Tummy Tuck
Surgery

Abdominoplasty, the medical term for what is commonly called a “tummy tuck”, involves surgically removing excess skin and fat from the middle and lower part of the abdomen and sometimes tightening the abdominal muscles. The result is a flatter abdomen, and sometimes a smaller waist, because the procedure corrects loose, sagging skin and excess fat. Both women and men are candidates for tummy tucks. The procedure is especially useful for women whose skin has stretched after more than one pregnancy. For people whose fat deposits are just on the lower part of the abdomen, a partial abdominoplasty, or mini-tummy tuck, may be an option.

Abdominoplasty is one of the most artistic and demanding procedures performed in plastic surgery. Excellence in abdominoplasty means careful planning of incisions; tightening of muscles; liposuction; preventing “dog ears,” bulges, and wide incisions; and blending in the contours to the adjacent hip and groin regions. Dr. Romano does this with great artistry and care, yielding magnificent results. There are several variations of tummy tucks (abdominoplasty) that Dr. Romano offers depending upon your anatomy:

• Standard Abdominoplasty: This is the most complete and artistic operation under most circumstances.
• Mini Abdominoplasty: (Mini-Tummy Tuck). This is an abbreviation of the above procedure for select patients who have loose muscles and not too much loose skin. (This enables the incision to be shorter.)
• Midline Abdominoplasty: This is an excellent procedure for select patients whose laxity is side to side. The incision is up and down in the center of the abdomen.

The tummy tuck surgery is one of the most often requested of all of the body contouring procedures I perform. Excessive, loose or hanging abdominal skin is a condition that patients consistently dislike, and it frustrates them because of their inability to make it better despite diet and exercise. This loose skin can make it difficult to fit in clothing and tuck in shirts or blouses. Patients come to me for a variety of reasons, some want me to remove old incisions and scars or to remove different degrees of fat and stretch marks and abdominal-wall-muscle laxity. These features may be a result of pregnancy or weight loss or just the aging process. The anatomic features that contribute to this condition is excess and loose hanging skin, often but not always associated with muscle laxity. There may also be some degree of excess fat. There is laxity in the ligaments that course from the muscles to the skin to support these areas. The relationship between the amount of excess skin, skin elasticity, vectors of laxity, and excess fat is what determines the surgical intervention and incisions. I will coordinate all of these features of your anatomy with your expectations, formulate a plan with you, and guide you through this process.

The surgery involves some liposuction, and then making a bikini incision that hides low on the abdomen, concealed by even very the most revealing garments. The belly button is preserved and looks very natural and youthful. Through the same abdominoplasty incision, prominent lower ribs can be contoured and I create a space to loosen any retaining ligaments, pull the edges together at just the right tension, trim the excess skin, and close up the incisions. Surgery involves a general anesthetic and an overnight stay in the hospital and is performed where I do surgery, which is in a hospital setting using an experienced MD anesthesiologist. The surgery is safe and predictable. There is some pain and swelling after surgery, but this is not severe or prolonged. The stitches are all dissolvable, with return to activity and some work in as little as ten to fourteen days and to some physical exercise in the third week.

The surgical procedure and results of tummy tuck surgery depend on your anatomy, the specific area involved, the amount of excess skin, and the vectors of laxity. Collectively these features all determine where the incisions need be made, how long the incision will be, and how much tissue will be removed. There are several variations of the tummy tuck/abdominoplasty operation that I offer patients in my practice depending on your anatomy:

• Standard Abdominoplasty: As describe above, this is the most complete and artistic operation under most circumstances.
• Mini Abdominoplasty: This is an abbreviation of the above procedure. I have distinctly determined over the years that it is well suited to only a few select patients. If you have loose muscles and not too much loose skin, the incision can be shorter.
• Midline Abdominoplasty: This is a great operation in select patients whose laxity is side to side. The incision is up and down in the center of the abdomen.

Please also review Dr. Romano’s article on body contouring in the Educational Articles section of the website.