The ideal abdominal contour is that of taut abdominal skin with a thin layer of subcutaneous fat and a well-toned muscle wall. In women, the ideal abdominal contour is one that is maximally tapered at the waist at the level of the umbilicus, smoothly transitioning from the chest to the abdomen and then on to the thighs, also commonly known as the hourglass figure.
There are many complementary procedures, including breast augmentation, breast lift, and liposuction, which help females restore their pre-pregnancy body. These are collectively known as “mummy makeover” procedures.
Abdominal laxity manifests as excess skin in the lower and upper abdomen. This skin drapes downwards and outwards over the undergarments or clothes, resulting in a “muffin top”. The skin develop have striae (stretch marks). In more severe cases, excess abdominal skin leads to accumulation of perspiration in the fold, resulting in fungal infections, skin inflammation and malodour.
There are often areas of persistent fat deposits despite weight loss. Men tend to deposit fat in the flanks (“love handles”) and the lower abdomen. In contrast, women tend to have deposits in the side boobs, inner arms, hips, thighs, and lower abdomen. There is often a generalized abdominal bulge, even if the individual is of normal weight. Individuals may be distressed with these findings and may adversely affect body image, self-confidence and social functioning.
The common causes of abdominal laxity are weight loss, following pregnancy or advancing age. Anatomical changes develop at the different layers in the abdomen. Previous obesity or pregnancy causes stretching and thinning of the skin and results in striae. There are areas of persistent fat deposits due to changes in adipocyte (fat storage cells) metabolism that render them resistant to weight loss. The abdominal muscle wall is irreversibly stretched by previous pregnancy or obesity, and results in generalized abdominal muscle weakness and bulge that persists even after returning to normal weight. The vertical rectus abdominis muscles, a pair of abdominal muscles that lie in the midline, may become horizontally separated (rectus diastasis) and contribute to the muscle bulge.
The abdominoplasty addresses the changes in the different anatomical layers involved in abdominal laxity. It removes excess skin, tightens the abdominal wall muscle and restores the body silhouette through a low-lying scar in the pubic region that is well-concealed. It produces exquisite, bespoke and sustained results for abdominal rejuvenation.
Successful reversal of these anatomical changes helps individuals restore their self-confidence and social functioning. The abdominoplasty is performed as an ambulatory procedure under intravenous sedation or short general anaesthesia and requires an overnight inpatient hospital stay.
The following are good candidates for abdominoplasty:
The abdominoplasty improves the body silhouette using well-concealed abdominal scars that are hidden within the underwear or swimwear. The excess skin folds are removed to recreate taut abdominal skin covering the muscle, including excision of striae in the lower abdomen. Abdominal muscle wall tightening is performed which recreates tapered waists that accentuate the chest and hip contours. The umbilicus is relocated to its natural, youthful position.
Individuals are advised to stop herbal supplements and traditional medicine 7 days prior to surgery to minimize bruising and swelling.
The excess skin and fat and proposed scar is marked out preoperatively. The design is individualized to ensure optimal results. The incision is performed and the skin and subcutaneous fat lifted off the abdominal muscle wall, up to the level of the lower margin of the chest for maximal skin advancement and tightening. The abdominal muscles are tightened, and the excess skin and fat excised. Proprietary techniques are used to bring in the waistline for enhancement of the postoperative results. The optimal amount of skin and fat to be excised is a fine art: sufficient to restore an aesthetic contour, yet within appropriate limits to avoid excessive wound tension and complications. A new umbilicus opening is made in the abdominal wall, to relocate it at a natural, youthful location. Special wound closure techniques are used to optimize wound healing and reduce postoperative scarring.
Most cases require overnight hospital admission postoperatively. Surgical drain tubes may be inserted during the time of wound closure to drain fluid from the wound cavity and this is often removed prior to discharge. Mild swelling and bruising is expected, which will mostly resolve by the 14th postoperative day. Many individuals are able to resume work after the 7th postoperative day.
Showering is possible after the drainage tubes are removed on the first or second postoperative day. Stitch removal is usually unnecessary as the stitches used are self-dissolving. Strenuous physical activity is avoided for the first 2 weeks to minimize bruising. Scar management is commenced two weeks after surgery to optimize wound healing. An abdominal binder is used for a month postoperatively to protect the underlying muscle tightening and repair.
At Picasso Plastic Surgery, we are pleased to specialise in tummy tucks in Singapore. Dr Yeo is privileged to have visited and learnt from some of the foremost overseas experts in this field. He is similarly privileged to have worked with outstanding tummy tuck surgeons and has accumulated experience in this area. Dr Yeo is regularly invited to speak on tummy tuck & weight loss contouring at plastic surgery conferences in the Asia Pacific region.