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.
At your initial visit we will evaluate your areas of concern and discuss options for treatment, recovery time, and the potential for scarring. In some cases, we may recommend no treatment at all, particularly if we feel the potential difficulties involved in treatment outweigh the benefit of removal. If there is uncertainty of the nature of the skin lesion, a biopsy may be recommended. Once a treatment plan has been developed, we will schedule a convenient time to perform the procedure in our office.
The No-Drain Technique
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.
Types of Treatments
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.
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.
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.
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.
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 is anatomically a more limited procedure. During a panniculectomy, 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 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 for functional reasons but desire a better cosmetic result may be advised to undergo a full or extended abdominoplasty.