a plastic surgery procedure designed to tighten the abdominal skin and muscles. Generally a variable amount of skin is removed below the belly button level and the skin incision is designed to be hidden within the boundaries of a bikini or undergarment.According to present day plastic surgery lore there are 5 types of abdomens
1 – requires no surgical treatment
2 – is best treated with liposuction only
3 – is best treated with a combination of liposuction & a mini abdominoplasty/tummy tuck
4 – is best treated with a combination of liposuction & a modified abdominoplasty/tummy tuck
5 – is best treated with a combination of liposuction & a standard abdominoplasty.
In relatively few cases there is little or no liposuction needed in a specific patient who lies in one of these categories.
Which category you are in depends on the relative amounts of excess skin/fat vs. abdominal muscle laxity you have above vs. below the navel. There are some good plastic surgeons who believe 4 should not exist. Also, there are probably naturalists, trainers, etc. out there who believe none of these should exist except 1. My experience & training lead me to believe that all 5 are valid & that diet & exercise can be combined with any of the 5.
There are a significant number of people out there with a condition know as diastasis recti (separation of the 2 central abdominal muscles) which is never amenable to diet or exercise. It is more common after the inherent stretching of pregnancy especially if the muscle is cut during C-section. These people need surgical tightening of the displaced abdominal muscles. Excess fat can be lost to some degree with diet & exercise depending on age, metabolism, etc.. Resistant fat may be amenable to liposuction. The end result of liposuction in turn is dependent on the ability of the skin left behind to shrink.
Excess skin is more of a problem. Its ability to shrink after liposuction, pregnancy, large weight loss (decrease in the amount of fat under the skin) or decrease in underlying muscle mass is dependent on age, genetic makeup & how much shrinkage is required to get the desired result. If you need a lot of shrinkage, especially if you are older, it just doesn’t happen. The result is flabby wrinkled skin that may have stretch marks. These people require surgical removal of the excess skin because once the skin has been stretched beyond a certain limit it will not shrink much like an overstretched rubber band that has lost its elasticity. If you are planning to or are in the process of losing weight, at any age, it is better to go ahead with the weight loss for health reasons. Once the weight is lost you can then continue an exercise program to tone the muscles. If the skin doesn’t shrink it can be excised at a later date. There is no form of exercise that can shrink excess skin. Mild excesses, however, may appear less so after increasing the bulk of the underlying muscle.
Sometimes a c-section scar forms a continuous scar between the skin & the deeper muscular structures. The scar contracts as most scars do & the skin deviates towards the abdominal muscles. In some people this creates a layer of fat & skin than can hang over the c-section skin scar. This is removed during abdominoplasty & the various layers of the abdominal wall are realigned.