Extensive tummy tuck does not only rely on skin removal. It is important to note that after pregnancy or massive weight loss, the apron-like abdominal skin is not the only “factor” that contributes to the sagging or barrel-shaped appearance of the waistline.
The splayed or separated abdominal muscle, excess fats, and hernia (weak spot in the muscle or connective tissue that causes the intestine to squeeze through) also contribute to the unattractive appearance of the waistline.
Leading Beverly Hills plastic surgeon Dr. Tarick Smiley has recently posted educational videos on his Snapchat account to demonstrate surgeries involving extensive tummy tuck. It is important to note that each surgery is highly customized due to varying anatomies of the patients.
One female patient has received extensive tummy tuck that involved muscle repair, navel repair, liposuction of the flanks and lower back, and mons pubis lift.
Liposuction was first conducted to remove the excess fat along the flanks and lower back before the actual components of the tummy tuck were performed.
The patient then received a hip-to-hip incision made very low so that her underwear can easily cover the resulting scar. Over time, the scar is expected to fade into the background.
The hip-to-hip incision has allowed Dr. Smiley to lift the skin off and expose the pair of vertical muscle between the breastbone and the pubic region. Using the permanent “individual” suturing technique, he was able to tighten the muscle in the midline, leading to a flatter abdomen in frontal view.
After muscle repair, he injected Exparel into the muscle; this is a long-acting numbing medication that can significantly reduce the amount of pain for about four days.
Then, he removed a wedge-shaped excess skin before closing and tightening (centrally) the remaining skin in order to achieve an hourglass figure effect.
Of course, the enlarged navel has also been repaired so it will not detract from the narrower, more feminine waistline.
Because the female patient had lost a lot of weight, she also had sagging of the mons pubis, which has been lifted and re-anchored to achieve a smooth transition between the pubic region and the lower abdomen.