Tummy Tuck: What are the Options?

Marc Schneider, MD
Article by
Fort Myers Plastic Surgeon

The tummy tuck, otherwise known as an abdominoplasty, is a surgical technique used to improve the appearance of the abdomen or belly. Most abdominoplasties involve tightening the muscle wall to help flatten the abdomen and liposuction to contour the flanks and hips.

Aging, pregnancy, weight loss or weight gain, and environmental effects such as smoking will change the elasticity and laxity of the abdomen’s skin. The skin can loosen either in just the lower abdomen, it may loosen only in the upper abdomen, or it can loosen throughout the abdomen. Where the skin has become lax and the quantity of laxity, determines our surgical approach. Abdominoplasty incisions for skin laxity vary significantly. In fact, we perform 5 differently located incisions based on the problem.

The endoscopic abdominoplasty uses the smallest incision, slightly shorter than a c-section scar and located in the same place. The procedure is only used in patients who have no skin laxity. Through this incision, liposuction and muscle plication is performed.

The mini-abdominoplasty procedure uses an incision a little bit longer than a c-section scar and enables us to remove small amounts of laxity of the lower abdomen.

A full abdominoplasty scar also lies low in the torso’s natural skin creases but extends to the hips. It allows the surgeon to remove the skin from where a c-section scar would be located to above the umbilicus (belly button). This produces tightening of both the lower and upper abdominal skin.

A reverse abdominoplasty incision is located under the breasts. There are some patients who only have skin laxity in the upper portion of the abdomen. This incision is ideal for this patient.

Finally the last incision occasionally used is the vertical midline incision. It may be used in patients who have had an extreme amount of weight loss and have significant laxity or in the rare patient who only has significant stretch marks located centrally around the umbilicus but these extend both above and below the belly button.

A variety of options exist depending upon the patients desires and how their abdomen has changed with time.