The tummy tuck is a very common procedure in plastic surgery.   Virtually all plastic surgeons and even those who are not trained in plastic surgery think that they can perform a tummy tuck.  However, merely going through the steps of a tummy tuck does not take genius and does not assure the best result.  The execution of a tummy tuck is dependent upon a whole host of intellectual and technical factors.  These factors will differentiate a tummy tuck that may be an improvement from a tummy tuck that is optimal. In addition, tummy tuck is frequently inadequate by itself to completely address all of the mommy makeover concerns, and additional procedures such as liposuction may need to be performed at the same time.

How does a patient know who is an expert in this procedure and who is merely paying lip service?  Discussing the procedure is much different from performing the procedure. Nonetheless, there are considerations that can optimize anyone’s physique.

1) The scar must be as low and symmetric as possible.  Tension placed upon the final skin closure is never uniform,  and the patient’s starting anatomy is never symmetric.  The fine tuning of final flap closure and incision modification is a series of compromises to create as low and symmetric a scar as possible, while compensating for preexisting skin and subcutaneous discrepancies and asymmetries.

2) The abdominal wall should be constantly assessed for hernias as they can be present anywhere.  They can be very small and many hernias cannot be felt upon physical exam or ascertained from imaging such as MRI or CT.  Identifying and repairing fascial defects like hernias is important for general health and abdominal wall integrity.

3) The dissection should be carried all the way up the xiphoid process.  Dissection that proceeds only to the level of the belly button or only slightly above prevents complete and adequate fascial plication or muscle tightening.  In addition, the skin and fat that can be recruited is dramatically reduced without this maneuver.  This can result in a protuberant abdomen or a bowling ball abdomen.

4) The plication should precede from the xiphoid to the pubis.  The plication should anatomically correct the diastasis and abdominal wall laxity to restore functionality to the abdominal wall.  However, it should not create muscle overlap or a nonfunctional and nonanatomic configuration.

5)  The cosmetic outcome and relative hourglass figure can be dramatically altered depending upon how the flaps are dissected laterally and how they are advanced at the time of closure.  It is the difference between a square, boxy look and that of a wonderful hourglass silhouette.

To learn more about tummy tuck in Los Angeles, please visit Dr. Kenneth Hughes’s website

https://www.hughesplasticsurgery.com/body-procedures-los-…

To see tummy tuck before and after pictures, please visit Dr. Kenneth Hughes’s website

https://www.hughesplasticsurgery.com/los-angeles-before-a…

Contact
Dr. Kenneth Hughes, Hughes Plastic Surgery
Dr. Kenneth Benjamin Hughes, Kenneth Hughes, MD