When You Have a Tt when They Pull the Bottom Pubic Area Up to the Top Does It Do Any Tighting to the Outside I Have Noticed Some

You should be commended on educating yourself before your plastic surgery procedure, specifically abdominoplasty or tummy tuck. During an abdominoplasty or tummy tuck, an incision is made in the lower abdomen. Tissue dissection is carried upwards to the bellybutton or umbilicus. Further tissue dissection is carried up to the sternum and rib cage. Then, the rectus abdominus or six pack muscle is tightened. By doing these maneuvers, the abdominal skin is then able to be pulled down. During an abdominoplasty or tummy tuck, the vector or direction of pull is downward. The pubic region is not really pulled up. In most cases the pubic region is reduced. Sometimes with previously morbidly obese female patients, who have lost significant weight, the pubic region in falls underneath the body. This can lead to a significant amount of excess skin and fat that hangs over and can even cover the pubic region. Thus, with some abdominoplasties or 360 body lifts, the pubic region may look raised. However, in reality, The pubic region has not been pulled up, but rather, the pubic region has just been reduced. Again, remember during abdominoplasty or 360 body lift, the abdomen is pulled down and the pubic region is not pulled up. Sincerely, Dr. Katzen

A tummy tuck is done by making an incision of the lower abdominal area / upper pubic area. If done correctly, the loose abdominal skin is pulled down and removed. The remaining abdominal skin is then stitched back to above the pubic area. The result is a very low, skinny scar that can we well hidden when wearing even a small bathing suit. The pubic area should be not affected unless the patient needs and wants a pubic lift or monplasty, which will lift the pubic area. We frequently perform pubic liposuction to help rejuvenate the pubic area, but it does raise the pubic hair line. Make sure you see a board certified plastic surgeon.

 

Often when a tummy tuck is done, the pubic hair region can ride up a bit. That is because there is looseness in that skin just as in the abdominal skin. When I design a tummy tuck, I try to compensate for that by making the lower incision EXTRA low and cut out a good portion of the skin of the pubis area. If that is not done, the scar ends up too high and the hair bearing pubic area also ends up too high. Good question and observation.

When you do a tummy tuck, you don't want the pubic area and scar line pulled up, you want it stay low under the bikini/underwear line.

How to do this?  First pull the pubic area and the front of the thighs up when the pre-operative marking is done. Make sure this line is covered by the bikini  preferably by having the bikini underwear in place when the marking is done.  Bend the front of the thigh to ensure that the line falls in the thigh crease which is where the bikini will be. This ensures that the line of incision will not go higher and be visible when tension is applied at the time of repair.

This gives an anterior thigh lift as well as improving the abdomen so they both blend in as a smooth continuous youthful surface. 

It is also possible to minimize the upward pull on the pubic area by blocking that tension with sutures from the upper flap down to the abdominal wall at the level of the umbilicus and having the main tension that smoothes the skin out laterally where the pull is desirable.

This was first described by Dr. Lockwood as the "High-Lateral Tension" tummy tuck, and added to by Dr. Le Louarn of Paris as the "HIgh Superior Tension" tummy tuck. These techniques avoid the problem you have observed where the pubic hairline and scar are pulled up too high.

I incorporate both of these techniques in my tummy tucks.

   When I perform tummy tucks, I put the scar as low as possible with the lateral portion of the scars low as well (no smiley face).  That waythe scar above the pubic area and the scar to the sides are both low and not visible in clothing.