- Remove extra skin from the lower belly
- Remove extra belly fat
- Tighten abdominal muscle
Incisions for full or mini tummy tuck surgery
In both mini abdominoplasty/mini tummy tuck (where only a small amount of skin is removed and no muscle tightening is done), and full tummy tuck/full abdominoplasty (where all skin below the belly button is removed and muscles tightened from breast bone to pubis), the size of the scar is usually the same.
Cosmetic patients obviously want the smallest surgical scar possible but in reality, length of scars are determined by the amount of loose skin and fat that a patient has. Patients who are candidates for mini-abdominoplasty may have less fat than a full tummy tuck patient but they may also have more loose skin–and a larger scar!
Patients who have a full abdominoplasty/full tummy tuck, have all skin from pubis to breast area elevated and so the whole abdominal wall is visible to their plastic surgeon. That is where hernias hide.
There are four main types of abdominal hernias. A hernia is a weakening of our abdominal wall which allows fat and intestine from inside our abdominal cavities to protrude or herniate out through weakened muscles. Muscles are weakened either because of injury, surgery, or child birth.
- Inguinal: also known as groin hernias–common after injury
- Umbilical: protrude through or around a belly button–common after pregnancy
- Ventral: protrude in between the two rectus muscles (the six pack abdominal muscles)–again after pregnancy
- Incisional: hernias caused by previous surgery anywhere
Hernias must be repaired or patients risk having a piece of intestine or internal fat getting caught in the abdomen wall defect and dying. That can lead to emergency surgery and be dangerous.
Surgery for Abdomen Hernias
Surgery to correct a hernia involves a cut through skin down to belly muscles. The hernia is then found and if abdominal tissues are strong enough, repaired by closing the hole leading from the abdominal cavity. If muscles are weak some sort of artificial mesh (Marlex mesh) or supporting tissue is used.
Surgeons usually make incisions through the mid-line abdomen skin leaving an ugly scar. However, in patients who may want a tummy tuck concurrently, a plastic surgeon can make a scar above your pubic area which will be nicely hidden under a panty line. Skin is then elevated, hernia repaired and reinforced by tightening of muscles, and wound closed after removal of extra skin. Any liposuction to remove extra fat from the sides is then done as a cosmetic procedure for which patients pay separately and is not part of the medical hernia repair whose costs are usually covered by health insurance.