abdominoplasty after weight loss

Abdominoplasty is a great procedure for people after major weight loss and bariatric surgery. Many of my patients can avoid the larger body lift surgery by doing an extended abdominoplasty, which allows for a shorter scar, shorter surgery, and easier recovery.

An abdominoplasty works in two ways. First, under the skin the abdominal musculature is tightened, like an internal ‘corset.’ The muscles loosen during pregnancy and major weight gain, and a separation of the rectus muscles forms. This separation is called a “diastasis.” (A hernia is an actual hole in the fascia, and is less common.) You cannot fix a diastasis by sit ups, as the muscles do not cross the midline. I find you can really notice this looseness when you “suck it in” and still cannot get your belly as flat as it is lying down. Some people have a full belly due to intraabdominal fat. This is not something that can be fixed by a tummy tuck. To get rid of intraabdominal fat, the only way is to lose weight .

Second, an abdominoplasty removes excess skin and fat, frequently removing all the skin between the belly button and the pubis. The scar looks like a C-section scar with a scar around the belly button. The length of the scar depends on the amount of skin and fat removed. Removing skin will rid stretch marks and wrinkling of the lower abdomen, and flatten and tighten the contour of the entire abdomen.

The abdominoplasty procedure is done under general anesthesia in one of two surgical facilities near my office in Palo Alto. The surgery facility in Palo Alto is outpatient; the Menlo Park facility has the capability of an overnight stay. Surgery for the abdomen alone lasts about three hours. I frequently combine abdominoplasty with liposuction or other cosmetic surgery procedures. I like to use pain pumps placed during the surgery that numb the area internally. This has improved patient’s pain experience postoperatively and decreases the amount of oral medication needed.

Depending upon the length and size of surgery, an overnight stay may be required. Abdominoplasty can be combined with non-cosmetic procedures, such as hysterectomy or umbilical and ventral hernia repair. When this is done, the surgery is at Stanford or Sequoia Hospital. Recovery takes two to three weeks.

People who are still losing significant weight or who are planning another pregnancy should wait.

To schedule your consultation for a body contouring treatment such as liposuction or abdominoplasty, contact my Bay Area practice in Palo Alto.