Are you sick of doing hundreds of sit ups a day without seeing the results in your abdomen? Is regaining your pre-baby, or ideal weight, tummy eluding you? Are you unhappy with the stretch marks and prune appearance of your abdomen? A tummy tuck may seem like a drastic measure, but it may be the answer for you.
Surely my belly will flatten with enough diet and sit-ups?
The abdomen is usually stretched by one of two means – a baby or intra-abdominal contents (most often fat). Once this stretch is removed, the degree to which the abdomen retracts to its initial state depends on a handful of factors – genetics, remaining muscle position/exercise and tone, the amount of fat between the skin and muscle and the remaining structural integrity or tone of the skin.
The main factor that will prevent a pre-stretched abdomen from flattening is “rectus muscle divarication.” This term describes the process of the stretching of the mid line strong fibrous connection between the six pack muscles. Although you can strengthen the abdominal muscles and lose the overlying fat, there is no method (other than surgery) of tightening this fibrous connection once it is stretched. In fact, strengthening the abdominal muscles may result in the stretch worsening as the oblique muscles overpower the rectus muscles and continue to pull them away from the midline.
What is involved in an abominoplasty?
Like many operations, a tummy tuck (abdominoplasty) needs to address several components to achieve the best results. An abdomen can be thought of being like a building, with foundations (muscle position and support), framework (fat) and then the exterior appearance (skin). Addressing one component without considering the others is likely to provide a sub-optimal result.
Your skin tone, position of fat, muscle position and tone, any hernias or prior scars will help determine which technique or pattern will give you the best results. Additionally your needs such as ability to take time of work and sports and the importance of scar position and length will need to be considered.
Complete abdominoplasty techniques involve:-
- Moving the rectus (six pack) muscles back into the midline
- Removal of fat surgically and by liposuction
- Removal of excess lower abdominal skin and stretch marks
- Placement of a scar in the bikini line, much like a good caesarean scar
- Replacing the umbilicus into a normal position
Which technique of abdominoplasty is best for me?
There are two main types of abdominoplasty techniques. The main differences are the pattern of skin and fat excision, and the direction of tension placed on the final closure of the wound. The Pitanguy abdominoplasty removes more skin and fat in the midline than closer to the waist, and closes mostly in a top to bottom fashion. The Lockwood abdominoplasty removes a more even distribution of skin and fat across the width of the abdomen and closes with tension from the waist towards the midline. The distribution of your fat, and to some extent preference, will determine which technique is better for you.
Very occasionally, a mini-abdominoplasty will be recommended. This is appropriate for patients with only lower abdominal (below the belly button) skin, fat and muscle laxity. The trade off for a slightly shorter scar, operating time and recovery is that the operation does not go above the belly button, so any laxity or stretch there is not repaired.
There are lots of other techniques that can be used, and each is appropriate for different patients and abdomens!
Will liposuction only work?
Very few patients will have a great result from liposuction only. Without repairing the abdominal muscle position and removing any skin damaged by stretch marks, the most likely result is a tummy that is less fatty but more droopy. It is like wearing an old jacket (or sleeping bag) where the filling has been compressed or worn out, but the layers on either side have not been changed.
We only offer liposuction only abdominal contouring to patients with good skin and muscle tone that have pockets of fat that are resistant to weight loss and toning. Such patients are generally young and athletic with love handles or small tummies.
When should I think about a tummy tuck?
The ideal time for a tummy tuck is after your weight has been stable for a year or so. The closer you are to your ideal weight, the better your result will be and the longer it will last. And the happier you will be!
If you are planning another pregnancy – wait! The abdominal muscle repair will not cope with being stretched by another baby.
Abdominoplasty is not an operation to lose weight. Even in abdominoplasties that remove large amounts of skin and fat, the weight removed is often only in the order of 4-5kg, and requires 4-6 weeks off exercise. You will achieve a better result by working harder at weight loss and planning an operation as your reward to yourself for achieving your weight goal.
Want to discuss your options?
Sydney Plastic Surgeon Dr Gavin Sandercoe and his team will help you decide which course of action is best for you to achieve and maintain the figure that you desire. Find out more during a surgical consultation.