While tummy tuck or abdominoplasty comes in different techniques based on the incision pattern, their quintessential goal is to create a flatter waist line by removing or minimizing the appearance of hanging skin, muscle laxity, and excess fat. If needed, the surgery is complemented by liposuction to further create a smoother profile.
It is quite understandable that most patients will choose surgical techniques that involve shorter scars, although you have to remember that some cases entail the use of longer incisions to achieve the most desired result and minimize the risk of skin asymmetry. This is particularly true if you require the most amount of correction in tummy tuck.
Traditionally, tummy tuck uses a horizontal incision that extends at the end of both hips. But because some patients only have little excess skin, they can get away with a shorter scar.
Nevertheless, the vast majority of tummy tuck patients require a hip-to-hip incision while only a few could benefit from a mini tummy tuck wherein a shorter incision is utilized, explains board-certified plastic surgeon Dr. Tarick Smaili.
The general rule of thumb is that the more extensive your skin laxity is, the longer is your incision if you want to achieve a more natural abdominal contour and minimize the risk of residual deformities such as “dog ears.” In fact, massive weight loss patients require skin excisions that can extend beyond the flanks, or in severe cases they might need a belt-like or circumferential incision to also address the hanging tissue in their back.
Simply put, a mini tummy tuck is only suitable for individuals with very little excess skin and do not require correction in their upper abdominal area, which is rarely the case.
Anecdotal reports show that most women asking for a tummy tuck procedure have skin and muscle laxity caused by previous pregnancies. For this reason, they generally require a full-length incision that may or may not include another one to free and reposition the navel.
Because of pregnancy, women are more prone to diastasis or splayed abdominal muscle than men. To determine if you have this problem, lie down on you back and raise both legs as straight as possible to see whether you have a “bulge” in your upper tummy, which can reveal the condition.
While the use of a shorter incision initially sounds appealing, take note that using it on patients who have extensive skin and muscle laxity could only lead to disaster. First and foremost, “puckering” of the skin, or more commonly referred to as “dog ears,” and wide scars are very likely to occur.
Tummy tuck surgery, or abdominoplasty, is a body contouring procedure in which the flap of skin and tissue is removed typically through a hip-to-hip incision placed below the navel and as close as possible to the pubic region so the scar lies hidden by the underwear or swimwear.
To achieve good results with the least amount of visible scars, careful planning prior to surgery is crucial. During consultation, patients are often required to wear their “favorite” jeans, underwear, and swimwear so their plastic surgeons can visualize the most ideal incision pattern hidden from plain view.
While it is aesthetically pleasing to lower the incisions as close to the pubic line as possible, anatomically speaking this may not provide good results for some women, particularly those who need more contouring in their upper abdominal region.
In some cases, a seemingly high-riding scar appears even if the initial plan is to position it low enough to be covered by the underwear or low-rise jeans.
A scar revision to lower the horizontal scar is possible after a tummy tuck surgery, although the “right timing” is crucial to achieve good aesthetic results. The general rule is to wait at least six months so the soft tissue will have ample time to relax and recover from the surgical trauma.
While the scars may be revised, sometimes it could not be lowered enough to be covered by the jeans a patient typically wears.
Aside from lowering the scar, some patients also need a revision to correct the residual deformity, which is often caused by poor surgical planning. One effective way to avoid the problem, or at least reduce one’s risk, is to find a plastic surgeon certified by the American Board of Plastic Surgery.
The residual deformity is primarily linked to inadequate tissue and fat removal, thus tummy tuck is now commonly performed in conjunction with liposuction in which the excess fat, usually in the flanks, is removed through a thin hollowed probe attached to a vacuum pump.
Some women may also need revision in the form of liposuction in their mon pubis to eliminate the unsightly bulges in the area that becomes more prominent when compared to the flat abdomen.
If tummy tuck is performed by a skilled, board-certified plastic surgeon, the likelihood of needing a major revision in the future can be significantly reduced as long as the patient is able to maintain a healthy, stable weight throughout her life.
The primary goal of tummy tuck (abdominoplasty) is to contour the midsection, which can be done by removing the redundant skin and pockets of “stubborn” fat. For additional contouring, plastic surgeons also reshape and tighten the abdominal muscle that has become lax due to weight fluctuations or previous pregnancy.
Traditionally, tummy tuck uses a horizontal incision that is positioned as closed as possible to the pubic region in an attempt to hide it. Meanwhile, the scar’s length and appearance (U-shaped or straight) depends on the amount of correction a patient needs.
After surgery, almost all patients are instructed to wear compression garment continuously for at least two weeks; this binder, according to several studies, can provide countless of benefits such as less swelling, quicker recovery, and less risk of infection caused by seroma—just to name a few.
A tummy tuck compression garment is also used to support the new contour and the abdomen as patients cough, breathe, sit, and stand.
