Tag Archives: umbilicus

Tummy Tucks for Men

 Abdominoplasty in male cosmetic plastic surgery patients

 

Abdominoplasty, or tummy tucks for men, is a procedure that is often performed on women, and most of my blogs have talked about female cosmetic plastic surgery patients having these procedures.

https://tavmd.com/2013/02/17/full-or-mini-abdominoplasty/

https://tavmd.com/2011/07/02/new-technique-for-tummy-tuck/

Tummy tucks can also be performed on males, and though the number of male cosmetic plastic surgery patients who need an abdominoplasty is significantly less than female patients, there is no substitution for this surgical procedure when it’s necessary.

 david chubby photo    tavmdphoto1_ezg_1

Tummy tucks for men

Reasons for a male to have an abdominoplasty differ from abdominoplasty in female cosmetic patients.

Typically females will have abdominoplasty for:

  • Excess loose skin
  • Excess fat
  • Separation and weakness of abdominal muscles

 

Males obviously do not have the sequelae of pregnancy to deal with and so do not have the separation of abdominal muscles that is a major reason for female abdominoplasty. They can, however, have extra fat and skin looseness.

Significant weight loss is the main reason for male tummy tucks.

 

Surgery techniques for abdominoplasty in men

Techniques for abdominoplasty in general include:

  • Excision of extra skin in the abdomen
  • Liposuction of fat from the abdomen, flanks and love handles
  • Suturing of abdominal rectus muscles

 

In male tummy tucks, liposuction and the excision of skin between the umbilicus, belly button, and pubic areas is performed in the same way as in female abdominoplasty.

The main difference is in the type of abdominal rectus muscle plication performed.

For female patients, I tighten the abdominal muscles in a diamond shape to bring the waist line in to a pre-pregnancy form and emphasize a small waist.

When men have tummy tucks, the idea is to tighten the muscles, if necessary, into a V shape, not to give them a small waist. This tightening of muscles is performed in a vertical manner.

The recovery from an abdominoplasty/tummy tuck  for men tends to be less difficult than for women because less tightening of the abdominal muscles is required. Men are typically able to resume work after 7-10 days.

 Still, the great majority of men looking for improvement in their abdominal contour and tummy shape will benefit from just a liposuction, without any removal of extra skin or a tummy tuck.  Many male tummy tuck patients also benefit from liposuction of the chest to reduce gynecomastia.

 

 

 

Morad Tavallali, M.D., FACS

Bulges After Abdominoplasty-Tummy Tuck

Bulges after abdominoplasty-tummy tuck  or liposuction surgery,  is not unusual for the cosmetic plastic surgery patient . There are multiple reasons for these bulges; some can be improved and others are normal sequel of cosmetic surgery.

Here are some previous posts about tummy tucks:

https://tavmd.com/2010/10/26/tummy-tuck-abdominoplasty-or-liposuction/

https://tavmd.com/2010/10/27/how-is-a-tummy-tuck-done/

abdominoplasty

 

 

 

 

Swelling

Normal post-operative swelling after abdominoplasty and liposuction may take up to four months to improve. Though the swelling is initially all over the abdomen and hips, as the patient moves around, the swelling will settle down in the area just above the tummy tuck scar of the pubis and cause a bulge. Lymphatic massage can help remove the swelling bulge.

Abdominal scar

The way the cosmetic plastic surgeon closes the scar of the abdomen will also lead to temporary bulges of the skin.

For a tummy tuck, the incision over the pubis is usually smaller than the incision of the upper part of the abdominal skin that is removed. The relative excess of skin in the upper parts of the abdomen means that the skin needs to be folded into the lower incision of the abdomen, causing small bulges of skin. If a longer incision is made in the pubic area, the bulges can be eliminated at the time of surgery, but at the expense of a longer abdominal scar. However, with a little patience, the bulges will flatten out and a straight scar can be achieved without making it longer.

