improvement that one expects.
2) Scars are always a consideration in a tummy tuck procedure. Once they are
placed, there is no way to remove them. A long tummy tuck scar is not a
choice if it would bother someone as much as the original abdominal problem.
3) While the scar may be different between a mini- vs. a full tummy tuck, the
recovery is not much different. The concern about recovery should be the least
consideration when making a decision between the tummy tuck options.
Dr. Barry Eppley
Indianapolis, Indiana