Endoscopic Tummy Tuck - Surgery Through the Belly Button?
- Asked by beach bum in New Jersey
- 5 years ago
I just need a little help in the abdomen area but didn't want to be cut from hip to hip. Just wondering if they can tighten things up through the belly button or something like that? I can find very little information on an endoscopic tummy tuck. Is there such a thing
Unlike Santa, Endoscopic Tummy Tucks do 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.
Endoscopic Tummy Tuck Disappointing If You Have Loose Skin
Thank you for your question. The Endoscopic Tummy Tuck is a great idea but not often used because it does not solve the most common problem which is loose skin and fat on the tummy.
The Endoscopic Tummy Tuck is used to tighten loose muscles but will not remove or tighten loose skin.
Since most patients seeking Tummy Tuck have loose skin the endoscopic approach is rarely used.
Hybrid tummy tuck(TM) vs endoscopic tummy tuck
When ladies have had very fit pregnancies, they often have only loose fascias and a separation of the muscles but no significant skin looseness.
We have developed a tummy tuck called the hybrid tummy tuck(TM) which involves a C-section type incision in the very lower abdomen. When women have C-section scars, we use that incision.
The equipment used for the hybrid tummy tuck is identical as for endoscopic tummy tucks, except that no additional incisions are necessary in the tummy. None. No side incisions to insert the lights, no insufflation canula insertion site, none.
The entire fascia is tightened up to the belly button, then around the belly button to the upper abdomen (that is the hard part).
It is simply not the case that every woman needs a hip to hip incision in order to tighten the fascia, especially for tall women, runway or print models with long pubic-to-belly button distances, or fit patients.
While the endoscopic tummy tuck also addresses that problem, the portal incisions in the sides and belly button leave several additional scars. Also, there is no skin removed with the endoscopic tummy tuck, so loose skin is often an issue after the procedure.
Dr. S’s 5 tips to know about an Endoscopic Tummy Tuck
1. An endoscopic tummy tuck can be a great way to tighten up the abdominal wall for a select group of patients that do not want tummy tuck incisions.
2. It is performed using an endoscope and camera like that which we use for a brow lift or your surgeon uses to take our a gall bladder
3. The resulting incision can be as short as 4” in length and would be in the area of a standard C- section. This is the perfect option for a patient that already has a C-section scar.
4. The surgery is performed by lifting the skin and tightening the abdominal wall with special threads made to be used with the endoscopic instruments.
5. Speak to your board certified plastic surgeon and schedule a full evaluation to see if you are a good candidate for this approach.
I hope this helps and good luck!
Endoscopic Tummy Tuck - Few Indications
Although possible, few patients are candidates as the only purpose would be to bring the separated muscles (rectus abdominus muscles) together. As no skin or fat is generally removed with this procedure it would result in minimal results and in most patients - unhappiness.
Limited incisions mean limited results
An endoscopic tummy tuck is a great solution for the very rare tummy tuck patient who has a small separation or loosening of the abdominal muscles, BUT DOES NOT have extra fat, and has no extra or loose skin.
As most patients have more than one of these problems, they are better served with a mini tummy tuck. At this stage, the most important thing to do is to receive an evaluation by Board certified plastic surgeon so that they may evaluate you and determine what components of your abdomen need to be addressed.
A mini tummy tuck with a well-placed scar will tighten your guy muscles smooth the abdominal skin and improve the contour of your abdomen.
Pat Pazmino, MD, FACS
Board Certified, American Board of Plastic Surgery
MIAMI AESTHETIC SURGERY
Endoscopic tummy tuck
Endoscopic tummy tuck is a procedure to tighten the abdominal muscles after abdominal wall laxity. Through a small incision, the muscles are brought together via stitches. in my practice, I have never seen anyone who has not needed more than muscle tightening. Almost everyone also needs removal of some skin and fat in the form of a mini- tummy tuck or a full tummy tuck.
Endoscopic tummy tuck
An endoscopic tummy tuck is performed through a few small incisions in the abdomen really only to tighten the muscles. I think this is really good for about 1% of patients. It will not tighten the skin.
Endoscopic Tummy Tuck
There are two major componenets to full Abdominoplasty
1. tightening the lax abdominal muscles
2. tightening the lax abdominal skin
If the muscles need to be tightened then yes you can do that with the endoscope, you also have to release the skin otherwise the skin bunches together when the muscles are tightened.
Remember the more limited the procedure is the more limited the results are.
Endoscopic Tummy Tuck
The reason you have not seen much about Endoscopic Tummy Tuck surgery is because it is rarely done. The ideal candidate for this procedure is the rare woman who has a muscle separation without skin excess and looseness (nor ugly stretch marks she wishes to exchange for a transverse scar).
In these cases, only a muscle tightening (plication) is required and various methods and instruments were devised to enable this operation.
The vast majority of post-pregnancy women DO have loose and or stretch mark covered skin and need MORE than just muscle tightening. Performing this procedure on them would leave the loose skin behind and result in a substandard result.
Dr. P. Aldea
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.