If dieting, sit-ups and walking and running leave you still far from your goal of a flatter belly, then a tummy tuck could be the only surgical solution. Everyone recognizes what a tummy tuck is, the removal of extra skin and fat from the abdominal area and tightening of the abdominal muscles all at the same time. But in my Indianapolis plastic surgery practice, this plastic surgery procedure is not a “one size fits all” operation. It must be customized to some degree for each patient’s needs and thier own unique anatomy.
Tummy tucks actually come in a variety of variations, depending upon the anatomy of one’s problems. When looking at an undesired loose, saggy, or fat stomach, the question is how much is skin, fat, and/or loose muscle. Everyone has differing ratios of these anatomical issues and knowing what the problems are determines the type of tummy tuck that one needs.
If one has good quality skin that is not loose, then excess fat may be the main make-up of the abdominal fullness. If so, liposuction without a tummy tuck may produce an acceptable result, sparing one a scar. With the emergence of Smartlipo, or laser liposuction, good results with liposuction alone may be able to be achieved even when one’s skin is little but loose. (but not too loose) The heat from the laser has the capability of doing some skin tightening.
When loose skin and fat is present, the question is how much should be removed. If the loose skin and fat is mainly below the belly button, then a mini- or limited tummy tuck may suffice. If there are rolls or wrinkles of skin above or around the belly button, a mini-tummy tuck can include a repositioning of the inside stalk of the belly button lower, helping work out this extra skin. Mini-tummy tucks can include no muscle tightening, muscle tightening from the belly button down, or full muscle tightening from the ribcage on down, depending upon how and where it is loose.
If you can grab more than a handful of loose skin and fat, or loose tissue is evident above the belly button, then it is likely that a full tummy tuck is needed. Almost all full tummy tucks get the vertical rectus muscles tightened.
These cut outs of skin and fat, above or below the belly button, determine the length of the resulting low horizontal scar. Mini-tummy tucks have shorter scars, just longer than that of a C-section. Full tummy tuck scars run from one hip point to the other. A longer scar means more skin and fat have been removed.
Which type of tummy tuck is best for any patient is a mixture of how much skin and fat one has and how long a scar one is willing to accept. In my Indianapolis plastic surgery practice, I like to go over all the advantages and disadvantages of each type for every patient so they can make the best decision for themselves. For some patients, they could go either way. For others, one or the other is fairly clear from the beginning.
A tummy tuck does not magically endow you with perfectly sculpted washboard abs. It does, however, give you a more contoured and tauter waistline than before. The improvements are often dramatic, and people who have had tummy tucks are some of my most happy patients.
Dr. Barry Eppley
Indianapolis, Indiana