Abdominoplasty, or tummy tuck, is the removal of excess, loose skin around the midsection which may or may not include the removal (excision) of excess fat in the area, and the repair of various abdominal wall defects (among these diastasis, hernias, and general abdominal wall weakness).
Patients present with some or all of these factors and I use an approach which customizes the procedure to meet every patient need.
In women (and men) with skin only problems, below the belly button, for instance, a small low incision above the pubic area can be used to eliminate the problem skin and tighten the lower abdomen. This skin only, infraumbilical abdominoplasty is more commonly known as a “mini tummy tuck”, and can be combined with liposuction of the flanks and upper abdomen in women with good quality upper abdominal skin and no significant abdominal wall issues.
In women with skin laxity/excess predominantly of the lower abdomen but extending into the area above the umbilicus moderately with no abdominal wall issues, a skin only umbilical float abdominoplasty can be done. In this type of tummy tuck, the connection (attachment) of the umbilicos to the abdominal wall is divided temporarily (to allow for mobilization and tightening of more skin) and then reattached internally without and evidence of scarring around the belly button. This approach removes and tightens more skin over a greater surface area so it naturally requires longer incisions than a “mini tummy tuck”. It is limited in that we wouldn’t want the belly button to be moved to far downward. In cases where there is significant skin laxity or excess over the entire abdomen (above and below the belly button) without any significant abdominal wall issues or concerns, then an umbilical transposition skin only abdominoplasty is the procedure of choice. Here, an incision is made around the surface of the belly button to detach it from the skin surface leaving it attached to abdominal wall. This allows for maximal skin removal and freedom to mobilize as much skin as possible. The belly button is then “brought back out” through the skin in the proper location.
In patients with abdominal wall issues (diastasis, hernias, weakness, and bulges) these issues are treated at the same time as the skin operation. This combination is the classic most common form of tummy tuck. Restoration and equalization of abdominal wall function (RETAF as I have called it since 1996) is a process of improving resting and functional tone of the abdominal wall. I pride myself on delivering not only aesthetically appealing outcomes but also functionally superior bodies! That means a strong core for fitness. The correction of these abdominal wall defects requires true customization and this is where I believe I really set myself apart from others performing this procedure.
If there is limited skin laxity (infraumbilical) together with a weak abdominal wall, an umbilical float skin abdominoplasty (without umbilical surface scar) is combined to treat these conditions and optimize outcomes.
The most common “tummy tuck” is umbilical transposition skin management with treatment of abdominal wall issues and is also known as “traditional” or “complete” abdominoplasty, it is by far the most common type of tummy tuck and the one you see represented the most on the website.
Extension laterally to achieve more skin laxity and or addressing not only rectus muscle contour but also obliques through customized contour plications of the abdominal wall fascia in a 3D fashion is known as flankplasty.
This is an opportunity to dramatically improve shape, aesthetically, and artfully and I have treated patients literally from all over the globe using these concepts!
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