Tummy Tuck and Liposculpture of the Abdomen

By Don J. Fontana, MD, PA

Don Fontana, MD

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Tummy Tuck and Liposculpture of the Abdomen

Of all the cosmetic procedures performed by a plastic surgeon, an abdominoplasty commonly called a tummy tuck is one of the most gratifying procedures for the patient. It is also one of the most frequently performed. Women and men who undergo this operation fall into two main types.

The first and most common group consists of women who have had multiple pregnancies, some of which were at a relatively early age. The woman delivered a large baby and despite exercise, diet and weight loss is unable to gain proper muscle tone, a flat abdomen or tighten the loose stretched out skin of pregnancy. Frequently the woman's body shape and muscle withstand the physical trauma of the first pregnancy, but after the second or third, there is little hope of returning to a normal body shape. In fact, strenuous abdominal exercises can in some cases worsen the condition by stretching the loose attachments between the main vertical muscles in the abdomen resulting in a condition called diastasis recti. Large pregnancies may cause other conditions weakening the umbilical area causing an umbilical hernia, which is repaired at the time of an abdominoplasty.

The second group of patients are those who have gained large amounts of weight either due to pregnancy or simply due to genetic predisposition to weight gain. These patients undergo programs of weight loss and exercise, which greatly improve their overall health, but cannot adequately tighten or strengthen either the abdominal wall muscles or loose abdominal skin.

The standard abdominoplasty involves removing the excess abdominal skin, tightening the abdominal muscle wall and liposuction of the abdomen and/or flanks. This is the routine used by the majority of plastic surgeons in the U.S.

What then makes the phrase liposcuplture of the abdomen different? A plastic surgeon who liposuctions the excess fat from the flanks or abdomen does so inflicting a significant amount of trauma to the tissues. This increases bleeding and bruising, and results in a higher chance of delayed healing. In addition there is a far greater likelihood of irregularities or “lumpiness” in the abdominal wall.

Liposculpture is an entirely different approach whereby a sheet of fatty tissue is sculpted from the abdominal subcutaneous layer. In the hands of an experienced plastic surgeon, the results are superior, healing is faster and swelling less severe than the routine liposuction. The abdominal skin contours tightly to the underlying musculature, reproducing the desired shape of the waist and truncal area.

If you are considering an abdominoplasty, be certain to inquire whether your surgeon performs liposculpture, and if so, look at his results. It can make all the difference.