Endoscopic tummy tuck - does it exist?

The endoscopic tummy tuck indeed exists. You probably can't find much about it because there are few patients for whom this is an effective procedure, and most of the patients suitable for this procedure are actually men.

A standard tummy tuck removes and tightens skin, tightens muscle, and removes some fat.

Liposuction only removes fat, leaving the muscle and skin unchanged. In fact, if the skin is loose and a lot of fat is removed, the skin can look looser after lipo.

Endoscopic tummy tuck only tightens muscle. it does not remove any skin at all. If there is extra fat, liposuction can be done at the same time.

The problem is that most women that complain about their tummy usually have loose skin in addition to loose muscles. Women that seek a tummy tuck because of a large weight loss usually have very loose skin, and often muscles that are not very loose. Sometimes they need their muscles tightened, but usually they need the opposite of what an endo tummy tuck does: they need skin removed but the muscle left alone.

Women that have had their muscles stretched from babies almost always have had their skin stretched, too. Not always, but most of the time. The only ideal candidate for an endo tummy tuck is someone with fairly smooth and tight skin - even when sitting up in a chair undressed - and laxity of the muscles (what we call a rectus diastasis - meaning that the two muscles that are joined in the center have been spread apart, usually by the pressure of the uterus.)

This procedure was touted widely when it was first described in the nineties, but after the initial enthusiasm settled down, it became clear that it was true that it was a great procedure, but that there weren't a lot of women who were best suited for it.

And even when women are well-suited for it, there is often a C-section scar, so either reusing that scar or extending it a bit can result in tightening of skin, and there are few women who couldn't benefit from that. So at the end of the day, there just aren't that many women for whom this procedure is well suited.

However, there are a lot of men who for reasons that are not understood get separation of the rectus muscles of their abdomen, but otherwise have good and tight skin. Most of the endoscopic tummy tucks I have performed have been on men in this situation.