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The Tummy Tuck (Abdominoplasty) remains one of the most frequently performed cosmetic plastic surgery procedures. After blogging about the extreme tummy tuck last week, the fleur-de-lis tummy tuck, I received a lot of questions about when I would use that technique instead of a traditional abdominoplasty. Bay Area residents want to know, so let me start small and work my way through the time-tested techniques for tucking your tummy — from liposuction to the fleur-de-lis abdominoplasty.

Abdominoplasty before and after pictures

Abdominoplasty - Left (before): Multiple rolls of redundant skin are seen after massive weight loss. Right (after): The loose abdominal skin is removed and the muscle wall is tightened, making finding clothes that fit much easier.

Tumescent Liposuction (Liposculpture, Suction Assisted Lipectomy or SAL)

Diet and exercise are always the first line of defense. No plastic surgery can eliminate the need for a proper diet and exercise plan. However, there are some problems that diet and exercise cannot fix. Localized accumulations of fat, which are disproportionate, are discussed in the previous post about Tumescent Liposuction. For bellies with small amounts of excess fat, that have good muscle and skin tone, tumescent liposuction provides a simpler and faster alternative to tummy tucks. Liposuction (SAL) cannot tighten loose skin. Even laser liposuction (LAL) and ultrasonic liposuction (UAL) cannot tighten skin that has lost its tone. If fact, liposuction can make loose skin look worse by further deflating the skin. By removing the fat, the support for the skin is removed, and the skin will fold over itself. The tummy tuck was designed specifically to address this problem.

Mini Tummy Tuck (Mini-Abdominoplasty)

When the abdominal skin and muscle laxity is isolated to the area below the belly-button (umbilicus), a mini tummy tuck may be the best option. For a mini tummy tuck, liposuction is often used in the upper abdomen and the sides to reduce unwanted fat, and a low abdominal incision is used to tighten the skin and muscles of the lower abdomen.

Tummy Tuck (Abdominoplasty) With a “Floating” Belly-Button

In situations where the abdominal skin and muscle laxity is isolated to the area below the belly-button, but there is a small amount of loose skin just above the belly-button a “floating” belly-button technique is used. This is not the normal way to do a tummy tuck, and patients for this technique need to be carefully selected by an experienced, Board Certified Plastic Surgeon. If you are a candidate, however, it usually means more improvement with the same scar as a mini tummy tuck.

Tummy tuck before and after pictures

Tummy Tuck - Top (before): Excess skin, muscle laxity and disproportionate lower abdominal fat contribute to a flabby appearance. Bottom (after): Excess skin and fat have been removed, and the abdominal muscles tightened. The sides of the rectus abdominus muscle are closer to the midline after the repair.

Tummy Tuck (Abdominoplasty)

The tummy tuck or abdominoplasty is the work horse of abdominal rejuvenation, and the gold standard to which every other abdominal tightening procedure is compared. It requires and incision low on the abdomen, and one around the umbilicus. The procedure allows not only for tightening the abdominal skin, but the removal of excess fat and tightening of the muscles of the abdominal wall. This muscle tightening provides a tighter foundation on which to build your new tummy.

Fleur-De-Lis Tummy Tuck (Fleur-De-Lis Abdominoplasty)

The fleur-de-lis tummy tuck is used when the amount and laxity of the abdominal skin is massive. This is most often seen after bariatric surgery or weight loss of greater then 75 pounds. The fleur-de-lis abdominoplasty incorporates all the features of a tummy-tuck with an additional incision running down the middle of the abdomen to remove excess skin from the midline. It is the biggest operation available, designed to reduce the most extreme amounts of excess abdominal skin.

The Lower Body Lift (Belt Lipectomy)

The lower body lift is a tummy tuck that extends all the way around to body. It is almost exclusively performed in post-bariatric surgery patients. The combination of extreme weight gain stretching out the skin, followed by loss of this weight, leaves a skirt of loose skin that can extend all the way around the back. In these cases, additional weight loss will not improve the appearance. The lower body lift is also called a belt lipectomy because a belt of excess skin and fat is removed. The abdominal muscles can also be tightened to enhance the abdominal contours, like in a traditional tummy tuck.

Body Beautiful on KRON4

Next Monday, March 14th, at 11:00 AM, I will be on KRON4’s Body Beautiful discussing Tummy Tucks. Feel free to call in and have your questions answered live, on the air. For a less public response, use the contact form on the left. While I do my best to provide you with accurate general information about all aspects of cosmetic plastic surgery on the San Francisco Plastic Surgery Blog, the only way to get information specific to your needs is with a personalized consultation appointment. Give me a call at (925) 943-6353 to schedule your consultation today.

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