Women who have completed their childbearing
are often confronted with abdomens that reveal stark evidence
of their fertility. The flat, tight abdomen of a teenager has
yielded to an abdomen with various accumulations of fat, lax
skin, some protrusion and occasional stretch marks. If a caesarian
section has been done, there is a scar attributable to that
as well. While the childbearing years may be over, there are
many future years to enjoy life and to wear a bikini, if possible.
Thus, there has been increasing interest in rejuvenation of
How is it performed?
As a result of the advances in techniques,
the new mini tummy-tuck with umbilical "float" has
been developed. Prior to surgery, the patient is stood upright
and outlines of all excess fat pockets made on the patient's
skin. The operation is performed on an outpatient basis under
"twilight sleep" intravenous sedation, which is administered
by a board certified anesthesia physician. In addition to the
intravenous sedation, the anesthesiologist will administer an
epidural anesthetic, or saddle block, which is commonly utilized
for women during childbirth. It is safe and very effective.
the operating room, a tumescent technique is utilized in which
fluid is injected into all the outlined areas to soften the
fat and make its removal more precise. Liposuction, utilizing
fine instruments, is then performed on all the fat bulges. Fat
pockets can be contoured anywhere, from the fold under the breast
down to the pubic area and from hip to hip, including the flanks
and love handle areas. The goal is to produce a thin and uniform
layer of fat over the entire abdomen and flanks.
horizontal incision is then made just above the pubic hairline
in a convenient skin crease. If a horizontal cesarean section
scar is present, then the new incision is placed beneath the
C-section scar so as to remove it at the same time that the
extra skin is removed. The loose skin is then carefully lifted
from the underlying muscles. The muscles themselves are surgically
tightened so as to flatten the abdomen and take up the slack,
lax tissues which were a result of pregnancy. The navel (umbilicus)
is then carefully detached from the muscle layer underneath
the skin. This frees the skin of the abdomen so that it may
be pulled down and tightened. It will allow for tightening of
the skin located between the navel and the chest as well. The
navel is then "floated downwards" and reattached to
the newly tightened abdominal muscles at a point approximately
½ " to ¾ " lower than its original site.
This new location is not noticeable at all. At this point, the
pubic area, including the mons pubis, which may have settled
downwards by gravity and through pregnancy, is lifted up and
attached at a higher level to the muscle layer. The remaining
skin is then pulled down and excess skin measured and carefully
trimmed off. The skin is then sutured to the mons pubis area
with multiple dissolving sutures in many layers so that there
are no stitches to be removed.
A thoughtful look at a youthful, athletic
abdomen reveals certain features. A vertically oriented navel
is youthful. A horizontal navel, frequently seen after pregnancy
is not youthful. The mini tummy-tuck with umbilical "float"
will produce a vertically oriented navel. Also, an athletic
and youthful abdomen will often times have a vertical groove
extending upward from the navel. Utilizing liposuction, a technique
entitled Abdominal Etching, can create this groove. Finally,
the mons pubis is elevated to a more youthful position.
can I expect after surgery?
You will recuperate at home and may experience
some discomfort for several days. Pain medication will be provided
for you. You cannot shower until the first dressing change,
which occurs several days after surgery. There will be some
swelling of the abdomen, which takes between 7 and 10 days to
resolve. You will be able to walk around on the day after surgery
and in fact, this is encouraged. It is estimated you should
be realistically able to return to sedentary work within 10-14
days after surgery. Athletic activities may be resumed approximately
3-4 weeks after surgery. There is ongoing healing under the
skin, which will require at least another 6 months for resolution.
It is common for there to be diminished sensation on the skin
of the abdomen; the sensation usually returns slowly over a
number of months.
What are the anticipated results?
The operation is designed to provide a
smooth, flat, graceful, athletic contour to the abdomen. The
small additions such as a groove in the upper midline, a vertically
oriented navel and an elevated mons pubis all speak of a
youthful, taut abdomen. It is therefore quite possible to wear
a low cut bikini after this rejuvenative surgery.
those who plan additional pregnancies:
Liposuction of the abdomen would certainly
be helpful to you. However, it would perhaps be unwise to perform
a mini tummy-tuck if future pregnancies are planned, because
the pregnancy would undo most of the benefits of the operation.