Dr. Shenker explores the best solutions for common tummy concerns.
None of us are born unhappy with our tummies, but many of us end up there at some point in our lives, and there are many variables that lead us here. For some it’s unwanted weight gain or a large weight loss. Sometimes life gets in the way and keeps us from the gym, or we’re presented with unwise food choices all too often. Physical illness can affect our weight as well. At The Cosmetic Surgery Clinic, the most common reason we see women for tummy work is that their abdomens never recovered after pregnancy and childbirth. For men, it’s a large weight loss.
Not all tummy concerns are created equal, but there are some common elements to most scenarios.
If the concern is fat …
The target of many tummy procedures is the layer of fat that lies beneath the skin, but above the abdominal muscles. This outer fat layer is usually thicker in women, and thinner in men, who tend to have more internal (visceral) fat. The outer layer of fat can often be managed by non-invasive procedures such as CoolSculpting®.
If CoolSculpting is not the right option for you, the next possible procedure would be liposuction. Both CoolSculpting and liposuction reduce the fat that lives under the skin safely and effectively. It is important to point out that both of these procedures only manage the fat layer.
If the concern is fat and loose skin …
If your concerns include fat and skin, some form of surgical excision will be needed. In plain terms, that means the skin that is loose, or scarred, or full of stretch marks, simply needs to be cut off. The procedures that can achieve this include a mini tummy tuck or a full tummy tuck, both of which are very common procedures for us at The Cosmetic Surgery Clinic, for both men and women.
On occasion, we see patients who have had an extremely large weight loss. Some patients lose the weight through diet and exercise, and some have bariatric surgery such as gastric bypass surgery or a lap band. In these cases, the amount of excess skin is usually too much for a standard tummy tuck to manage, and the best choice is a fleur-de-lys procedure, so named because the shape of the incision pattern is modelled on the shape of a lily.
The advantage of the fleur-de-lys procedure is that excess skin is removed in both the vertical direction, as in a standard tummy tuck, and in the horizontal direction thanks to the vertical component of the scar. While this procedure does involve a longer scar, the shape and contour achieved is simply unachievable with any other procedure.
If the concern is muscular …
In most cases the third element that contributes to unhappiness with one’s tummy, in addition to the skin and the fat, is the underlying muscle layer. The rectus abdominus muscle, also known as the “six pack” muscle, can get weak, loose, separated in the midline (known as a diastasis recti), and can make a woman look pregnant when she is not. When the muscle is involved, there is no other choice but a full tummy tuck to fix the problem.
Your tummy questions, answered.
Now that you know that CoolSculpting, liposuction, a mini tummy tuck, a full tummy tuck and a fleur-de-lys procedure are all options, let me address the common questions we get about tummy procedures.
How do I know which procedure is the right one for me?
The only way to know for sure is to have a formal consultation with a well-trained and experienced plastic surgeon. In the hands of such a surgeon, the decision of which procedure to do is quite clear. Your desires and, more importantly, your anatomy will point to the correct procedure for you.
I haven’t seen my belly button since the year 2003. Will I get a new one?
The answer to this one is no. Your belly button will be uncovered, reshaped, and made both visible and beautiful, but it will be the same one mother nature gave you when you were born. Not new, just improved.
Are tummy procedures just for women?
Absolutely not. Every procedure described above can be and is done on both men and women. The surgical techniques do vary somewhat, as men and women have different ideal trunk, waist, and hip contours, but the principles remain the same.
I want to see my “six pack” after my procedure. Is that possible?
Like many questions in surgery, the answer is maybe! A visible six pack depends on having minimal fat overlying the muscles, so as not to obscure them. Managing that is your surgeon’s job. But a visible six pack also requires well-toned, frequently exercised, and highly developed abdominal muscles. That’s your job! Without both parties doing their jobs, no six pack will be visible. There are surgical techniques like high definition liposculpture that can help achieve the six pack look.
Can I have liposuction at the same time as my tummy tuck?
Yes. Supplemental liposuction of the upper abdomen and waist and hip areas is almost always part of a tummy tuck. The only exception would be in very thin patients who have little or no fat under the skin.
What is the recovery time?
Typical recovery happens in three phases. The first one or two days after surgery involve doing a lot of nothing. Resting, gathering your energy, and sleeping. Between days 2 and 14, you will slowly return to doing light normal activities of daily living: showering, driving, making a meal, working on a computer, etc. A gradual return to more physical work or recreational activities occurs between weeks 4 and 6 after surgery.
Do I have to have those yucky drain tubes after my tummy surgery?
Nope. Those are ancient history. There are several techniques we use at The Cosmetic Surgery Clinic to eliminate the need for drains in tummy surgery. I haven’t used one for years.
What’s up with that weird garment I have to wear after surgery?
That weird garment is a compression girdle. It supports the muscle repair, and the skin incision. It helps minimize swelling and it holds everything together when you have to cough or sneeze or laugh in the early days after surgery. It won’t be the sexiest piece of clothing you wear after surgery, but it will likely be the most important. You need to wear it for 4- 6 weeks after surgery.
Can I have additional procedures done at the same time as my tummy surgery so that I only have to recover once?
What a smart idea! The answer is a resounding yes. Many women choose to have some breast or arm or even some facial surgery at the same time as their tummy surgery to maximize the efficiency of their time off work or away from their normal activities.
So when it comes to men or women who are unhappy with the state of their tummies, there really is an option for just about everyone. Schedule a consultation today to determine which option is right for you.