You're right. It is hard to find pics of thin patients who've had tummy tucks! But it's not because the results are not as great as other patients. The same concerns can still be treated and greatly improved -- loose skin, stretch marks, rectus diastasis. Although your abdominal wall is thinner and has less fatty tissue, the fascial layer should have equal integrity to another's. Here's a link to my photo gallery, case 2 is a thin, athletic woman who had a tummy tuck for these exact concerns.
thin women who have loose abdominal skin often have no choice but to get a tummy tuck in order to look good. As shown in your pictures, you have weak abdominal wall, and even an umbilical hernia. An abdominoplasty tightens the abdominal wall and give you a tight and flat tummy.
Diastasis, as you know, can happen regardless of how well you care for yourself. In thin women, especially, the resulting bulge can be a nuisance. Fixing that bulge can be done a variety of different ways but the core of what is being done does not change regardless of the physique in which it is being altered. The fascial layers that are pulled together are tough, strong tissues that can, generally speaking, withstand the tension placed with the repair. In a healthy individual with good nutrition and no genetic collagen problems, the thickness of the overlying skin and fat would not be expected to effect the end result except that the positive changes are sometimes more noticeable in thin women where the muscle can be seen through the overlying tissues.
The abdomen is 3-dimensional, while flatness is a 2-D concept so it is important to understand all of the factors that influence the shape of the abdominal area. Tightening the skin, repairing a muscle separation when necessary, and removing localized external fat are all important. Internal fat, muscle tone from exercise, and body type also influence the shape of the abdomen. Muscle repair is very reliable.
If you want a flatter abdomen and a possible hernia repaired, some type of surgical intervention will be necessary. The plication will be the essential feature. I have not seen a plication fail in hundreds and hundreds and hundreds of tummy tucks.
Kenneth Hughes, MD
Los Angeles, CA
Yes, there are fewer thin patient who have abdominoplasties (tummy tucks), but they are not uncommon, and are good candidates for the procedure and can have great outcomes. Just because the overlying skin and fat layer is thin, does not mean that muscles cannot be repaired with nice flat result. A modification of the procedure might be indicated in your situation if a significant skin excision is not needed. We always tailor the procedure to your specific needs.
Yes you do appear to have an umbilical hernia, and this can be repaired at the time of any abdominoplasty procedure. We do this frequently.
Thank you for your question and photograph. You look like you will be a good candidate for an abdominoplasty with hernia repair and diastases repair.
The condition of your abdominal muscles and the amount of volume of your internal organs and fat determines the flatness of your abdomen. The skin does not play a role in the flatness of your abdomen. Abdominoplasty will tighten the skin and make the skin tighter but will not determine how flat the abdomen is.
It looks like you will benefit from a repair of your diastasis and possible umbilical hernia. The location of the scar will be an important consideration for you to discuss with your surgeon in planning your best options. Good luck.