Many factors can contribute to undesirable abdominal fullness and contour problems. Weight gain, childbirth and simple aging changes can lead to excess fat deposits, skin laxity and abdominal muscle stretch. These three issues are usually present to some degree in almost all patients presenting for consultation.
Liposuction to remove excess abdominal fat addresses only one of these abdominal issues. This offers limited improvement in patients who also present with significant skin laxity and muscle stretch from weight gain or childbirth.
Abdominoplasty successfully treats all three of these common issues. The surgery is usually performed through an easily hidden incision along the lower abdominal suprapubic area. Excessive muscle stretch is first corrected by a suture technique to tighten the lax muscle layer. Next, excess fat is removed by liposuction and direct surgical removal of the undesirable abdominal and flank fat. Skin laxity is then trimmed and the incision is closed with internal dissolvable sutures. No sutures are present on the skin surface or have to be removed.
I always look at patients presenting with abdominal issues in a 360 degree manor. The vast majority of patients with abdominal fullness problems also have flank (love handle) and lower back fat or skin excess. Addressing these truncal problems at the time of abdominoplasty has added immensely to the “wow” effect of the patient’s post-operative result.
Treatment of flank and back fat deposits and skin rolls is accomplished using two techniques. First the firm attachments of the skin to the underlying muscle fascia are released through small 3mm incisions using a specially designed instrument. Next Excessive fat in these areas is removed often using ultrasonic liposuction techniques. The combination of these liposuction and release techniques allows the tissues to redrape freely and eliminates a high percentage of the back and flank contour irregularities when an appropriate amount of removed fat can be transferred into the buttocks to improve contour and fullness.
As every patient’s truncal issues differ dramatically, it is vital that an individual treatment plan be developed for each patient. As a part of this planning process, each patient is photographed in a 360 degree fashion. I review the photographs with the patient and areas of concern are identified. A surgical plan is then developed. In most patients undergoing Abdominoplasty, treatment of back and flank issues is usually offered at minimal additional cost.
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