The female patient shown in the videos has a significant amount of stretch marks above and below the navel due to previous pregnancies and weight fluctuations. Furthermore, there was a C-section scar below her belly button.
The patient received the standard tummy tuck technique in which the resulting scar went from hip to hip and was positioned very low so it would be well concealed by the underwear.
But before the actual tummy tuck surgery, Dr. Smiley performed liposuction of the flanks. The idea was to remove the excess fat along the lateral trunk so he could “pull the skin better” and ultimately deliver a smoother, more feminine contour.
In the video, Dr. Smiley said he used the tumescent liposuction technique in which the fatty area is infiltrated with a solution that contains epinephrine to control bleeding, and lidocaine, which is a type of local anesthesia to numb the treated site.
After sculpting the flanks with liposuction, he proceeded to the creation of tummy tuck incisions, allowing him to remove the loose skin, together with the stretch marks, in the lower abdomen.
While some of the stretch marks along the upper abdomen were not removed during surgery, there is a significant improvement nonetheless (about 90 percent reduction). It is important to preserve enough skin to allow good wound closure and to ensure a well-concealed tummy tuck scar and “unremarkable” healing.
Before closing the curved tummy tuck incision, Dr. Smiley tied the separated abdominal muscle that runs between the sternum and the area just above the pubis. He used permanent sutures that were created one at a time to ensure that each stitch was as strong as the next.
Furthermore, Dr. Smiley corrected the supra-umbilical hernia right above the navel, a common issue among tummy tuck patients, he said.
A hernia is a tear in the abdominal fascia, which is a sheet of connective tissue, and so the abdominal fat or intestine pokes through and thus it may lead to medical problems (e.g., blood flow blockage or organ “strangulation”). Hence, this “hole” must be reinforced with sutures or sometimes with the use of mesh by the surgeon performing the tummy tuck.