A tummy tuck is a surgical procedure performed for abdominal contouring for both men and women. This procedure is performed by a Plastic Surgeon. The technique varies between patients based on clinical presentation.  What are the different types of tummy tuck surgery?  Which factors determine the most appropriate technique for an individual patient?

Mini tummy tuck

Of the different types of tummy tuck, the mini tummy tuck – as the name suggests – is the least invasive.  It involves removal of a small amount of excess skin and soft tissue limited to the lower abdomen.  It addresses excess skin that does not respond to diet and exercise.  The procedure is limited to the lower abdominal region, below belly button level.   A mini tummy tuck generally does not involve tightening of the abdominal wall muscles.  If a muscle repair was performed of the lower abdomen alone, an unnatural abdominal contour may result.  A mini tummy tuck is a technique generally reserved for thin individuals with a small amount of redundant skin.  It does not place a scar around the belly button and involves the least amount of scarring of all types of tummy tuck surgery.

Standard tummy tuck

A traditional full tummy tuck involves removal of excess skin and soft tissue as well as tightening the abdominal wall muscles (the so-called rectus plication).  This type of full tummy tuck surgery carries an incision from hip to hip along the lower abdomen, as well as a small incision around the belly button.  The rectus diastasis – or gapping between the rectus abdominal muscles that commonly develops following pregnancies or significant weight fluctuation – is repaired above and below the belly button level.  This is the most common type of full tummy tuck surgery and may be combined with liposuction of the flank region for further waistline definition as indicated.

Circumferential tummy tuck

Given that rates of bariatric surgery are increasing, more patients are presenting for body contouring following massive weight loss.  The skin has stretched beyond its ability to contract and many body sites demonstrate loose skin.  The excess skin and soft tissue is not limited to the abdomen in these cases, but extends around the body onto the back.  These patients may benefit from circumferential abdominoplasty, one of the most extensive tummy tuck surgeries.  This procedure extends a standard tummy tuck circumferentially, removing excess skin and fat and subcutaneous tissue around the back.  A circumferential tummy tuck may be performed in one surgery vs. two stages, which will depend on clinical presentation, patient preference, and other medical conditions.  Although the risk of wound healing complications is greater than for a standard tummy tuck, this is a powerful technique to improve contour of the entire torso in patients following massive weight loss.

Fleur-de-lis tummy tuck

The fleur-de-lis procedure is the only type of tummy tuck that will remove excess skin and soft tissue in the horizontal as well as vertical plane.  This procedure is similar to the extended tummy tuck in that it removes large amounts of excess skin and fatty tissue. It may also be an option for patients following massive weight loss given loss of skin elasticity.  In addition to the standard lower abdominal transverse scar, the trade-off for the fleur-de-lis tummy tuck is a vertical scar extending both above and below the belly button.  This scar would be apparent when wearing underwear and two-piece swimwear.  The fleur-de-lis tummy tuck is less commonly performed due to more extensive and visible scarring, however it may be a useful technique in select patients.

Your health prior to tummy tuck surgery

It is important that you are in good health prior to tummy tuck surgery. For all types of tummy tuck surgery, it is important for patients to commit to smoking cessation at least one month pre- and post-operatively.  This lowers the risk of healing complications, including wound dehiscence (separation), skin flap or umbilical necrosis, and infection.  Achieving a healthy and stable BMI less than 30 – ideally closer to 25 or less – is also recommended to achieve a better aesthetic outcome with lower risk of systemic complications. In some cases your board certified plastic surgeon may require you to lose a certain amount of weight prior to being eligible for a tummy tuck.

Please contact us at Power Plastic Surgery if considering tummy tuck or body contouring procedures in the Toronto area. Board Certified Plastic Surgeon, Dr. Power will discuss the different types of tummy tuck and make personalized recommendations based on your aesthetic goals and clinical presentation.

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