The basic tenet of any abdominoplasty (aka tummy tuck) is to achieve a smoother, flatter abdominal contour when liposuction alone is not adequate. This may occur when your body has experienced pregnancy, significant weight loss, or loss of skin elasticity over time. 

Perhaps more than any other procedure that I do, abdominoplasty requires a combination of techniques customized to my client’s body:

1. Removal of excess skin

This is the sine qua non of abdominoplasty ! Imagine that fold of loose skin you’ve been pinching, pulling and hiding under an elastic waist band just gone…forever. No more rippling, wrinkling, rubbing or irritation. And as if that isn’t enough, stretch marks on the lower abomen are removed with the skin! So, if stretched out skin is your issue, abdominoplasty is the solution.

2. Liposuction to remove excess fat

As compared to the older, and still common, technique of removing fat with a scalpel, newer liposuction techniques leave blood and lymph vessels intact which decreases the risk of excessive drainage or bleeding or loss of blood flow (ischemia) to the skin which is pulled tight and left in place. This allows me to remove more fat and skin than in a traditional tummy tuck and eliminates the need for a drain after surgery.

3. Plication to tighten loose muscles

Weight gain, pregnancy, and genetics may conspire to cause weakening and spreading apart of the midline abdominal muscle layers, known as “diastasis”. If you see a vertical bulge when you lie flat and raise your legs, then you have diastasis. These muscles can be pulled together again during your abdominoplasty.

4. Repair of abdominal wall hernias

Unlike diastasis, which is thinning of the muscles, a hernia inolves a hole through the muscle layer which allows your internal tissue to push through, particularly when bearing down. Hernias can be detected during your initial examination and are most commonly found at the site of prior surgical incisions and at the umbilicus (belly button) which is an inherent weak spot beginning when the small hole through which the umbilical cord exits must close during infancy. Not all cosmetic and plastic surgeons are comfortable with hernia repair and require that this be done by another surgeon prior to abdominoplasty. During my ten years of general surgical practice I have repaired hundreds of abdominal wall hernias employing a number of techniques which can be tailored to my client’s needs.

5. Removal of prior scars and incisions

Some clients have had prior traumas or surgeries such as c-sections and hysterectomies which leave scars in the lower abdomen. These often create a “stuck down” appearance at the scar and a “shelf” of overhanging skin. I routinely loosen and remove old scar tissue in the lower abdomen during abdominoplasty.