Full Complete Abdominoplasty Versus Mini Tummy Tuck
Patients often present to my office weekly in Beverly Hills, desiring abdominoplasty or tummy tuck procedure after having given birth to one or multiple children, as well as to significant weight fluctuation or weight loss after gastric bypass surgery. Determination must be made during the examination as to the extent of dissection required for the abdominoplasty.
A mini abdominoplasty is simply through a similar C-section-like scar which is extended towards the iliac crest roll or hips bilaterally, dissected up to the umbilicus. However, an incision is not made circumferentially around the belly button. These patients can have plication of the midline rectus sheath from the umbilicus down to the suprapubic region; however, the skin above the umbilicus up to the ribcage is usually not affected. Patients who do well with mini tummy tucks have skin laxity below the umbilicus or belly button and reasonably good skin tone without excessive skin above the belly button. On the other hand, the majority of patients require full abdominoplasties. These patients have skin laxity both above and below the belly button and require complete dissection above the umbilicus with a circumferential incision around the umbilicus, maintaining it to the umbilical stock to the fascia and dissected up to the subxiphoid process that is a structure below the mid-sternal region and up and sometimes above the subcostal margins below a ribcage. These patients are able to have skin pulled down from above the belly button, smoothing it out and removing the entire dermoglandular resection, both from the belly button down to the suprapubic region. The amount of skin to be removed will dictate the type of abdominoplasty to be performed, the extensive complete abdominoplasty versus a mini tummy tuck. Both however should have drainage tubes placed, 7 or 10 mm JP drains and plication with Ethibond interrupted sutures is used in my practice to tighten the lower rectus sheath and a mini tuck in the upper and lower rectus sheath and a full abdominoplasty.