Click on the above link to listen to Dr. Walter Tom on “Ask the Expert” describe the different treatments for tightening loose abdominal skin.
In our too fast paced society we want results yesterday with a no downtime but significant results. Many of my patients desired an alternative to a traditional tummy tuck with a large incision, long recovery time and general anesthesia. Using tumescent local anesthesia patients have been able to undergo cosmetic procedures that in the past we thought was impossible to perform with such ease and quicker recovery.
Initially I have seen many patients who opted for SmartLipo laser liposuction because it avoided incisions and one received skin tightening because of the laser effect. However there was definitely a subset of patients who had a lower abdominal scar from a C-section or hysterectomy. These old scars were problematic as despite the wonderful effects of the laser the skin overhanging the incisions could be resitant to tightening. Excision of the scar became clearly evident as the next maneuver to give our patients a flat, smooth “tummy”.
Hence, the Bikini Tuck was introduced. What is a Bikini Tuck? A Bikini Tuck is performed safely under local anesthesia without the risks of general anesthesia. Fat is reduced by liposuction and then the excess skin is removed keeping the incision below the bikini line. Recovery is simpler. Mothers in particular like this alternative because of the safety of local tumescent anesthesia over general anesthesia.
Lipo-abdominoplasty (Lay terminology lumps this into the general category of tummy tucks) is performed completely under tumescent local anesthesia just as we perform laser liposuction and awake or conscious breast augmentation.
With only oral sedation used the patient is administered small doses of oral Ativan, Benadryl and Tylenol. No narcotics either intravenous nor orally are administered. Tumescent anesthesia is administered through small needle puncture sites.
Liposuction is then performed with or without a laser. After body contouring has been completed the lower abdominal skin is excised (again under tumescent and local anesthesia). In the majority of selected cases only the skin is excised leaving the reduced fat layer with intact lymphatic and blood supply. The skin is closed with hidden dissolving sutures reinforced with small butterfly tapes. The patient walks out of the office within 20 minutes after completion of the procedure and is driven home by their responsible adult driver.
The key elements are that a tumescent liposuction is used to more completely contour the body leaving a reduced layer of fat under the skin with good blood and lymphatic supply. There is essentially minimal to no blood loss because little fat is excised compared to traditional abdominoplasty. Drains are rarely required because the lymphatic system is intact reducing post op swelling. Primarily just the skin is excised and healing is improved because of this underlying fat layer reducing dramatically the potential complications of traditional tummy tuck.
The Bikini Tuck is a good alternative for removal of stretch marks and loose skin even for those who have never had a C-section or hysterectomy.
I beleive that the Bikini Tuck meets the criteria of minimal downtime, significant results with greatly diminished risks.
It’s Bikini time!
In health and beauty,
Walter W. Tom, MD