This blog will address the ncision site options for abdominoplasty. We have emphasized in the past the profound benefits of the tummy tuck. When a person– man or woman reaches a point in their life where the lower abdominal skin and fat no longer is attractive and diet and exercise will no longer produce the flat tight lower abdominal wall that we all truly desire––then an abdominoplasty or tummy tuck can be considered.
As with all electives especially cosmetic procedures, we 1st assess the patient’s safety and suitability for the procedure. The preoperative evaluation includes the consultation and any laboratories or consultations with other physicians needed in order to establish –the scar be.
Ideally the scar should be as low as possible––preferably beginning at the upper border of the pubic hair. Or if there is a low transverse C-section incision then we can use this as the central portion of the scar and extend laterally to each side––as far as need be in order to remove the entirety of the excess hanging skin. Remember the goal here is to produce the flattest tightest most attractive abdominal wall possible given the preoperative anatomic conditions. This can mostly be achieved by the lowest possible scar with a slight curve to each side. Ideally, again we would like this incision site to be coverablewith the skimpiest of bikinis. This however may not always be possible therefore the patient must allow some degree of flexibility with respect to scar placement. Also keep in mind that the patient’s elasticity of the skin may sometimes allow the lowest possible scar to migrate postoperatively.
There are some modifications to scar placement often in order to shorten the overall length all of the scar laterally and to permit closure in the vertical axis––which may not be achievable due to the lack of an over abundance of skin––a small W in the midline may be required. In other words—pre–operatively, the top of the belly button must be advanced to the lowest possible portion of the midline above the pubic hair. If this can’t be done then we use a small W dart in order to facilitate the primary closure.
In addition, occasionally we may need a small vertical component of the abdominal incision in order to facilitate removal of excess skin in the horizontal plane. In other words the vertical or up-and-down excess can be removed with a low transverse incision or a lazy W incision. However, if the circumference of the torso is excessive we may need a vertical scar in addition to the lower transverse scar-to achieve maximum abdominal wall tightness.
Abdominoplasty or tummy talk is a very good procedure to achieve the tightest possible abdominal wall. Call for an appointment –check out our videos and 3-D animation on our website–DRTOMTREVISANI.COM and let’s get moving on a better you.