The ‘Tummy Tuck’ — Right for Me?
By Lyla Koon, Freelance writer
 
The flat stomach is back! With the profusion of ads showing low-cut jeans, high-cut shirts and pierced belly buttons, women are seeking a flatter abdomen.
 
An abdominoplasty, or “tummy tuck,” can restore that youthful, “hourglass” appearance in the right patient – ideally one with loose excess skin in the lower abdominal area. A good candidate would be close to their ideal body weight and not smoke.
 
There are usually three steps to an abdominoplasty, according to Mark Deutsch, M.D., FACS, with Perimeter Plastic Surgery. The first involves tightening the abdominal muscles, which may have become lax over time either due to pregnancy or weight gain. Next the surgeon removes excess skin in the abdominal area and finally, liposuction may be used in the flanks region.
 
If the patient has loose skin only between the umbilicus or “belly button” and the pubic area, then a “mini” abdominoplasty is indicated. This procedure uses a short, low scar just above the pubic area that does not include an incision around the umbilicus. Therefore only the muscles below the umbilicus can be tightened. Dr. Deutsch explains that if the patient has loose skin and fatty rolls both above and below the umbilicus, then a “full” abdominoplasty is indicated.
 
“Again, the incision can be kept low near the pubic area, but extending it slightly longer and including an incision around the umbilicus means I can tighten the muscles both above and below this area,” he says, “allowing a maximum tightening of the entire abdominal skin.” If the patient has had a Caesarean section, this scar is often removed and the abdominoplasty incision takes its place.
 
Women should not worry about getting pregnant after undergoing an abdominoplasty, “although women who are thinking about getting pregnant in the next year or two should consider postponing the surgery until after having the last child,” adds Dr. Deutsch. A pregnancy will stretch out a previously tight stomach in patients who had undergone abdominoplasty, so he recommends that women wait at least 3 to 6 months after the baby is born. This also allows all of the circulating hormones to return to their normal levels.
 
For some patients, only liposuction is recommended, and not a tummy tuck. “However, if there is loose skin in the lower abdominal area, then liposuction alone is unlikely to lead to a good outcome,” says Dr. Deutsch. A decision on the best course to take is made only after a thorough consultation.
 
Patients undergoing a full abdominoplasty generally stay overnight, while mini-abdominoplasty patients can go home the day of surgery.