Pregnancy, weight loss and the natural ageing process can all cause the abdominal muscles and the skin on the tummy to become weak and loose, which in turn can mean that no amount of exercise will smooth or tighten the area.
Tummy tuck also known as abdominoplasty is a surgical procedure that addresses excess skin and lax abdominal muscles whereas liposuction addresses only excess fat. Tummy Tuck is part of the group of ‘body-contouring’ procedures, which also includes Fat Removal (liposuction), Skin-Tightening (arm, thigh and buttock lifts) and Muscle enhancing (calf, buttock and pectoral implants, and abdominal six-pack etching).
Dr Allen Rezai, leading Consultant Plastic and Reconstructive Surgeon of Harley Street, London, and leader of Elite Plastic & Cosmetic Surgery Group in Dubai Healthcare City, says “Abdominoplasty is becoming increasingly popular in the Middle East, is the 2nd most sought after body contouring procedure after liposuction”.
Best candidates for Tummy Tuck surgery, according to Dr Rezai, include individuals who have loose abdominal skin and muscles, stretch marks, and/or extra fat buildup which is resistant to regular exercise routines and healthy diets. “As with liposuction surgery, abdominoplasty is not a treatment to be used for weight loss or obesity, in fact, the most ideal candidates are often people who are more slender, with loose skin.” Additionally, he says “patients should be in good general health, at or near a stable weight, and have realistic expectations for the final outcome.”
Technical Variations of Abdominoplasty
Procedures used to reshape the tummy include liposuction, mini-abdominoplasty (also includes apronectomy), standard abdominoplasty, extended abdominoplasty and flankoplasty.
Mini-Abdominoplasty also known as mini-tuck,
Excess skin and fat above the pubic bone are removed.
The Abdominal muscles below the belly button (umbilicus) can also be tightened if needed.
The belly button remains intact.
The procedure is performed under general anaesthesia, takes sixty to ninety minutes, and is occasionally done as a day case. However, most patients stay in hospital overnight.
Apronectomy (a form of mini-abdominoplasty)
Involves removal of larger excess skin and fat (the apron) hanging down over the pubic area and genitals.
The belly button remains intact.
The procedure is performed under general anaesthesia and may take up to two hours. Patients stay in hospital overnight.
Excess skin and fat between the pubic bone and belly button is removed and the abdominal muscles are tightened.
This leaves the belly button itself in place. However, in pulling the skin at the level of the umbilicus down to the pubic level, the umbilicus must be brought through the new skin lying over it. Consequently, this form of tuck results in a long curved scar at the pubic level, along with a circular scar around the umbilicus.
The procedure is performed under general anaesthesia and may take up to three hours. Drains may be used, and patients remain in hospital for at least one night.
This is a more radical extensive procedure than standard abdominoplasty.
The incision is continued around the waist and onto the back.
Excess skin and fat are removed from this wider area around the flanks, resulting in a longer scar.
As with the standard abdominoplasty, the umbilicus must be brought through the skin, resulting in a scar around it.
The procedure is again performed under general anaesthesia, and may take between three to five hours to perform, especially as the patient has to be turned during surgery. Patients remain in hospital for at least one night.
All the above procedures can be combined with Muscle Plication, in which the muscles over the abdominal wall are sutured back in to position, tightening the muscles, flattening the tummy and reducing the waistline.
An important point of consideration with abdominoplasty is scarring. Scarring will fade over time and, in many patients, will heal to form very faint white lines. However, it is important to remember that surgical scars are permanent and will never totally disappear.
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The following is a classification system developed to better determine the type of procedure required:
Indication: Fat deposit with normal/tight abdominal muscles and skin.
Treatment: Liposuction only
Indication: Mild excess skin, normal/tight abdominal muscles with or without excess fat
Treatment: Mini-abdominoplasty with or without liposuction
Indication: Mild excess skin, abdominal muscle laxity below the umbilicus with mild to moderate excess fat:
Treatment: Apronectomy with muscle plication, with or without Liposuction
Indication: Mild excess skin, total (above and below umbilicus) abdominal muscle laxity with or without excess fat:
Treatment: Mini or Standard Abdominoplasty with muscle plication, with or without Liposuction
Indication: Large excess skin, total muscle laxity, with or without excess fat:
Treatment: Standard or Extended Abdominoplasty and flankoplasty with muscle plicaton, with or without liposuction.
Patients with excess abdominal wall fat usually benefit from weight loss prior to an operation. Pre-operative weight-loss is especially encouraged for patients with significant excess intra-abdominal fat (fat beneath the abdominal wall muscles). These patients have a somewhat bulging abdomen with minimal to moderate excess abdominal wall fat (sub-cutaneous fat), normal abdominal muscles and no excess skin.
The Importance of a thorough Consultation
The importance of the initial consultation cannot be overemphasised. At your consultation, Dr Rezai will fully discuss every aspect of your aesthetic goals and address any concerns you may have. He places the utmost importance on providing his patients with all the information they need to make fully informed decisions, ensuring each one arrives at the outcome that’s best for them.
A thorough medical history and physical examination during the consultation usually reveals whether or not you are a good candidate for the procedure, and if so, what the best treatment option would be. Working together during your consultation, a bespoke surgical plan will be developed for you. Dr Rezai will explain in detail the treatment options available, the techniques that would be used, and any potential risks and complications you need to be made aware of.
Dr Rezai uses his expertise and experience to guide you towards the best option, taking into account your anatomy, aesthetic goals and personal circumstances.
For more information about surgical and non-surgical Body Contouring procedures, or to book a Consultation with Dr Allen Rezai please visit Elite Plastic & Cosmetic Surgery Group’s website
or call +971 4 431 2396