This is a 43 year old mother of three, 5’’ and 140 pounds, who was interested in body contouring options. You can see from her pre operative photos that she is not overweight, has only a modest amount of fat at best and has a very full abdomen that protrudes significantly.
She is seen here after a full tummy tuck (abdominoplasty) and a small amount of liposuction around her flanks and abdomen. A full abdominoplasty consists of compete elevation of the skin of the abdomen and tightening of the underlying abdominal fascia that is stretched by pregnancies. This is commonly referred to as “tightening the abdominal muscles.”
It’s easy to think that this is not the same person in her post-operative photos, but it is.
- The problem with her abdomen was not excess fat or terrible stretched skin—it was loose fascia. Her amount of fullness is simply a lot and is not the normal that would be seen in most women. She actually benefited from tightening of the muscles more than most patients with her anatomy. It’s not always easy to predict how “flat” an abdomen will become after an abdominoplasty, but it is always flatter and often much flatter than it was before surgery.
- Fat on the inside of the abdomen cannot be treated with plastic surgery. This is a weight loss issue. Some patients have a tendency to accumulate fat on the inside of their abdomens more so than others and this has to be recognized by your surgeon. The “beer belly” abdomen is a classic—a large protuberant abdomen that has little fat on it and is actually hard. Spend any time at your local festival and you will see plenty in middle aged men. This is not as common in women, but it does occur and tends to run in families.
- Women hold in their abdomen almost universally. They subconsciously flex their abdominal muscles during the day so that it appears flat. Only about two percent of women don’t do this on a regular basis. Men don’t hold it in. The point of the matter is that your abdomen can be flatter with or without surgery if you hold it in. Abdominal muscle exercises will help the situation with a post pregnancy abdomen, but it will unlikely result in an abdomen that you prefer. You cannot exercise your abdominal wall to achieve the same results of an abdominoplasty. You cannot exercise your skin either for that matter.
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