Anyone who has lost a significant amount of weight or women who have had several children often suffer from sagging abdominal skin, bulges and stretch marks. Although exercise is great for the muscles, you can’t exercise away redundant skin or stretch marks. A tummy tuck can remove the excess skin, eliminate many of the stretch marks and reposition separated abdominal muscles.
The majority of patients who undergo abdominoplasty surgery are candidates for a standard tummy tuck. Excess skin on the lower abdomen from the pubic area to just above the umbilicus is removes as a long elliptical wedge of skin and fat. The remaining abdominal skin is elevated off of the underlying muscles, which are then tightened with sutures to help flatten the stomach. The belly button is kept in its place but is brought out through a new opening in the now tightened skin.
"After three pregnancies and two C-sections, no amount of exercise could get rid of my excess skin and tummy bulge. I chose Dr. McMahan after seeing many other doctors because my consultation with him was by far the most thorough. My recovery was much easier than I expected and I’ve lost two dress sizes. I can actually wear a bikini again. Thank you Dr. McMahan!"
~ Laura, Columbus
Those who have less excess skin and a bulge that is mostly below the umbilicus may benefit more from a mini-tummy tuck than a full abdominoplasty. In a mini-tuck, a smaller segment of skin is removed from the lower abdomen and only the lower abdominal muscles are tightened. Liposuction is typically performed to remove excess abdominal fat with a mini-tuck, which is not generally done with a full tuck. A mini-abdominoplasty leaves a shorter, lower scar than a full tuck and usually only one drain is used rather than two for a standard procedure.
Those who have lost a tremendous amount of weight, either through diet and exercise or from a gastric bypass, gastric sleeve procedure of lap band usually have more excess skin to be removed than can be done with a standard tummy tuck. A fleur-de-lis procedure also removes an inverted ‘V’ of skin from the upper abdomen to tighten the skin in a horizontal dimension in addition to a vertical dimension but leaves a vertical midline abdominal scar.
A circumferential tummy tuck or lower body lift is also performed on patients who have lost a significant amount of weight. It combines a standard tummy tuck with removing a considerable amount of skin on the hips and lower back, which can provide somewhat of an outer thigh lift and buttock lift.
In many cases, the muscle repair is often the most important part of the surgery, especially in cases where there is a significant bulge and loose muscles. Most surgeons do a one-layer repair, which can tear out with coughing or straining. We hear from nurses at out surgery center that this happens to some patients on the operating room table as they wake up and nothing is done about it. Dr. McMahan performs a stout, two-layer muscle repair to prevent his patients from accidentally breaking the stitches.
The most painful part of a tummy tuck is the muscle repair. To dramatically reduce pain, Dr. McMahan infiltrates the muscle with a combination of local anesthetics just before the end of the surgery. A lot of our patients wake-up very comfortable and this tumescent infiltration can significantly reduce the need for narcotics for several days after surgery.