DIFFERENT TYPES OF TUMMY TUCK PROCEDURES

What is a Tummy Tuck (Abdominoplasty)?

Tummy Tuck, also referred to as Abdominoplasty, is a surgery performed to address concerns that relate to the belly following trauma, pregnancy and/or weight loss. The most common concerns are stretch marks (scars caused by skin that has been forced to stretch too much too quickly), excess skin, excess fatty tissue and weakened separated muscles. Other problems can include hernias involving the belly button and significant abdominal wall muscle separation that can affect posture and result in lower back pain. In addition, individuals can express concerns regarding their pubic area which includes fullness and ptosis (droop). This typically causes difficulties with tight fitting clothing and hygiene problems.

These concerns can be addressed with a well-planned Tummy Tuck (Abdominoplasty). The excess skin can be removed including most, if not all, of the lower abdominal wall stretch marks. Doing this means removing many of the stretch mark scars that you can’t hide, and creating a single scar below your bikini line that can be comfortably hidden. If required (and it usually is), the pubic area is thinned out and lifted.

Also, any muscle separation (along with any hernias) is also repaired. This is a vital part of most Tummy Tucks and provides significant functional benefits. Ultimately the purpose of a Tummy Tuck (Abdominoplasty) is to primarily change function (medical/lifestyle issues) and secondarily change form (appearance).

All surgery involves scars. Whenever a surgeon makes an incision, a scar will form. No magic exists to prevent a scar from forming or to make a scar disappear. The surgeons’ job is to ensure the scars are ideally positioned and have the best chance of healing well.

When it comes to Body Contouring Surgery, in order to understand the scar patterns necessary, it is best to consider the entire procedure like dress making – the surgeon is the tailor, and they need to tailor your skin to fit your smaller body. Dressmaking involves removing material and running seams to create the best pattern/fit. In surgery, those seams are scars.

With respect to a Tummy Tuck procedure, the greater the contour improvement required, the greater the size and number of scars necessary – hence the different types of Tummy Tucks available.

Different Types of Tummy Tucks (Abdominoplasty)

The term Tummy Tuck is really a simple term that encompasses any operation that reconstructs the abdominal wall. This is because the degree of problems one has will dictate the type of Tummy Tuck that is necessary.

The different names applied to the different Tummy Tucks typically relates to the surgical scars created. Common names include:

• Mini-Tummy Tuck (Abdominoplasty)

• Regular Tummy Tuck (Abdominoplasty)

• Extended Tummy Tuck (Abdominoplasty)

• Fleur-de-lis Tummy Tuck (Abdominoplasty)

• OPEN BOOK TUMMY TUCK™ (Abdominoplasty)

Many variations exist within each type and the above is a very simplistic breakdown.

What is a Mini Tummy Tuck (Abdominoplasty)?

A Mini Tummy Tuck is less invasive than the standard Tummy Tuck (Abdominoplasty) surgery.

Many patients enquire about a Mini-Tummy Tuck, although it is only suitable for a small number of women. Specifically, it caters to those with a modest amount of loose skin in the lower abdominal area, just above the pubic level. Opting for this procedure implies contentment with and no need to alter the skin around the belly button and upper abdominal region.

Essentially, a Mini Tummy Tuck addresses excess and loose skin specifically in the very lower abdomen, just above the pubic area. The resulting scar is often comparable in size to a caesarean scar, and notably, there is no surgery of the belly button. This procedure typically qualifies as a day surgery with no associated muscle tightening.

What is a standard Tummy Tuck (Abdominoplasty)?

This is the commonest form of Tummy Tuck procedure. It involves correcting all three abdominal wall layers; that is, the skin, fat, and muscle layers. It is ideal for addressing vertical excess skin along the abdominal wall.

A horizontal incision is made in your lower abdomen usually made from hip to hip, just above your pubic region. Another incision is made around the navel to free the navel from the skin and fatty layer.

The skin and fat are lifted from the underlying abdominal muscles to the level of the rib cage. The ‘six-pack’ muscles are usually stitched together from the top to the bottom to surgically tighten them. This helps to restore a normal alignment to the ‘six-pack’ muscles and corrects any central hernias. Additionally, tightening these muscles acts like an internal corset, strengthening the abdomen, and helping create a stronger core. This muscle repair can sometimes help with lower back pain and continence issues. The skin and fat layers are then stretched down, and the excess skin and fat are removed from the lower abdomen. If required, the pubic area is lifted at the same time. Finally, a new opening is made for the navel, and it is stitched into position.

