To start, we make an incision just above the mons pubis from hip to hip. Next, we remove extra skin then tighten the fascia and muscles. Usually, we remove the entire area from the belly button to the mons pubis. If you have a c-section scar, we remove it. We don’t remove stretch marks located above your belly button. However, we do tighten the skin as it pulls toward the mons pubis. The belly button remains on the abdominal wall. Additionally, we recreate it by making a new opening in the overlying skin. Then, we pull the umbilicus through and suture it in place, creating a beautiful, “new” belly button.Generally the longer the incisions in an abdominoplasty the more skin removed. That also means more tightening occurs. Dr. Martin hides the incisions by placing them low on the abdomen, allowing the scar to hide in the bikini line.
Abdominoplasty with liposuction
Over the last 10 years, combining liposuction of the abdomen with a tummy tuck has developed. Prior techniques would not allow a combination of abdominoplasty/liposuction due to high incidences of tissue breakdown. With advances in techniques, we can combine the two procedures much more easily. This procedure modifies the dissection of the abdominal flap and by performing less aggressive liposuction. This approach allows us to achieve spectacular results with only one procedure. Additionally, we can perform liposuction on other areas of the body at the same time. If you smoke, you’ll need to choose a different type of tummy tuck.
For minimal extra skin below the belly button, you may benefit from a mini-abdominoplasty. With this procedure, we make a smaller incision. This leads to a shorter scar. We still tighten your skin in the lower abdomen. However, the skin in the upper abdomen remains. We also tighten loose fascia in the lower stomach. Again, the incision is low, allowing the scar to hide in the bikini line.
For excess skin above the belly button (epigastric) area a reverse tummy tuck may be needed. This procedure is performed with an incision under the breasts and the skin is lifted up as opposed to being pulled down. A reverse abdominoplasty will have minimal effect on loose skin located below the belly button. The resulting scars are usually hidden under the breasts but scar migration can be a rare complication. Occasionally this technique is combined with a standard abdominoplasty allowing for spectacular results.
For large amounts of skin in the epigastric area or if a previous vertical scar exists, a fleur-de-lis abdominoplasty may be indicated. The resulting scar has the shape of an inverted T and the abdominal tissue can be pulled very tight with this approach. This is used most often in post-bariatric patients who have undergone an open gastric bypass.