Where does the tummy tuck area get its blood supply?

Question

My question is can someone tell me from what area does the tummy tuck gets its blood supply?

Semih Yildiz, MD, FEPOBRAS · Answer

The abdominal skin normally receives blood through many small perforating vessels from deeper abdominal wall arteries. During a tummy tuck, some lower abdominal perforators are divided when the skin and fat are lifted, so the remaining flap relies more on blood coming from the upper and side areas of the abdomen. Important contributors include branches related to the superior epigastric, intercostal, subcostal, and lateral abdominal vessels.

This is why plastic surgeons are careful about how widely they lift the tissue, how much tension is placed on the closure, and whether liposuction is done at the same time. Smoking, diabetes, prior scars, very tight closure, and aggressive undermining can all affect blood flow and wound healing. The belly button has its own stalk and blood supply that must also be protected during surgery. If you are asking because of a healing concern after surgery, it is best to have your surgeon examine the area directly.

Jose Telich, MD · Answer

This is a fantastic question kiki94!

The abdomen was divided into Huger’s vascular zones. Zone I is primarily supplied by the arcade formed by the superior epigastric and inferior epigastric vessels and ranges from the xiphoid to the transverse line connecting both anterosuperior iliac spines. It lies in between the lateral borders of the rectus abdominis muscles. Zone II receives its blood supply from the superficial epigastric, superficial circumflex iliac, and inferior epigastric vessels. This zone II is the area defined superiorly by a line connecting both anterosuperior iliac spines and inferiorly by the groin and pubic creases. Zone III is supplied by segmental intercostal, subcostal, and lumbar vessels. This zone comprises the lateral abdomen and flanks.

The skin flap from a tummy tuck gets it blood supply from arteries that arise fromzone III until new blood vessels grow from the underlying tissue.

J. Timothy Katzen, MD, FACS · Answer

Dear kiki94,

Your question regarding the blood supply to the area affected by a tummy tuck (abdominoplasty) is very insightful. In a tummy tuck procedure, the blood supply to the abdominal skin and tissues comes primarily from the superior and inferior epigastric arteries. These arteries branch from the internal thoracic artery and the external iliac artery, respectively.

During a tummy tuck, the plastic surgeon carefully manipulates the skin and fat to preserve these critical blood supplies. The goal is to maintain adequate perfusion to the remaining tissues while removing excess skin and fat and tightening the abdominal wall. This careful preservation of blood supply is crucial for the healing process and to minimize complications.

Thank youf for your question regarding how the tummy tuck area gets its blood supply from.

Sincerely,
Dr. Katzen

Connie Hiers, MD, FACS · Answer

With the tummy tuck, most of the blood supply to the tissue is from the uncut skin in the upper and lateral abdomen. The lower and central areas are all cut away from their blood vessels.  Except in smokers and those with upper abdominal incisions, most have enough blood supply for the tissue to live and heal well.

Camille Cash, MD · Answer

During the tummy tuck the regular blood supply to the lower abdomen is disrupted from the surgery.  The tummy then relies on blood supply coming from the upper abdomen to properly heal the surgical area until normal channels are restored.

Justin Booth, MD · Answer

Many of the blood vessels that normally supply the abdominal skin are cut/cauterized during the operation so the vessels that end up supplying the tummy tuck come from the chest/upper abdomen and laterally from the flanks/back. 
This is why aggressive liposuction of the central abdomen at the same time as a tummy tuck is generally not recommended.
Hope this helps!
Best wishes,
Justin Booth MD FACSAustin Plastic Surgery Institute

Mats Hagstrom, MD (license on probation) · Answer

When we referred to blood supply, we generally talk about specific tissues or organs.
There are pretty good and anatomy references, showing the blood supply to various tissues of the abdominal wall.
The blood supply that is most important in context to this procedure are blood vessels that come through rectus abdominis muscle, and are branches off of the inferior epigastric artery. The artery sub divides into multiple branches through the rectus abdominis muscle, including typically three perforator arteries that go up through the fat layer to the skin surface on each side.
During the procedure as the skin and fat layer is separated from the muscle fascia. These typically six perforator vessels are transacted.
This terminates the primary blood supply to the skin of the front of the abdomen, which is now forced to rely on the secondary blood supply coming from the periphery.
If the peripheral blood supply is insufficient, then there will be ischemia of the central lower abdominal skin. This can be made worse by putting the skin under significant tension.
I suggest referring to anatomy text or images which can describe the anatomy, including its blood supply in far greater detail.
Best,
Mats Hagstrom, MD

Where does the tummy tuck area get its blood supply?

Answers (7)

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