Answer: A lower body lift properly describes a procedure that utilizes an incision across the back, at the waistline. Tissues of the buttocks and posterior and lateral thighs are lifted and excess skin is removed along the waistline. This procedure addresses the posterior portions of the trunk and thighs only. Contouring of the anterior portions of the trunk and thighs are similarly addressed by an abdominoplasty and a medial thigh lift. In almost any setting, these procedures are performed in stages. For patients in whom all of these procedures are indicated (a total body lift), most often the anterior procedures would be performed as the first stage, and the posterior procedures would be performed as the second stage. Some amount of liposuction is very often performed as a part of all of these procedures.

Answer: Tummy tucks are much more common in women than in men. They probably always will be because they are much more commonly indicated in women, for a variety of reasons. First, irreversible changes from expansion of the muscle, fascia and skin of the abdomen that may occur with pregnancy are all addressed with a tummy tuck. Secondly, many gynecological surgery procedures are performed through incisions along the lower abdominal skin fold. Because a tummy tuck is performed through a similar but more extended incision, many women who already have this scar from previous surgery or will be having a gynecological procedure, elect to also have a tummy tuck. Thirdly, abdominal fat in women tends to accumulate more in the subcutaneous fat layer beneath the skin rather than inside the abdominal cavity. This results in greater skin expansion which may be irreversible after subsequent weight loss. Men tend to have the opposite abdominal fat distribution with more intra-abdominal fat than subcutaneous fat.

With the increasing popularity of weight loss surgery however, tummy tuck procedures are becoming much more common in men. Excess lower abdominal skin and laxity of muscle and fascia can be eliminated just as effectively in men as in women. There is typically a scar extending from one hip bone to the other. If the surgery is meticulously performed and the scar carefully positioned by your surgeon, it should remain very well concealed along the skin fold at the belt line, and remain hidden beneath the waistline of your shorts.

Answer: Both of these options are possible. Tightening of the muscle/fascia is a routine part of a full abdominoplasty but it is not always necessary. Avoiding this step can reduce the amount of post-op pain and tightness that a patient experiences, and may allow for a more rapid recovery. For patients who have only skin laxity and excess and no laxity of muscle/fascia or separation of the muscle in the central abdomen (rectus diastasis), a “skin only” abdominoplasty may be the best procedure for abdominal contouring. For patients with a significant rectus diastasis, tightening of the muscle/fascia will most likely be necessary to produce the desired improvement in contour. Expansion of the intra-abdominal contents by pregnancy or obesity is usually the cause of a rectus diastasis. The best way to test for this is to lie down flat on your back and do a double straight leg raise while lifting your head up off of the ground. A rectus diastasis is indicated by bulging along the midline of the abdomen.

Answer: There are different types of abdominoplasty procedures. The associated scars vary depending upon the best indicated procedure for each individual patient. With the standard abdominoplasty, the scar usually extends across the lower abdomen from one hip bone to the other. For patients with excess skin that extends beyond the front of the trunk over the hips and around the back, an extended abdominoplasty or belt-plasty may be indicated, where this additional excess skin is removed and the scar extended across the hips and possibly all the way around the waistline. For patients with more limited skin excess at the central lower abdomen only, a mini-abdominoplasty may be the best procedure, where a shorter, C-section type scar is used. Many patients seeking abdominal contouring are good candidates for liposuction, where only a few very small incisions are made. Regardless of the procedure chosen, and the resultant scar, a large majority of patients are satisfied with their abdominoplasty procedure when the desired improvement in contour is achieved.

Answer: There are different types of abdominoplasty procedures. The associated scars vary depending upon the best indicated procedure for each individual patient. With the standard abdominoplasty, the scar usually extends across the lower abdomen from one hip bone to the other. For patients with excess skin that extends beyond the front of the trunk over the hips and around the back, an extended abdominoplasty or belt-plasty may be indicated, where this additional excess skin is removed and the scar extended across the hips and possibly all the way around the waistline. For patients with more limited skin excess at the central lower abdomen only, a mini-abdominoplasty may be the best procedure, where a shorter, C-section type scar is used. Many patients seeking abdominal contouring are good candidates for liposuction, where only a few very small incisions are made. Regardless of the procedure chosen, and the resultant scar, a large majority of patients are satisfied with their abdominoplasty procedure when the desired improvement in contour is achieved.

Answer: It sounds like a tummy tuckor abdominoplasty is the correct procedure for you. With the standard, full abdominoplasty, the abdominal muscles are tightened as well. This step is not always necessary, but does further tighten the waistline and flatten the belly. When just the skin and fat is removed, the procedure is more appropriately called a panniculectomy. These procedures can and should be done through the C-section scar site, without giving a second scar. The tummy tuck scar however is usually longer than the C-section scar.

Answer: The recovery period for a mini tummy tuck is about 5 to 7 days. The belly button is not repositioned with a mini tummy tuck and the muscle/fascia is not tightened. These are the main differences between a mini- and a full tummy tuck. Because the muscle is not tightened, the recovery is not very difficult. Post-op pain should be minimal. You will experience tightness that may make it difficult to stand straight upright for a few days only. A drain tube may or may not be required. If so, it may be in for 3 to 7 days. That is what will be most important in determining the duration of recovery. Once the drain tube is removed, you should be able to return to more or less everyday activities, with the exception of exercise. Extremes of stretching and heavy lifting should be limited for a minimum of two to six weeks after surgery.

Answer: There are different types of tummy tucks. The differences between types have to do with how various steps are combined: the length of the incision and scar, the amount of skin that is removed, whether or not the belly button is repositioned, whether or not muscle/fascia tightening is performed, whether or not liposuction is performed and if so, in what areas. Any different combination of these steps may be performed in a “tummy tuck” procedure and may be given a variety of names. In general, a “mini tummy tuck” involves tightening skin only below the belly button, no repositioning of the belly button, no muscle tightening, and usually a shorter scar. A “full tummy tuck”, on the other hand, involves tightening of the entire abdominal skin, with removal of all of the skin from the pubic region to just above the belly button, repositioning of the belly button, tightening of muscle and a longer scar. With all tummy tuck procedures, the changes made are permanent. With aging, weight gain, and subsequent pregnancies however, these changes may be diminished or reversed. The particular step that some surgeons are hesitant to perform in someone who is contemplating or planning future pregnancies is the muscle tightening. This is usually performed with permanent suture material. If a woman has a pregnancy after such a procedure, the abdominal wall may expand differently than otherwise, resulting in cosmetic deformity from muscle/fascia laxity that may be more difficult to correct. Having this procedure however is not a contraindication or risk to future pregnancies.  For such patients, many plastic surgeons would recommend deferring surgery until after all pregnancies or would perform a “skin only” tummy tuck, with any combination of the above steps but avoiding muscle/fascia tightening. Again, the skin removal and any other steps performed will have permanent effects. After subsequent pregnancies, if there is more stretching, laxity and redundancy of tissues, then a tummy tuck can be redone, this time including muscle tightening. Since you are not planning any future pregnancies, a full tummy tuck with muscle tightening may be the best procedure for you. Again, each of the additional steps mentioned can be customized to fit your individual goals and anatomy.