Major tummy tuck surgery entails not just the removal of apron-like abdominal skin. To achieve more proportionate and natural-looking results, it typically combines other surgical maneuvers including liposuction (fat reduction), muscle repair, navel repair, and pubis lift.
Dr. Tarick Smiley, a celebrity Beverly Hills plastic surgeon, has recently posted a series of videos on Snapchat to demonstrate one case of major tummy tuck in which the female patient has large redundant skin following massive weight loss.
While the standard tummy tuck uses a hip-to-hip incision pattern, the patient has required an extended version, meaning the scar slightly extends into the side. Nonetheless, Dr. Smiley has made every effort to place it “beneath” the bikini area (i.e., very low) for its optimal concealment.
But prior to the removal of excess skin, Dr. Smiley had performed liposuction of the flanks in which the unwanted fat was removed with a cannula (straw-like device attached to a vacuum pump). This additional step would allow the patient to achieve a more slender, curvier side.
In the past, tummy tuck and liposuction performed at the same time was greatly discouraged due to the perceived higher risk of complications. However, recent clinical studies and surveys have shown otherwise. Provided that liposuction is not too aggressive (i.e., only a small amount of fat is removed) and it does not involve the area above the navel, the combo procedure is reasonably safe.
Meanwhile, large volume liposuction or extensive liposuction involving the area above the belly button is ideally performed 3-6 months after tummy tuck to allow the body, particularly its blood supply, to recover from the surgical trauma.
Going back to the topic of major tummy tuck’s components, it is also critical to reshape the belly button, which might become distorted or enlarged following massive weight loss or pregnancy. In the video, Dr. Smiley is seen creating an incision around the inner rim of the navel to improve its appearance and to look more proportionate with the slimmer waistline.
To further create more proportionate results, the patient received pubis lift (the area is susceptible to sagging after massive weight loss). The idea is to encourage a smooth transition between the mons pubis and the lower abdomen.