Cosmetic Surgery

Abdomen Reduction at Mayo Clinic

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(Synonyms: abdominoplasty, tummy tuck)

A flabby abdomen is due not only to fat, but to poor elasticity of the skin, excess skin, and a stretching of the inner girdle of connective tissue (fascia) and abdominal muscles (rectus muscles) that extend from the ribs to the pubic bone. This inner girdle, which holds the internal organs in place, is responsible for the tone and appearance of the abdomen.

Particularly after this fascia has been stretched during pregnancy or weight gain, the abdomen protrudes. Abdominoplasty (tummy tuck) can remove loose, excess skin and fat, and tighten slack fascia.

A tummy tuck also can remove stretch marks and excess skin in the lower abdomen below the belly button. Liposuction may be used to improve the contour of flanks or hips. A tummy tuck may narrow the waist, but not the hips. To achieve a balance between the two, the surgeon may recommend liposuction of the hips and thighs at the same time.

Anyone planning on losing weight should do this before a tummy tuck. Significant weight loss after the procedure can result in even more excess skin.

Candidates for abdominoplasty must abstain from all nicotine products and avoid secondhand smoke for at least six weeks before and after surgery, and refrain from taking aspirin three weeks before and after surgery.

What to expect

Abdominoplasty entails removing most of the skin and fat between the belly button and pubic hair in a horizontal oval or elliptical shape. The fascia, which overlies the abdominal muscles, will be tightened with permanent sutures.

The skin around the belly button will then be repositioned. The belly button will be brought out through a small incision and sutured in its normal position. The incision from hip to hip above the pubic hair will be stitched together and will leave a scar that falls along the natural crease within the bikini line. The length and visibility of the scar varies from person to person.

Drains may be placed during surgery to prevent fluid collections (seromas). In some cases, drains are left beneath the skin for several weeks following surgery. Patients will be instructed how to empty and care for drains. They will also wear a supportive garment, called an abdominal binder, for four to six weeks after surgery. This helps prevent fluid buildup and provides abdominal support during healing.

Risks

Risks associated with abdominoplasty include, but are not limited to:

• Infection
• Seroma (fluid collection beneath the skin) is the most common risk of tummy tuck surgery. Drainage tubes left in place help reduce this risk. Fluid may also be removed by the surgeon in the office using a needle and syringe.
• Hematoma, a collection of blood under the skin.
• Smoking, diabetes and excess weight increase the risk of skin death. Depending on the size of the area, skin may heal on its own within weeks or require another operation to remove.
• Reduced sensation or numbness in the abdominal area, and sometimes, in the upper thighs. This usually diminishes in the months following the procedure.

This procedure is performed by specialists in Plastic and Reconstructive Surgery.