Abdominoplasty (Tummy Tuck)
Abdominoplasty is the official term for a tummy tuck operation. They’re the same thing and have been around for about 50 years. It involves removing a horizontal wedge of skin and fat from the lower front of the abdominal wall between the belly button and the pubic area. The belly button is left in position, as it is attached to the abdominal wall muscles. The upper abdominal skin is lifted up from its attachments to the underlying muscles. If there is a divarication of the rectus muscles (refer below), it is strongly repaired. Next, the upper abdominal skin is stretched down to the pubic area, thinning and tightening the entire front of the abdominal wall. The skin is then all carefully closed, resulting in a long low horizontal scar line at about the level of the top of the pubic hair. The belly button is then brought back out and neatly repaired.
It’s still the operation of choice for the front of the tummy area when there is excess skin or a divarication. It results in a low scar across the front at the level of a caesarian section scar, from hip to hip. If there is excess loose skin at the sides or back though, a circumferential procedure might be required to achieve the best result.
ARC Plastic Surgeons may use the Vectra 3D computer imaging system as part of their patient consultation. The system simulates the outcome of many surgical procedures with three-dimensional imagery.
Contact Us about our Fixed Price Package for Abdominoplasty (Tummy Tuck) Surgery, starting from $10,000. T&C’s apply.
An abdominoplasty does not address loose skin or excess fat around the flanks or back. Excess loose lower body tissue (skin and fat) may be present at the sides and back in some women after pregnancies, and in most people who have undergone Massive Weight Loss (MWL).
If it is, an abdominoplasty alone will not be enough to achieve the best possible result as it would leave those loose areas uncorrected. A circumferential abdominoplasty or a body lift might be required.
From the 1980’s onward, the operations which correct the trunk shape all the way around have been described in the medical literature as extended abdominoplasty, belt lipectomy, circumferential abdominoplasty and bodylift. Really these different names all mean more or less the same thing: an abdominoplasty with the skin and fat removal extended all the way around to the back in order to thin the sides and back of the abdominal wall at the same time as the front. It leaves a long low scar all or nearly all the way round, at the junction of the buttock and the lower back.
At ARC, a circumferential abdominoplasty is performed where the patient has excess skin at the front, sides and back, but has not had MWL.
The ARC Bodylift is a circumferential abdominoplasty in a Massive Weight Loss patient.
In our practice, more than a 20kg weight loss (excluding pregnancy) is classed as MWL. It has the same scar but is more extensive than a circumferential abdominoplasty, as more skin removal and more upper abdominal and back thinning is required in MWL patients.
Our technique has evolved in order to specifically address the shape problems patients have after MWL, and we use the Bodylift term to describe all the planning and technical steps we use when performing this operation.
The ARC Bodylift has been developed to optimize scar position, smoothness of contour and maximum safe skin removal in the bodylift operation.
Thigh Reduction & Brachioplasty (Arm Reduction)
The arms and legs often require treatment in MWL patients. Loose skin on the arms and legs can cause embarrassment and shame to the patient, and make clothing choices difficult. There can also be functional issues, such as chafing between the legs, making exercise painful.
The trade-off for thigh or arm reduction, as in all body contouring operations, is a scar. For arm reductions, the scar runs from the armpit to the elbow; for thigh reductions, it runs from the inside groin to the knee. Though these scars are considerable, most patients will happily trade a scar for an improved contour. Over time, the scars often become barely visible.
Generally, these procedures are done in combination with liposuction, to further empty the loose skin of any fat. This allows an ARC Surgeon to only remove skin, and preserve all of the important structures in your arms or legs such as nerves, blood vessels, and lymphatics. This promotes more rapid healing, and better preservation of sensation.
Abdominal Wall & Trunk Liposuction
Abdominal liposuction can be used where there is excess fat but no excess skin, and no divarication. We often use it as part of our body contouring procedures, and sometimes on its own.
Liposuction has many variations but they are all basically the same technique: filling the fatty tissues with a local anaesthetic solution and a vasoconstrictor to minimise blood loss, then carefully aspirating or removing fat from under the skin using a thin hollow tube. Good results are obtained when the skin is elastic, and the treated area has bulges that weight loss and exercise can’t fix.
At ARC Plastic Surgery, we use both the Byron Syringe technique for gentle and accurate aspiration of small areas, and the Microaire power assisted system where larger volumes are removed. This is a safe and gentle system which enables accurate aspiration of larger volumes.
Divarication of the Rectus Abdominis Muscles
A divarication is the separation of the vertical rectus abdominis (six pack) muscles which results in a weak area, a bulge at the front of the abdomen, or even a hernia.
In pregnancies, it is normal for a separation to develop between the rectus muscles. It’s designed to make room for the growing baby. After pregnancy, the split is supposed to join back together, but unfortunately it commonly doesn’t. This can result in a thickening of the waist with loss of body shape, a bulge like a pot belly even if you are thin, discomfort, loss of core strength, back pain and even a hernia.
Annoyingly, exercise can’t repair a divarication. It is readily repaired as part of all abdominoplasty, circumferential abdominoplasty and body lift procedures when necessary.