Abdominoplasty is a procedure that has undergone significant changes over the last few years. Recent innovations that have made the procedure less invasive for some qualified candidates. In addition to a traditional abdominoplasty, which is especially helpful for men who have obtained excess weight or skin in their mid section, as well as for women who have undergone multiple pregnancies with relaxed muscles and stretched skin. It is also helpful now for patients who only have mild skin relaxation and/or muscle relaxation since the new modified less invasive procedure is available. The following abdominoplasty patient can expect a flatter, more contoured, and more visually satisfying mid section area.
Procedures for Abdominal Contouring
For patients with good quality skin and no abdominal wall laxity, or have a small to moderate amount of excess subcutaneous fat, liposuction is an option. Dr. Core’s primary form of dealing with excess subcutaneous fat is through a technique called ultrasonic assisted lipoplasty, also termed lipo selection. This is where a solid probe that is quite thin is placed under the skin and ultrasonic energy is emitted into the subcutaneous fat. This is specific for fat cells and causes the fat cells to rupture leaving other surrounding structures intact. The aspert is then removed gently with a low powered suction. This is in contrast to a traditional liposuction whereas high powered suction is used to remove fat. For information about lipo selection can be seen on our page dealing with liposuction.
For those patients who have minimal excess skin laxity of the lower abdomen and/or minimal laxity of the abdominal muscles, a mini abdominoplasty is an option. A mini abdominoplasty involves a small transverse incision just above the pubic area measuring approximately 6-8 inches in length. A small amount of skin is taken out and the abdominal area is liposuctioned. A small amount of undermining is done below the umbilicus and the muscles re-tightened with several sutures in the lower abdominal midline. A drain is usually placed for 8-10 days in order to prevent the buildup of tissue fluid in the pocket. Recovery from a mini abdominoplasty is fairly rapid with the patient returning to full activity in approximately two weeks.
Dr. Core is one of the original inventors of endoscopic abdominoplasty and has been practicing this technique since 1993. Endoscopic abdominoplasty is only for those patients who have no skin problem and who have only muscle laxity. A small incision approximately one inch long is made just above the hair bearing portion of the pubic area and in the umbilicus. The skin envelop is then elevated to reveal underlying musculature, which is then repaired under direct endoscopic vision and the skin is then allowed to retract into place. A drain is also used for this procedure and recovery requires two weeks due to the fact that muscle is, of course, what causes the soreness after abdominoplasty. However, this is an excellent option for those people who have excellent skin – only abdominal wall laxity caused by separation of the muscles usually from pregnancy. However, this procedure can also be applied in men who have had intra abdominal fat that has caused their muscle to separate over the years and it can also be used in men who have not had trouble with excess fatty tissue but who have what is termed a diastasis recti, which is a separation of muscles in the midline, which can be repaired endoscopically by bringing then together.
For the majority of our patients who have trouble with excess skin as well as muscle laxity, the cosmetic abdominoplasty is most commonly the option. The high lateral tension of abdominoplasty is the one most commonly practiced by Dr. Core but he also practices the newer technique of lipo abdominoplasty developed in Brazil. The Brazilian technique involves a combination of liposuction with minimal undermining in central muscle repair.
Skin Only Abdominoplasty
For many of our patients who have maintained good abdominal muscular integrality and have not had problems with diastasis recti, we have found significant improvement in recovery times by not addressing any tightening of the abdominal wall muscle. For these patients of whom skin is the only issue we are able to perform a “skin only” abdominoplasty. This involves liposuction and undermining of the skin flap with stretching of the skin to tighten the abdominal area. The incision is within the panty line and the postoperative result is excellent. We have found that in many cases of abdominoplasty the tightening of the abdominal musculature is not as necessary as once believed. This procedure as in most other abdominoplasties, also requires placement of a drain which is present for approximately 10 days and full recovery is actually much quicker than regular abdominoplasty with full activity being able to be undertaken within 3-4 days.
Your New Bellybutton
Dr. Core employs a technique which he developed in 1996 called the “caudal flap technique”. In the caudal flap technique the scar of the umbilicus is placed within the recess of the umbilicus instead of around it. The typical circumferential scar around the umbilicus, which is employed traditionally appears like a target and makes the umbilicus too noticeable and is a tell-tale sign that the patient has undergone abdominoplasty. In the caudal flap technique the result is an inverted U (see photo) and completely eliminates a visible scar in most patients and gives a natural appearance to the umbilicus.
In general the type of abdominoplasty for which your candidate will depend on the quality of your skin, the amount of skin laxity, the condition of the underlying abdominal muscles, as well as whether or not you have excess weight that is inside the abdomen under the abdominal muscles or if you have excess weight that is between the skin and muscles. In consultation Dr. Core will assess your physical issues and will explain to you what would be the procedure that would give you the most optimum outcome in terms of aesthetics.
Contact Core Plastic Surgery
If you have any questions or if you would like more information about abdominoplasty, please contact our practice today to schedule a consultation.