The resultant horizontal scar for a standard Tummy Tuck is typically hidden low down on your abdominal wall and concealed within normal underwear. Another scar is located within the belly button.

What is a Fleur De Lis Tummy Tuck (Adbominoplasty)?

The Fleur De Lis Tummy Tuck (FDL), is a more complex and extensive surgical procedure than a traditional Tummy Tuck. in addition to the excess skin removed from a traditional Tummy Tuck, a FDL Tummy Tuck is suitable for patients that also have excess skin horizontally along the lower half of their abdominal wall.

The Fleur De Lis Tummy Tuck incision includes the traditional horizontal incision from hip to hip which can be hidden by regular underwear. There is also another vertical incision from the bottom of the ribs down to the pubic area, intersecting with the first incision – resulting in an ‘inverted T’ scar.

This vertical midline scar arises from the removal of a large, inverted wedge like segment of skin required to remove the excess skin along the lower abdominal wall horizontally.

Therefore, more excessive skin can be removed during the Fleur De Lis procedure compared to a traditional Tummy Tuck procedure.

The amount of excess skin and acceptance of an additional scar will be what determines whether you have a FDL Tummy Tuck procedure.

So, you will have to decide whether you want optimal contour enhancement with more scars or less scars which means sub-optimal contour enhancement.

What Is The Open Book Tummy Tuck™ (Abdominoplasty)?

Whilst these above Tummy Tuck options will be an ideal choice for most patients, with the ever-increasing number of people changing their lives with life altering massive weight loss, better options were necessary to reconstruct their bodies.

As such, the Open Book Tummy Tuck™ (Abdominoplasty) was an operation born out of necessity. Dr Dona introduced this technique and coined the term “Open Book” based on how the abdominal wall appears halfway through the operation – the skin and fatty layers are opened like a book before being closed into its new form.

In addition to the excess skin that can be addressed with a FDL Tummy Tuck, the OBTT technique will also remove excess horizontal skin along the upper abdominal wall. So, you will have an additional Horizontal scar along the upper abdominal wall running within the lower breast fold – the vertical midline scar joins the upper and lower horizontal abdominal scars.

As is explained by Dr Dona, “when someone loses a massive amount of weight, they become, fitter, healthier and smaller – unfortunately the skin has a limited amount of elasticity and is unable to shrink-wrap around the smaller body.”

Dr Dona goes on to explain, “if you consider the skin to represent an old dress, then effectively you become a much smaller bodied individual walking around with a dress that is way too big for your body. My job is to make that dress fit your body.”

“The Open Book Tummy Tuck was developed to provide maximal contour improvement of the body with the skin tailored to precisely fit and showcase the smaller, fitter, healthier body hidden beneath.”

Of course, other areas of the body are also reconstructed as required, especially the abdominal wall muscles which usually require significant tightening. Furthermore, the Open Book Tummy Tuck is often combined with other contouring procedures such as Breast Reductions & Breast Lifts (Mastopexy), Total Body Lifts (Lipectomy) and/or Bra Lipectomies.

Surgery & Scars

All surgery involves scars. Whenever a surgeon makes an incision, a scar will form. No magic exists to prevent a scar from forming or to make a scar disappear. The surgeons’ job is to ensure the scars are ideally positioned and are given the optimal conditions for healing well.

When it comes to Body Contouring Surgery, it is best to consider the entire procedure like dress making – the surgeon is the tailor, and they need to tailor your skin to fit your smaller body. Dressmaking involves removing material and running seams to create the best pattern/fit. In surgery, those seams are scars.

With respect to a Tummy Tuck procedure, the greater the contour improvement required, the greater the size and number of scars necessary.

Most Tummy Tucks result in a single scar along the lower abdomen, which is nicely concealed within normal underwear line, and an additional scar around, or within, your belly button. However, sometimes additional scars are required to maximally contour the skin and provide optimal shape. A Fleur De Lis Tummy Tuck has a second additional scar along the entire midline of your abdomen up to you lower chest.

In addition to the two scars of a Fleur De Lis Tummy Tuck, the Open Book Tummy Tuck has a third scar extending horizontally along the entire lower chest in the lower breast fold. The midline scar joins the lower abdominal and lower chest scars of the Open Book Tummy Tuck.