This patient in her 30s developed significant abdominal skin laxity after having twins, which did not improve despite having a healthy lifestyle and normal body weight (5’2” tall, 110 lbs, BMI 20.1). She decided to have a tummy tuck including abdominal muscle tightening. She did not require abdominal liposuction. The postoperative abdominoplasty photos taken 1 year after surgery show an excellent contour and a low, symmetrical, faded abdominal scar that would be hidden under most swimwear or undergarments.
Meticulous surgical planning and attention to multiple fine details are required to achieve the best possible outcome:
- Careful placement of the surgical incision so the resulting scar is low and hidden by clothing
- Debulking of the pubic region (“fupa”) so it doesn’t appear puffy in comparison to flat abdominal contour
- Full rectus muscle tightening (some surgeons do not tighten the upper part close to the ribs, but this can lead to a bulge)
- Careful insetting of the umbilicus to minimize scarring and ensure it has a natural-appearing contour
- Thinning of the tissue over the pelvic bones by trimming adipose tissue off the deep aspect of the flap and doing Scarpa fascia releasing incisions. This avoids a bulky “muffin top” appearance in this area, which happens if surgeons do not plan accordingly.
- Wound closure with sequential tension sutures (quilt stitches). This technique eliminates the need for wound drains since it closes the potential space where large amounts of fluid (blood or seroma) could otherwise accumulate. In addition, these sutures take tension off the lower abdominal incision, which might decrease the risk of wide or hypertrophic scars.
Disclaimer: Similar results cannot be guaranteed since outcomes vary among patients.
