Abdominoplasty, known more commonly as a "tummy tuck”, is a major
surgical procedure to remove excess skin and fat abdomen and to tighten the
muscles of the abdominal wall. The procedure can dramatically reduce the
appearance of a protruding abdomen.
Indications:
The best candidates for abdominoplasty are men or women who are in
relatively good shape but are bothered by a large fat deposit or loose
abdominal skin that won't respond to diet or exercise. The surgery is
particularly helpful to women who, through multiple pregnancies, have
stretched their abdominal muscles and skin beyond the point where they can

return to normal. Loss of skin elasticity in older patients, which frequently
occurs with slight obesity, can also be improved.

18.A: Bulging of lower & middle abdomen- before. B: After abdominoplasty.

Women with excess skin or lax fascia may try diet and exercise, only to
discover that weight loss and improved muscle tone do not solve these
problems. A tummy tuck offers these women an opportunity to regain the
tighter, flatter abdomen they had in youth

16&17.A: Before abdominoplasty. B: after operation- see point to point comparisons

The surgery
There are several ways to perform a tummy tuck. The most common technique is called a
full tummy tuck or full abdominoplasty and involves four steps (Figure ]
1. Removing the excess skin and fat between umbilicus and pubic hair in a horizontal
oval
2. Tightening the fascia with permanent sutures
3. Repositioning umbilicus (Umbilicus does not actually move, but the skin
surrounding it does)
4. Suturing together the remaining skin above pubic hair [photo-14,18].

Modified Techniques
Some modifications of the standard tummy tuck have evolved to address the issues of
women with different concerns.
1. Mini tummy tuck. This procedure removes loose skin of the lower abdomen, but it
does not reposition the skin around the umbilicus or tighten loose upper abdomen skin. It
may or may not tighten the fascia of the lower abdomen. It is best suited to thin women
with firm inner girdles who have loose lower abdominal skin.

2. Panniculectomy. A pannus is skin and fat that hangs below the abdomen in the shape
of an apron. Women who have a pannus are commonly very overweight. Because of their
weight, a full abdominoplasty poses substantial healing risks, so a panniculectomy
(pannus removal) might be recommended instead. This operation removes hanging skin
of the lower abdomen and does nothing with the fascia or the skin above the pannus
3. Conservative abdominal liposuction with a full tummy tuck. This procedure is
performed for women who desire conservative liposuction of their upper abdomens and
flanks. Because of possible healing complications, aggressive abdominal liposuc-
tion should not be performed at the same time as a full tummy tuck.[photo-15,16,17,]
4. Endoscopic tummy tuck. In this technique, an endoscope is used to tighten the fascia,
but the skin is not removed. Liposuction of the abdomen may be more thorough than the
other techniques.Because most women with lax fascia also have loose skin, this technique
is not commonly indicated.

Hospitalization & post-operative care:

For 1 to 4 days.
Stitch removal after 5 to 7 days.
Support garment/abdominal binder for 6 to 8 weeks.
Back to routine work: within 2 to 4 weeks.
Complications: Delayed healing, hematoma formation, infection , Umbilical
necrosis, Numbness and pigmentation changes ,rarely fat embolism.

Reasons to Avoid or Postpone a Tummy Tuck
Future Pregnancies, Previous Abdominal Scars, Obesity, Smoking &
medical problems contradicting the surgery are the problems when
the surgery is either post-pone, contra-indicated or the incision is altered .

See Photo Gallery