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Lateral Tension Abdominoplasty: A Superior Tummy Tuck Technique

Abdominoplasty, also known as tummy tuck surgery, is one of the most useful abdominal sculpting procedures available today. During a tummy tuck, an incision is made into the patient’s abdomen, allowing the surgeon to remove excess skin and reposition the abdominal muscles. Ideal for patients who have experienced pregnancy or significant weight loss, abdominoplasty has a number of both medical and aesthetic benefits.

With all of that in mind, however, it’s important to remember that abdominoplasty is considered an invasive procedure. The sizable nature of the alterations made during abdominoplasty come with a number of possible risks. Likewise, most patients need to dedicate several months to healing following a tummy tuck (with 2-3 weeks of this period being bed rest). Choosing the right surgeon—and the right abdominoplasty method—is therefore of paramount importance.

For most patients, we strongly recommend what is known as a “lateral tension abdominoplasty.” This method of performing abdominoplasty surgery both confers additional advantages and reduces the risk of complications. Before analyzing this surgical technique in more detail, however, we suggest reviewing the various risks and rewards of abdominoplasty:

Benefits of Abdominoplasty Surgery

  • Having a tummy tuck will improve the appearance of your abdomen. This is, of course, the primary advantage of abdominoplasty for most patients. In addition to getting rid of unsightly excess skin, tummy tuck surgery can remove a portion of the patient’s subcutaneous fat, thereby reducing or even eradicating the need for additional liposuction. (Note, however, that abdominoplasty is not intended to be a “weight loss” procedure. Patients should be within 10-15 pounds of their ideal weight before undergoing this surgery.) Furthermore, tightening the skin will often significantly reduce the appearance of stretch marks, a common concern for women who have recently given birth.
  • Having a tummy tuck can help patients maintain a healthy weight. Overcoming obesity is a great challenge for many people owing to metabolic and hormonal factors that are out of their control. As such, it’s extremely disheartening to realize that sagging, unsightly skin is often an inevitable byproduct of weight loss. (Indeed, loose skin can arise from losing as little as thirty pounds, depending on your age and the quality of your skin.) Understandably, many formerly overweight individuals become disillusioned when they find out that weight loss alone cannot create the body of their dreams. As a direct result, they lose the motivation to stay slim.

If, on the other hand, these patients have tummy tuck surgery, everything changes. They see that it is actually possible to get a taut, toned tummy. They’re given a sense of reward for all of their hard work, and this reward inspires them to stay in shape. According to a report published in the journal of Plastic and Reconstructive Surgery in 2016, Swiss researchers discovered that patients who had undergone bariatric weight loss surgery had significantly improved outcomes if they also had an abdominoplasty performed. Patients who had a tummy tuck following weight loss surgery gained, on average, a pound a year (or less). Meanwhile, those who had only bariatric surgery typically gained upwards of four pounds per year. Because the risk of weight gain following bariatric surgery has so many health implications, many clinicians now argue that abdominoplasty should be covered by medical insurance.

  • Abdominoplasty can protect against hernias and back problems. This advantage is particularly pronounced in patients who have had a cesarean section or an appendectomy. When the muscles of the abdomen are weakened or damaged by pregnancy, obesity, or the aforementioned procedures, they can no longer support the back fully. As a result, many people with weakened abdominal muscles go on to develop what is known as a “sway back.” While a sway back is not usually dangerous, it almost always results in at least some degree of chronic lower back pain. Abdominoplasty is often a more effective long-term solution to this issue than medication thanks to its ability to tighten loose and damaged muscles. (Moreover, this tightening allows the patient to exercise more easily and effectively. Ergo, they can set about strengthening their core further after they’ve recovered from surgery.)

Ventral hernias, on the other hand, can be harmful. Ventral hernias occur when abdominal tissue begins to bulge through weak areas in the abdominal muscles. While most ventral hernias are simply very uncomfortable, some of them become strangulated—and these type of hernias are considered a medical emergency. If you have weak abdominal muscles due to pregnancy, obesity, or prior surgery, it’s therefore a good idea to err on the side of caution. Having preventative tummy tuck surgery can spare you from enduring a painful and potentially risky situation.

  • Abdominoplasty can be used to treat urinary incontinence. Some women who have given birth vaginally go on to develop a condition known as stress urinary incontinence. Stress urinary incontinence causes the bladder to leak unpredictably, especially when the sufferer laughs, sneezes, or engages in vigorous exercise. Fortunately, this embarrassing condition is fairly easy to treat via abdominoplasty as long as you make your surgeon aware of it.

Risks of Conventional Full Abdominoplasty Surgery

Due to the fact that abdominoplasty surgery involves altering major structural elements of the abdomen (i.e., its underlying musculature), it’s considered major surgery. For this reason, patients who have health problems cannot undergo abdominoplasty surgery. If you have heart disease, lung problems, diabetes, or any condition that impairs the functioning of your immune system, you will not be a suitable candidate for tummy tuck surgery.