 

Abdominal hernias

Patients who have tummy tucks and abdominoplasty by definition have a weakness of the abdominal wall muscles. This is what causes the roundness of the shape of the abdomen. With tummy tuck surgery, the muscles are tightened to give a flat abdominal contour. In some patients, the muscles themselves may be very thin and not strong enough to hold the abdominal contents, leading to hernias. These hernias require a specific and separate procedure for closure. Sometimes it can be performed at the same time as an abdominoplasty, but at times it may only become apparent after abdominoplasty and liposuction remove the fat covering the belly.

Excess fat

Some surgeons, such as myself, routinely perform liposuction at the same time as abdominoplasty surgery to get more contoured results. Other cosmetic plastic surgeons do not perform any liposuction with abdominoplasty, and still others perform it as a second procedure 6 to 12 months after the tummy tuck surgery.

With any liposuction it is possible to leave a little extra fat on one side or the other that may require a touch up later. The reasons for this are that patients have different amounts of fat on either side of the body and the tumescent solution injected for the liposuction swells the area up and makes it difficult for plastic surgeons to achieve a symmetrical result.

 

Scoliosis

The curvature of the spine called scoliosis, which many of us have, leads to the appearance of bulges on the abdomen only because of the way we stand. There is the same amount of fat on the abdomen on the two sides, no hernias or skin fold, just a curvature of the spine that makes the body curve to one side and cause an apparent bulge!

The causes for bulges after abdominoplasty and liposuction are many but can be identified and corrected with a little patience.

Morad Tavallali, M.D., FACS

Full or Mini Abdominoplasty

Full tummy tuck and mini tummy tuck differences

I just had a patient leave my office who was a little disappointed with the results of her mini tummy tuck surgery/mini abdominoplasty. She wanted the result of a full abdominoplasty surgery/full tummy tuck surgery with a mini surgery!  This was despite my having spent a while explaining the differences to her (and documenting that I had recommended a full tummy tuck to begin with!). Obviously I should have tried harder to convince her to do the cosmetic plastic surgery she said she did not want!

I have written about the differences between a full and a mini tummy tuck/abdominoplasty in other posts:

https://tavmd.com/2012/01/04/mini-tummy-tuck-explained/

https://tavmd.com/2010/10/26/tummy-tuck-abdominoplasty-or-liposuction/

https://tavmd.com/2010/10/27/how-is-a-tummy-tuck-done/

Let’s try another way.

Full tummy tuck/abdominoplasty

A full tummy tuck surgery includes four basic steps the way I perform it:

  1. Liposuction of the abdomen and flanks
  2. Tightening of the muscles of the abdomen from breastbone to pubic bone
  3. Removal of the skin between the umbilicus (belly button) and pubic area
  4. Re-positioning of the belly button (umbilicus)

 

Initial healing (read: getting back to work) after a full abdominoplasty is about 10 days in my patients.

 

Area of skin removed with Full tummy tuck

 

Full tummy tuck photo

 

Here is a schematic of the abdomen. In a full tummy tuck, all the skin in the shaded area is removed. The belly button is then has a stab incision in the skin that is pulled down.

Mini tummy tuck or mini abdominoplasty

A mini tummy tuck surgery includes:

  1. Liposuction of the abdomen and flanks
  2. Tightening of the muscles between the belly button and pubis only
  3. Removal of a few inches of skin above the pubic area
  4. No movement of umbilicus

The initial healing period lasts five days.

Here is a schematic of the area of skin removed.

mini abdominoplasty skin removal

Mini tummy tuck photos

 

Note that only a little skin is removed from below the umbilicus, not all the skin as in a full abdominoplasty. This means that if you have loose skin above your belly button, a mini abdominoplasty will not help! You will still have loose skin there.

For some patients, the quicker healing time or lack of scarring around the umbilicus is the deciding factor for which procedure to have. In my experience, only few patients are good candidates for a mini tummy tuck, and most benefit more from a full abdominoplasty. Once patients realize that the size of the abdominal scar is the same in a full or mini abdominoplasty, they often choose a full tummy tuck.

Those who still want a mini procedure probably need more convincing!

 

Morad Tavallali, M.D., FACS