submitted by Daniel A. Sterling, MD, FACS

What is the best way to get rid of a lower belly pouch?

 There are multiple ways to approach the abdomen in terms of giving an improved contour.  There are several reasons for having a “lower belly pouch” and those include excess skin, excess fat, a weak abdominal wall, and less commonly a ventral hernia or umbilical hernia.  Depending upon the diagnosis, the proper procedure can be selected to improve these problems.  If a patient has a combination of excess skin and excess fat then usually an abdominoplasty, otherwise known as a tummy tuck, is the best option.  If the excess is purely fat and the overlying skin is in good condition and does not have an excessive amount of stretch marks, liposuction can be performed.  In certain situations a combination of liposuction and a mini tummy tuck or mini abdominoplasty can be performed which will give an excellent result.  At the time of the tummy tuck, a weak abdominal wall can be addressed by suturing the loose fascia overlying the muscles on the abdomen to give an improved and flattened contour.  Women commonly refer to this as sewing the muscles together, and this is somewhat inaccurate in that it is the connective tissue or fascia overlying the muscles that is sutured together in the midline to give a tightened abdominal wall.  Many women have what is called diastasis recti which is a widening of the abdominal wall in the midline after having children.  This can cause a stretching of the abdomen both above the belly button and below the belly button and can be improved greatly.  Once the tummy tuck or abdominoplasty or even liposuction has been performed abdominal strengthening exercises can be continued after a period of postoperative recuperation.

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Submitted by Daniel A. Sterling, MD, FACS

Will sutures from mini abdominoplasty or liposuction be visible?

All of the sutures used for a miniabdominoplasty or liposuction are absorbable thus no sutures are visible following either of these procedures.  Even in a standard abdominoplasty all of the sutures are buried and are completely dissolvable.

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For confidential personalized information and advice, please call us at 1-800-640-0290 during business hours: Monday through Thursday 8:30 a.m. - 4:30 p.m. and Friday 8:30 a.m. - 4 p.m. EST. You can also visit our website on liposuction for more information or use the online contact form to send an inquiry. LATE AFTERNOON & EVENING HOURS NOW AVAILABLE. 

Submitted by Dr. Daniel A. Sterling

I  am going through a stressful situation and have lost a great deal of weight (50 lbs). I am 5’ 6” and weigh 115 lbs. I have been trying to gain weight but have not been successful no matter how much I eat. I have a lot of excess skin in my abdominal area and would like to have it removed. Am I a candidate for this procedure?
 

When someone loses a significant amount of their body weight unintentionally it is important to make sure that your overall health is good. Once you ensure that there are no underlying health problems your physical appearance can be addressed. Elective cosmetic procedures are only done under the safest circumstances. If there is a lot of excess skin following your weight loss you are in all likelihood an excellent candidate for an abdominoplasty (tummy tuck) because people who see the best results are those who have minimal excess body fat and mostly excess abdominal skin.
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For confidential personalized information and advice, please call us at 1-800-640-0290 during business hours: Monday through Thursday 8:30 a.m. - 4:30 p.m. and Friday 8:30 a.m. - 4 p.m. EST. You can also visit our website for more information or use the online contact form to send an inquiry. LATE AFTERNOON & EVENING HOURS NOW AVAILABLE . 

Submitted by Dr. Daniel A. Sterling

I have been researching surgery after weight loss and feel one of the procedures I am a candidate for is a panniculectomy. I am confused about the difference between this procedure and an abdominoplasty.

The difference between a panniculectomy and abdominoplasty is one of functionality versus cosmetic. In other words, a panniculectomy is a removal of a large fatty overhanging apron which may have skin infections etc. for a functional purpose so that the person may ambulate or exercise better. An abdominoplasty on the other hand is aimed at improving the cosmetic appearance of a less severe overweight or sagging abdomen. In either case there is a vast improvement in one’s appearance, however, one is considered a functional operation and the other one cosmetic. The operation itself is very similar except for a few small technical details.

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For confidential personalized information and advice, please call us at 1-800-640-0290 during business hours: Monday through Thursday 8:30 a.m. - 4:30 p.m. and Friday 8:30 a.m. - 4 p.m. EST. You can also visit our website for more information or use the online contact form to send an inquiry. LATE AFTERNOON & EVENING HOURS NOW AVAILABLE . 

Submitted by Dr. Daniel A. Sterling

I had gastric bypass surgery two years ago and lost 140 pounds.  I exercise three to four times a week.  I am 5 foot, 4 inches and my weight is 140 pounds.  Some areas of my body have responded well in that the skin has tightened.  My abdomen, however, has a lot of excess skin, as well as the upper portions of my arms.  I read your website and feel that I am candidate for a tummy tuck and arm reduction, can these procedures be performed at the same time?

It certainly sounds like you have lost the majority of your excess body weight and have maintained that weight loss for a significant period of time.  The redundant skin that is present will not respond to exercise and therefore surgical correction is the only option to give you the result that you desire and deserve.  Certain procedures can be combined, usually based on the length of the procedure.  Depending upon the severity of the deformity, certainly a brachioplasty (arm lift) and abdominoplasty (tummy tuck) could be combined. Many people need a circumferential lower body lift rather than an abdominoplasty as this gives the added benefit of a buttock lift and a lateral thigh lift at the same time.  A brachioplasty is normally about a 2 hour procedure.  It is my experience that patients do much better recovery wise when surgery is limited to approximately 5 hours under general anesthesia. Procedures longer than 5 hours make recovery for the patient far more difficult and increase the incidence of complications.  That being said, an abdominoplasty and brachioplasty combined should take approximately 5 hours. 

Submitted by Dr. Daniel A. Sterling

What is the difference between a tummy tuck and a mini tummy tuck, and how do I know which procedure I am a candidate for.

A mini tummy tuck is very rarely indicated and is limited to people who have a small amount of redundant skin below the belly button.  The vast majority of people have excess skin both above and below the belly button, as well as loosening of the underlying abdominal wall.  For certain people with a very limited amount of redundant skin and a small amount of excess fat a mini tummy tuck may provide the result they are looking for.  However, the majority of people get a much more comprehensive result with a full tummy tuck and the resultant scar is not significantly larger than that of a mini tummy tuck in any case. 

The mons pubis is the hair bearing area of the lower abdomen, just above the genitals. Some people have excessive fat accumulation in the mons, sometimes in conjunction with a fatty abdomen and sometimes isolated to the mons area. Fat accumulation of the mons pubis effects both men and women. In women, the fat may extend to the upper part of the labia.

Liposuction of this area takes about 30 minutes and can be done with a light anesthetic or under local anesthesia with sedation. Recovery is rapid (about 1 to 2 days) though swelling often persists for 7 to 10 days. Complications, such as bleeding and infection, are rare.

The result is a more attractive, streamlined mons pubis which gives a feeling of rejuvenation.

The mons pubis of a woman viewed from the side.

Weight gain and weight loss, aging and pregnancy all contribute to a sagging pubis. It is not generally known that this area can be lifted and rejuvenated.

A sagging pubis is often lifted in conjunction with an abdominoplasty or body lift, but can also be lifted as an isolated procedure.

The resulting scar looks like a C-section scar (horizontal -- just above the pubic hair) and usually heals well. Surgery takes about 30 minutes, and can be done under local or general anesthesia. Recovery is about 1 to 2 days. Complications are rare.

The lifted pubic area gives a feeling of rejuvenation. Overhanging skin in this area may interfere with clitoral stimulation.  By lifting up the sagging skin, the clitoris may be more exposed.