Tummy Tuck or Mini Tummy tuck?
I get many patients who come in requesting a Tummy Tuck. The biggest plus is the fact that they will get a much flatter tummy, and if they get liposuction around the love handle area, a drastic reshaping of the entire midsection. The biggest drawback is the scar. It goes most of the time from hipbone to hipbone. Invariably, I get the question, can we do a mini tummy tuck? The patient is hoping to get most of what she needs with a smaller scar and a less involved surgery. What to do?
The first thing for the patient to realize is that although the two procedures, tummy tuck and mini tummy tuck, have a similar name, they treat different conditions. Please view my illustration above to see the difference between the two procedures. My schematic shows the amount of skin removed, the amount of muscle work performed, and the final incisional scar in each procedure.
Mini Tummy Tuck
The Mini Tummy Tuck treats the minor pouching out of the lower belly caused by stretching of the lower abdominal muscles. It is primarily a muscle tightening procedure. Combined with liposuction of the love handles it can truly reshape the midsection. One word of caution: I always take out the deep layer of fat in the lower abdomen, because if I don’t, fat will redistribute in that pocket . You cut out enough skin to take out the slack created by tightening the muscle and defatting the skin, and the scar just goes from one side of the pubic mound to the other. It is a very well disguised scar, and very thin because not much tension is used to close the scar. It’s a great procedure provided you are committed to it’s limitations.
These are the conditions and limitations for the Mini Tummy Tuck:
- The procedure is not a good skin tightening procedure.
- It can only tighten a limited area directly above the pubic mound. If you try to tighten more, you end up extending the scar sideways, and you get a longer scar that is no longer well hidden and still not the amount of tightening that will make you happy.
- It really doesn’t take care of stretch marks.
- It does not take care of any muscle wall separation above the belly button.
The Tummy Tuck treats two conditions: a muscle separation above and below the belly button; and excessive or loose skin in the belly. It is really two operations, a muscle repair and a skin excision. The skin excision part is called a Dermatolipectomy. All the skin between the belly button and pubic mound is taken out. Thus it can take care of all the stretch marks below the belly button. The skin above the belly button is stretched to reach the top of the pubic mound. Any stretch marks above the belly button will come to lie just above the pubic mound.
The scar from a Tummy Tuck usually goes from hip bone to hip bone, but this is not an absolute. If there is a lot of loose skin, or a fold of abdominal skin, the scar may extend beyond the hipbones. However, keep in mind that I can strategically place the scar below the panty line. Sometimes I can make the scar slightly shorter, but the patient has to be aware she might have darts or little pouches on the side of the wound, which can be taken care of later under local anesthesia. This is important when a patient wants to keep the scar within the limits of certain underwear or bathing suit.
There is a third surgical alternative for patients who have just a muscle separation and very little skin excess, or who want no visible scars. The whole procedure is done through the belly button, and I will make a separate post devoted to this surgical technique.
You’ll need help If your abdominoplasty is performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.
Tummy tuck procedure steps and results
What happens during tummy tuck surgery?
Medications are administered for your comfort during abdominoplasty surgery. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.
Step 2 – The incision
A full tummy tuck procedure requires a horizontally-oriented incision in the area between the pubic hairline and navel. The shape and length of the incision will be determined by the degree of correction necessary.
Through this incision, weakened abdominal muscles are repaired and sutured while excess fat, tissue and skin is removed.
A second incision around the navel may be necessary to remove excess skin in the upper abdomen.
Your abdominoplasty procedure will result in a flatter, firmer abdominal contour that is more proportionate with your body type and weight.
The final results may be initially obscured by swelling and your inability to stand fully upright until internal healing is complete.
Within a week or two, you should be standing tall and confident about your new slimmer profile.
Tummy tuck recovery
Following your surgery, dressings or bandages may be applied to your incisions, and you may be wrapped in an elastic bandage or a compression garment to minimize swelling and to support your abdomen as it heals.
A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect to minimize swelling after tummy tuck surgery.
You will be given specific instructions to aid your recovery from tummy tuck surgery: how to care for the surgical site, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in your general health, and when to follow-up with your plastic surgeon.
tummy tuck recovery
Be sure to ask your plastic surgeon specific questions about what you can expect during your individual abdominoplasty recovery period.
- Where will I be taken after my surgery is complete?
- What medication will I be given or prescribed after surgery?
- Will I have dressings/bandages after surgery? When will they be removed?
- Are stitches removed? When?
- When can I resume normal activity and exercise?
- When do I return for follow-up care?
Previous abdominal surgery may limit the potential results of a tummy tuck. In women who have undergone cesarean section, the existing scars may often be incorporated into the new scar.