Even if you are in generally good health, conventional full abdominoplasty surgery carries a number of risks. These risks include:

  • Post-surgical infection. This risk is present with any surgical procedure, but it’s a particular concern with abdominoplasty due to the long healing time it requires. Post-surgical infections can be dangerous and disfiguring, so it’s extremely important to be aware of this danger. Talk to your surgeon about how to recognize the symptoms of infection and how to prevent infection. With timely treatment, many infections can be resolved without serious harm coming to the patient.
  • Changes in skin appearance and sensation. Because the blood supply to the abdomen is reduced during conventional abdominoplasty surgery, the skin and underlying tissue can become damaged. In rare instances, patients have reported experiencing numbness and other changes in skin sensation following tummy tuck surgery. Long-term skin discoloration and prolonged swelling also sometimes occur after abdominoplasty. In very rare cases, the death of fatty tissue and vein thrombosis have been reported, too.
  • Scarring. In order to perform tummy tuck surgery, a surgeon must make a lengthy incision in the patient’s abdomen. This is necessary to allow him or her to remove an even swath of skin. While a skilled surgeon will be able to make this incision in a very precise way, thereby minimizing the chance of scarring, some risk still exists. To reduce this risk as much as possible, ask your surgeon about how to properly care for your incision.

What Makes Lateral Tension Abdominoplasty Superior To Conventional Abdominoplasty?

Many of the risks above are worsened by the reduction in blood flow that accompanies conventional full tummy tuck surgery. A lack of circulation increases the chance of lasting numbness and damage because the tissue is deprived of the essential substances it needs to stay healthy during surgery. Full tummy tuck surgery lasts from between one to five hours, so this deprivation can be significant. Lateral tension abdominoplasty is therefore an excellent choice owing to its ability to preserve a greater amount of blood flow during the operation.

Lateral tension abdominoplasty has other advantages, too. The primary incision made during this procedure sits very low on the torso, often only slightly higher than the pubic region. Using a low incision means that even if scarring does occur, it won’t be noticeable. As Dr. Tehrani explains in this video, the scar from lateral tension abdominoplasty can easily be hidden with a bikini. Additionally, Dr. Tehrani uses a unique upper incision that is hidden by the bellybutton. Conversely, during a traditional full tummy tuck, the incision is often made around the bellybutton. In some cases, this can result in a visible scar that sits high up on the abdomen—an undesirable result for many patients.

While lateral tension abdominoplasty is not risk-free, it has the potential to be substantially safer than conventional full abdominoplasty surgery when performed by a skilled surgeon. As mentioned previously, however, lateral tension abdominoplasty is a relatively rare procedure. Few surgeons have the knowledge, expertise, and experience needed to perform it properly. Dr. Tehrani’s particular type of lateral tension abdominoplasty is therefore somewhat unique in the cosmetic surgery world: In addition to employing honed lateral tension techniques, it works to lift and tighten the upper thighs as well. Liposuction is also incorporated into the procedure for superior fat reduction.

Tips For Recovering From Tummy Tuck Surgery

In addition to choosing the right abdominoplasty method to meet your needs, it’s important to employ proper aftercare. After having a tummy tuck, we strongly recommend that you do the following:

  • Rest. This is the most important step, particularly immediately after surgery. It is absolutely vital that you not put stress on your abdominal muscles while they are still healing. Remain in bed as much as possible and do not attempt to lift anything heavier than five pounds. (Note that a walker or cane can provide excellent support when you do need to get up and walk around.) If you have children, make sure you have someone present to help you with childcare duties.
  • Wear any compression garments suggested by your surgeon. Compression garments can reduce swelling and bruising and speed healing. They also provide essential support for your abdominal muscles while they’re still healing. As such, if your surgeon has given you special compression garments to wear, you should follow his or her instructions. If you find the garments uncomfortable, talk to your surgeon about possible ways to make the experience more bearable.
  • Keep readily digestible foods and anti-nausea medications on hand. Some patients experience nausea following tummy tuck surgery. This is not due to the surgery itself, but rather due to the anesthesia that is used. It’s therefore a good idea to stock up on easy to eat, easy to prepare foods and anti-nausea aids. Ginger tea and ginger tablets can also be helpful if you’re looking for a more natural nausea solution or concerned about medication interactions.
  • Purchase a toilet seat booster. If you have low toilets, you will find sitting down on them difficult and possibly painful after tummy tuck surgery. As such, we recommend that you purchase and install toilet seat boosters prior to your surgery. These boosters will allow you to use the toilet without putting undo stress on your muscles or incisions.
  • Adopt a comfortable sleeping position. In the first few weeks following your surgery, you will probably find it more comfortable to sleep in a special “healing” position. We advise sleeping with your  legs and head both slightly elevated (similar to the position you were in on the operating table during surgery). This can minimize swelling and improve healing. If you find it difficult to maintain this position in bed, you might want to try sleeping in a recliner instead.

Tummy tuck surgery is a major operation and not without its risks and inconveniences. With that being said, however, it’s important to remember that for some people, not having an abdominoplasty can be more damaging over the long term. If you have loose, sagging skin and weakened muscles as a result of pregnancy or weight loss, it’s strongly recommended that you talk to both your primary care physician and a board-certified plastic surgeon about tummy tuck surgery. Many patients who have undergone this procedure recover without incident and report looking and feeling better as a result of their surgery. As always, the choice about whether or not to have surgery is ultimately up to you.

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