Abdominoplasty

Abdominoplasty is one of our favorite procedures for significantly reshaping your body. We have over 20 years of experience in this procedure and hundreds of satisfied patients. It is the ideal procedure for simultaneously tightening the skin, repairing the abdominal wall, and removing excess fat from the lower abdomen.

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No drains!

For many years we routinely placed drains following abdominoplasty.  However, a few years ago we changed our technique, placing progressive tension sutures internally to both better shape the tissues, avoid tension at the incision, and make drain placement unnecessary.  The benefits to our patients have been dramatic.  Many people who have undergone abdominoplasty in the past said that having a drain was one of the most bothersome aspect of their recovery.  We now find we are able to do all types of abdominoplasties (described below) without drains.

Best candidates

Cosmetic abdominoplasty is best suited for those patients who are otherwise healthy, at a stable weight, and are not significantly overweight. Proper diet and exercise after surgery will only improve your result.

Types of Abdominoplasty

Abdominoplasty is not just a single operation. Each patient needs to be individually evaluated to determine which type of abdominoplasty would best suit their needs. The quality of the skin, the strength of the abdominal wall, the amount of excess fat, and any underlying abnormalities (hernias, previous surgical scars, etc.) all need to be considered in choosing how the abdominoplasty will be performed. Below are some common variations:

Limited abdominoplasty

This involves a shorter scar and less extensive skin and fat removal than a traditional abdominoplasty. Through this shorter scar we are still able to tighten the abdominal muscles and remove a modest amount of excess skin and fat, but it is not an operation well suited to those with excessive or poor quality skin.

Full abdominoplasty

This “typical” abdominoplasty allows tightening and repair of the abdominal wall, removal of a significant amount of excess skin, removal of lower abdominal fat, and resetting and contouring of the umbilicus (belly button). The trade off for this longer scar is better overall contouring of the abdomen than can be achieved through a short scar technique.

Extended abdominoplasty

When patients have a significant amount of excess skin, such as after significant weight loss, we may recommend an extended abdominoplasty. This longer incision typically extends all the way across the abdomen onto the side of the body, allowing more excess skin to be removed.

Circumferential abdominoplasty

When there is significant skin excess that extends all the way around the waist, we may suggest a circumferential procedure. This more extensive procedure leaves a scar that is long (most or all the way around the body), but can result in a dramatic improvement in patients with significant skin excess, especially after massive weight loss.

Panniculectomy

Panniculectomy is anatomically a more limited procedure. During a pannicuectomy we remove the excess skin and fat from the region between the umbilicus and the pubic bone (lower abdomen). The umbilicus is not repositioned and the muscles are not routinely tightened. This is typically a functional operation designed for those who are experiencing significant problems resulting from overhanging skin and fat (pannus) resulting in recurrent skin breakdown and infections. Although improvement in the appearance is usually seen, the goal is really a functional one, not cosmetic. Insurance may sometimes cover this procedure, especially after significant weight loss.

Patients who require a panniculectomy forfunctional reasons but desire a better cosmetic result may be advised to undergo a full or extended abdominoplasty.

Combination procedures

Abdominoplasty can often be combined with other procedures, both cosmetic and reconstructive. For many patients, this is a very good option, as it enables them to address more than one problem in a single trip to the operating room, and recover from both their abdominoplasty and their other operation at the same time. Some common operations we have performed with abdominoplasty include:

We are comfortable working with your gynecologist, urologist, general surgeon or others to carry out other procedures at the time of your abdominoplasty. In some cases, we may suggest you NOT combine other procedures with your abdominoplasty, especially if it will significantly increase your time in the operating room or increase your chances of complications. Doing the operation well and safely is always our first concern.

Abdominoplasty corrections

We have seen a number of patients over the years who have undergone abdominoplasty elsewhere with results that leave them dissatisfied. We welcome the challenge of correcting these kinds of problems. While some corrections can be fairly straightforward (a minor scar revision), others can be more complex and may involve essentially redoing the abdominoplasty procedure. We would be glad to meet with you to discuss how the results of your previous abdominoplasty can be improved.

The surgery

We perform abdominoplasty surgery at either the Lawrence Surgery Center or Lawrence Memorial Hospital. Both are fully accredited and well equipped for your surgery and care afterward. The operation will be performed under a general anesthetic and generally takes around 2-4 hours depending on the extent of the procedure performed. Patients are generally kept overnight for monitoring after more extensive abdominoplasty procedures under the care of nursing staff and discharged on the following morning. Patients undergoing less extensive procedures may go home on the same day.

Recovery

The rate at which you recover is highly individual, depending on the extent of the procedure performed and your own rate of healing. Patients usually require strong pain medications for the first few days, then can progress to less sedating drugs. If your job requires a fair amount of physical activity, we suggest you plan on being off work for about 2 weeks. Of course, some patients return faster than 2 weeks, but this can be hard to predict. We usually have our patients wear an abdominal binder or other supporting garment during their recovery to help support the repair.

Insurance coverage

If you have significant problems related to overhanging skin and fat, particularly after massive weight loss, your medical insurance may cover part or all of your procedure. Coverage is sometimes available for panniculectomy or abdominoplasty if you have a history of multiple episodes of skin breakdown, infections, rashes, etc., related to this excess tissue. If we feel insurance coverage is a possibility we can submit a letter to your insurance company prior to the procedure to determine if your procedure will be covered.

In most cases, insurance companies will only cover a panniculectomy. More extensive abdominal surgery (full abdominoplasty, circumferential abdominoplasty, etc.) is typically considered cosmetic and not eligible for coverage.

Attention patients with Medicare

Quick fact

Over 127,000 patients had an abdominoplasty procedure in 2015. That’s over double the number that had the procedure in 2000. (ASPS statistics)

5 Reasons why you should have your abdominoplasty performed at Lawrence Plastic Surgery:

  • Experience– We have hundreds of happy patients and great results after performing this procedure for over 20 years.
  • Accredited facilities We only perform this operation at Lawrence Memorial Hospital or the Lawrence Surgery Center.
  • Safety– We place your safety above all else. We have given educational talks at national conferences on safe practices and abdominoplasty and take the issue very seriously.
  • Surgeon certified by the American Board of Plastic Surgery
  • Great staff and office environment– Our experienced staff,including a Certified Plastic Surgery nurse, work alongside your surgeon every step of the way to give you not just a great operation but a great experience.

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