What is a tummy tuck?

A tummy tuck or Abdominoplasty is a surgery designed to smooth and tighten of the skin of the abdomen and improve the abdominal contour. Conditions such as pregnancy and weight gain with subsequent weight loss can result in stretching of the tummy skin and the deeper structures of the abdomen, the fascia, which makes up the "foundation " of the tummy. This fascia must be firm and flat for the skin overlying it to also appear firm and flat. The tummy tuck surgery must be individualized to each patient, as each patient presents with varying degrees of skin and fascia laxity. The incision for a tummy tuck is ideally placed low on the abdomen, just above the pubic hair. The length of the incision is determined by the amount of laxity of the skin or the amount of hanging tissue present. The skin and fat are lifted off the underlying fascia and muscles up to the ribs. If the fascia is loose or the abdominal muscles are separated, this is corrected with sutures at this time. This recreates a firm, flat "foundation " for the skin to lie on.The bed is then bent slightly to relax the abdominal skin, the upper abdominal skin pulled downward, like a window shade, and the excess trimmed off. The incision is closed with sutures that are all beneath the skin and dissolve in approximately 3 weeks. In the simplest form, there is only loose skin from the belly button down to the top of the pubic hair and no fascia stretching. This is corrected by the low incision and only the skin below the belly button is tightened. As the amount of laxity increases, it is necessary to free up tissue above the belly button and this requires making an incision right around the belly button and leaving it attached to its stalk on the abdominal wall. After the skin has been freed, pulled downward and trimmed off, the belly button is brought out, in its same position on the abdominal wall but through the skin from the upper abdomen which is now positioned lower.