Background: Tummy tuck surgery is one of the most common and successful types of body contouring surgeries. It is used in many post-pregnancy and weight loss women to correct the effects of having babies and the changes that process can induce on one’s body in the mid-section area. This type of tummy tuck usually induce the debate between whether one should have a fully or mini-type of tummy tuck.
But women with a high BMI (body mass index) and significant weight for their height often requires a different type of tummy tuck. Even with weight loss a high BMI creates a roll or rolls of skin and fat that a frontal-based tummy tuck alone can not properly address. The tissue redundancies extend well beyond the frontal hip points and well into the back. This requires that the extent of the tummy tuck excision go around the waistline and become closer to a 270 to 300 degree tummy tuck rather than a traditional 180 degree frontal tummy tuck.
With an extended tummy tuck comes the realization that there will be a longer scar into the back area. This location of a tummy tuck scar often does not look as good as any tummy tuck scar on the abdominal side and there is no real natural skin fold to hide it. For those patients that need it, however, this is usually perceived as an inconsequential trade-off in most cases. It is often also necessary that liposuction be performed in and around the back and waistline area to maximize the contouring effect.
Case Study: This 42 year old female had lost 50 lbs of weight on her own but could not get rid of the rest of her stomach and back rolls. Despite her best effort at exercise she could just not budge her body shape to get any better.
Under general anesthesia, she had an extended tummy tuck performed with a large horizontal excision of skin and fat from the abdominal area which extended into the back stopping just shy of the midline spine. Her abdominal and flank skin and fat that was removed weight 9 lbs. Liposuction was then performed on her back and lateral chest wall rolls to remove another 1.5 liters of fat aspirate.
Recovery time for her extended tummy tuck took a full three weeks to be able to return to any work and a full 8 weeks for a truly complete recovery. Complete recovery is defined as the incision being completely healed with no open areas or sutures that would extrude. And that she was finally back to a full return to all activities including any type of exercise.
An extended tummy tuck is often needed for the patient who has undergone a lot of weight loss or who still carries a fair amount of weight with a high BMI. The resultant scars will be much longer than a standard tummy tuck but is worth the trade-off for a better circumferential waistline reshaping result.
Highlights:
1) Many types of tummy tucks exceed the scope of the traditionally perceived ‘full tummy tuck’.
2) Patients who have lost a lot of weight and started out fairly big before weight loss need an extended type of tummy tuck.
3) Extended tummy tucks create longer scars that wrap around the waistline to lessen the chance of significant skin redundancies and large dog ear deformities.
Dr. Barry Eppley
Indianapolis, Indiana