Patient 12 Gallery

Before and after abdominoplasty and liposuction in a 37-year-old mother. After having three children – including a set of twins – her belly had stretched beyond the point of skin contraction, causing permanent stretch marks (called “striae gravidarum”) and separation of her abdominal muscles (“rectus diastasis” in Latin).

Her goal was to have her abdomen feel like it had more stability and to be able to exercise without feeling like her “intestines might spill out.” Abdominoplasty surgery removes excess lower abdominal skin and fat, including some – but not all – stretch marks. Any stretch marks that lie above the belly button, on the hips, thighs or flanks will remain, but will likely be less noticeable due to less looseness of the skin in the region.

The abdominal muscles that are associated with a six-pack (rectus abdominis) on either side of the umbilicus (navel, belly button) are repaired, and liposuction removes excess fat from the upper and lower abdomen, pubic region, flanks and upper inner thighs. Liposuction is combined with every tummy tuck in our practice, which compliments the excisional portion of the procedure.

The umbilicus is maintained on its own blood supply, like the stem of a flower. When the abdominal skin is pulled downward during closure of the lower abdominal incision, it is brought out through a new incision – like bringing a button out of a buttonhole. If there is a past navel piercing (which many of our patients would like removed), this old belly button piercing is also removed.

Follow up photos are shown 3 years after surgery, with mature scars and a durable result. She has become motivated to get fitter and lose some weight.

The second last image shows her muscle separation prior to repair of the muscles, and the very last image shows full two-layer rectus fascial plication, where the belly button is maintained in the midline with its own blood supply, and the muscles are back together in the midline. A permanent double stranded nylon suture is used – the body will heal scar tissue around it, and it will remain as a permanent repair.