With the continuous use of binder and surgical drains, it is possible to avoid or at least minimize the risk of seroma or fluid build-up in the abdomen, which is closely tied to more swelling and infection.
And by minimizing seroma and swelling, compression garments have been known to encourage faster and more convenient recovery as long as they are properly worn and they fit snugly.
While a good binder should fit snugly, it should not be too tight that it affects normal blood flow in the tissue, something which could result in delayed healing and other related problems. Too much compression may also lead to higher risk of blood clots and swelling in the legs.
However, these potential drawbacks can be avoided by getting the right binder size—i.e., it provides enough amount of compression and support but still allows the blood to flow easily toward the wound.
But the “potential” side-effect of compression garments on blood flow is little in comparison to the actual surgical technique’s. The rule is to maintain an excellent blood flow in the tissues to minimize the risk of blood clots and poor wound healing.
Most patients are instructed to wear their first-stage compression garments continuously for two weeks, except when bathing or showering. It is ideal to have at least two binders so they can always have something clean to wear.
After two weeks, most patients can shift to a second-stage binder which is worn less frequent.
Abdominoplasty or tummy tuck comes in two basic techniques that are based on the length of incision: traditional and mini tummy tuck. To improve results, the surgery is occasionally performed in conjunction with liposuction in which the goal is to remove the “superficial” fat near the skin.
The length of incision is one of the factors dictating the length of recovery, thus mini tummy tuck generally requires a shorter healing time because of its shorter incision that typically measures 10-15 cm, versus a hip-to-hip scar used in the traditional or full abdominoplasty.
For most mini tummy tuck patients, they can resume normal activities and return work a week or two after their surgery. However, this generalization only applies if they only have desk jobs or light work.
Meanwhile, patients should postpone going to work if it involves heavy lifting and strenuous tasks.
Aside from the length of incision, the extensiveness of muscle tightening also affects the average recovery time. For patients whose abdominal muscle has received little or no manipulation, they could expect less post-op symptoms and shorter downtime compared with those who have a more extensive surgery.
While most patients can return to normal activities a week after their surgery, heavy lifting and straining too much should be avoided for at least six weeks to prevent wound reopening, bleeding, and other complications that may jeopardize the final result of mini tummy tuck.
To support the new contour, most plastic surgeons require the use of compression garments for two to three weeks.
Meanwhile, it is possible to shorten the recovery time through keeping the swelling at a minimum; this can be done by avoiding salty and fatty food, wearing compression garments, using surgical drains for about a week, and having lymphatic drainage massage.
However, the purported benefits of lymphatic drainage massage are still up for debate. Proponents argue that deep strokes can help edema, or accumulation of bodily fluids, to resolve faster, while other doctors suggest that it has no or very little effect on the final result.
While the incision length and the amount of muscle tightening during a mini tummy tuck dictate the recovery time, it is important to note that each patient heals differently. For instance, it is safe to surmise that younger women tend to heal faster than older ones.
Also, smokers experience longer recovery than non-smokers because the nicotine constricts the blood vessels and prevents normal delivery of nutrient-rich blood to the wound. For this reasons, a good doctor will not perform cosmetic surgeries on smokers unless they will stop smoking well in advance of their operation.
A good plastic surgeon will make every effort to minimize or hide the appearance of scars without jeopardizing the result of surgery. The same principle particularly applies to tummy tuck, also called as abdominoplasty, that is used to remove the excess skin and fat and at the same time contour the waistline.
Tummy tuck is typically performed by creating a horizontal incision below the navel. As much as possible, plastic surgeons position it very close to the pubic area in an attempt to hide the scar even if you are wearing a scanty bikini or extremely low-cut jeans.
However, it may be difficult to position the scar very low if the traditional tummy tuck is used, a procedure you will likely need if you have a significant amount of hanging skin and fat in your abdominal area.
Meanwhile, it may be possible to lower the horizontal incision in the traditional tummy tuck if another incision, which runs vertically in the mid line slightly above the pubis, is simultaneously used.
Take note that the shape of the scar is also dictated by the amount and position of the excess skin and fat. While some doctors use straight incision in an attempt to lower the scar, many surgeons prefer to curve it up a bit, resulting in a U-shaped scar, because it allows them to create a more natural contour.
Sometimes, tummy tuck is combined with a buttock lift; this combo procedure is typically reserved for massive weight loss patients dealing with significant deformity. While it can provide a near normal appearance, the caveat is the belt-line scar extending around the waistline.
Always bear in mind that the placement and length of the incision is not based on what you want; primarily, it is based on your underlying anatomies, amount of hanging tissue, position of your navel, etc. There is no point of using a very short incision if the surgery cannot provide a desirable silhouette.
Even with the use of long incisions, they can heal and fade into a barely visible line with the right techniques such as minimizing the tension in the skin to avoid widening of the scars.
During consultation, your doctor might ask you to bring bikini panties that you usually wear so he can determine if he can possibly lower the scar to hide it, but not to the point that he will compromise the overall result.