The most common Plastic Surgery procedure performed on men and women is body contouring. The abdomen is the area of the body that is most frequently contoured. Body contouring includes procedures such as liposuction, liposculpture, abdominoplasty (tummy tuck) and dermatolipectomy. In the next series of articles, I will review the different options for shaping of the abdomen.
Many patients come to Galumbeck Plastic Surgery for an initial consultation because they are unhappy with their shape and proportion, usually in the form of a tummy bulge, love handles or a muffin top. The first step to a better shape is to determine what is causing the underlying problem.
Evaluation of the Abdomen
Fat, tummy muscle position, skin quality, and belly button shape all need to be assessed to determine the procedures needed to give the patient the best results.
- Fat – Excess fat is the most common reason that people have abdominal contouringperformed. Fat may either be superficial or deep. Superficial fat is fat that is between the skin and the tummy muscles. Deep fat is fat located deep to the tummy muscles and is around the internal organs. Superficial fat can be removed and shaped, while the deep fat cannot. Determining the location of abdominal fat is a key indicator in predicting results from body contouring.
- Muscle Position – The front of the tummy has a pair of abdominal muscles know as the rectus abdominis muscles. A band joins the two muscles in the center of the abdomen. This band has no elasticity, so when it is stretched a gap remains between the two tummy muscles. This gap is known as the diastasis recti. Pregnancy and weight gain (especially of the deep fat) are the most common causes of diastasis recti. The abdominal bulge after pregnancy occurs not because the tummy muscles are weak, they are just in the wrong position. Repositioning of the tummy muscles by tightening the gap between them is a key component in a tummy tuck.
- Skin – Both the elasticity of the skin as well as skin excess need to be addressed to determine the best body contouring procedure to perform. Hanging skin with stretch marks will usually not tighten after liposuction is performed and the excess skin would need to be removed. However, skin that is not excessively loose, has few stretch marks and good elasticity would contract well with liposuction alone.
- Umbilicus – The navel is another feature of the abdomen that should be evaluated
during a consultation for abdominal contouring. If the belly button protrudes (an outie) or if a hernia is present, the navel may be repaired during an abdominoplasty. Alternatively, an umbilicoplasty can be performed if only the belly button needs to be reshaped.
The Role of Diet and Exercise
I think that diet and exercise go hand in hand with abdominal contouring. None of the procedures that will be discussed are replacements for good eating habits and exercise. Although fat cells are removed with most of the shaping procedures, the fat cells that are left behind can grow with weight gain. However, diet and exercise cannot achieve the results that body contouring can. While good eating habits can shrink fat cells and exercise can tone and strengthen muscle, these activities cannot correct abnormal muscle position (diastasis recti), address excess or inelastic skin, or sculpt disproportionate fat deposits. Thus diet, exercise and body contouring all work harmoniously to give the best shape possible.
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