Abdominoplasty or tummy tuck surgery is a cosmetic plastic surgery procedure performed by board-certified plastic surgeons with or without liposuction to:

  • Remove extra skin from the lower belly
  • Remove extra belly fat
  • Tighten the abdominal muscles

Here is a link to more information about abdominoplasty: Tummy tucks

Tummy tuck photo

Incisions for full or mini tummy tuck surgery

In mini abdominoplasty/tummy tuck surgery (in which only a small amount of skin is removed and no muscle tightening is done) and full abdominoplasty/tummy tuck surgery (in which all the skin below the belly button is removed and the muscles are tightened from the breast bone to the pubis), the size of the scar is usually the same.

Cosmetic patients obviously want the smallest surgical scar possible, but in reality, the length of  scars is determined by the amount of loose skin and fat a patient has. Patients who are candidates for a mini abdominoplasty may have less fat than a full tummy tuck patient, but they may also have more loose skin—and a larger scar!

Patients who have a full abdominoplasty/tummy tuck have all skin from the pubis to the breast area elevated, so the whole abdominal wall is visible to the plastic surgeon. That is where hernias hide.

Here are some more articles about tummy tucks:

Abdominal Hernias

There are four main types of abdominal hernias.  A hernia is a weakening of the abdominal wall, which allows fat and intestine from inside the abdominal cavities to protrude or herniate out through weakened muscles.  Muscles are weakened because of injury, surgery or child birth.

  • Inguinal: also known as groin hernias—common after injury
  • Umbilical: protrude through or around a belly button—common after pregnancy
  • Ventral: protrude in between the two rectus muscles (the six-pack abdominal muscles)—again occurs after pregnancy
  • Incisional: hernias caused by previous surgery anywhere on the body

Hernias must be repaired or patients risk having a piece of intestine or internal fat getting caught in the abdomen wall defect and dying. This can lead to emergency surgery and be very dangerous.

Surgery for abdomen hernias

Surgery to correct a hernia involves a cut through the skin down to the belly muscles. The hernia is then discovered and if the abdominal tissues are strong enough, it is repaired by closing the hole leading from the abdominal cavity. If the muscles are weak, some sort of artificial mesh (Marlex mesh) or supporting tissue is used.

Surgeons usually make incisions through the mid-line abdomen skin, leaving an ugly scar. However, in patients who may want a tummy tuck concurrently, a plastic surgeon can make a scar above your pubic area, which will be nicely hidden under a panty line. The skin is then elevated, the hernia is repaired and reinforced by tightening the muscles and the wound is closed after removing extra skin. Any liposuction performed to remove extra fat from the sides is then done as a cosmetic procedure, for which patients pay separately because it is not part of the medical hernia repair, whose costs are usually covered by health insurance.

Before rushing to your plastic surgeon, make sure your insurance company will cover this approach to surgery. It sure makes sense to me to do it this way.