All methods of abdominoplasty may also be performed at the time of other major abdominal surgery to facilitate the abdominal surgeon in carrying out the procedure and minimizing postoperative complications (hysterectomy, cholecystectomy, etc.).

Alternative Procedures - Click on heading to learn more or scroll down.

Endoscopically Assisted Abdominoplasty With Suction Lipectomy - Top

Concept - If there is a tendency for weakness of the abdominal wall muscles, with associated excessive fat of the abdominal wall, but minimal excess skin, ultrasonic assisted lipectomy of the abdomen and flanks with an endoscopically assisted suturing of the muscles may be performed. The advantage of this procedure is that avoids the large lower abdominal incision and also preserves sensation of the abdominal wall. Recuperation from this procedure is less than that of a full abdominoplasty. Depending on expectation, this procedure may be offered the most patients who do not desire the large abdominoplasty scar and are willing to accept some skin laxity beyond that of the standard abdominoplasty.

Surgery - The patient first undergoes ultrasonic assisted suction lipectomy of the flanks and abdominal wall. After suctioning an incision is made around the umbilicus; a second incision is sometimes utilized, measuring approximately 2 cm, in the suprapubic area. Through these two small incisions an endoscope is placed and the separation of the rectus abdominus muscles (rectus diastasis) is repaired. A drain is placed, and the incisions in are closed. The patient is placed in abdominal binder.

The procedure may be performed in a surgicenter setting as an outpatient. A pain pump, infusing local allows for minimal pain in the first 48 hours.

This procedure has been successfully performed at the time of other intra-abdominal endoscopic procedures such as tubal ligation, hysterectomy, cholecystectomy,etc.

Recovery - The patient is placed in a binder for one to three weeks and is told not to do heavy lifting or high reaching for approximately six weeks. This procedure gives a natural result with minimal scar. Optimal results are obtained after 3 months.

Return to Work - 1 week if no lifting is required.

Full Activity - 6 weeks.

Complications - Seroma (Fluid collection), bleeding, infection, decreased sensation, hernia, limited result.

Endoscopically Assisted Abdominoplasty
Before	After

Conventional Abdominoplasty With Bikini-line Incisions - Top

Concept - This procedure is ideally suited for the patient with excessive amounts of abdominal wall skin and laxity of abdominal muscles. Rarely, for optimal result, a liposuction procedure is done 6 month later.

This procedure may be appropriate with certain modifications for patients who have had extreme weight loss, secondary to diet or gastric bypass surgery. This frequently requires longer incisions and hospitalization.

Surgery - The surgery is performed at surgicenter as an out-patient. A pain pump is frequently utilized for both postoperative discomfort. Incisions are made around the umbilicus and in the suprapubic area. The skin and fat are lifted off of the abdominal wall muscles. The muscles are tightened with sutures and occasionally mesh. The excess skin and fat is removed and the incisions are closed over drains.

Recovery - The patient may have drains for 1 to 2 weeks. The patient is required to wear a binder for approximately 3 weeks, may drive-in 10 days, and is requested not to lift heavy objects or reach in high places for approximately six weeks.

Return to Work - 1 to 2 week if no lifting is required.

Full Activity - 6 weeks.

Complications - Seroma (Fluid collection), bleeding, infection, decreased sensation, hernia, limited result and wound separation.

Conventional Abdominoplasty
Before	After

Combined Abdominoplasty and UAL Suction

After Abdominoplasty and then 2nd UAL Suction

Reverse Abdominoplasty - Top

Concept - Some patients have a better result by pulling the excess skin upward, beneath the breasts rather than downward to the bikini line. This places a hidden scar underneath the breast. The muscles can still be tightened through this approach. Occasionally liposuction will be performed at the same time.

Surgery - The patient first undergoes ultrasonic assisted suction lipectomy of the flanks and abdominal wall. After suctioning an incision is made beneath the breast and sometimes around the umbilicus. The rectus abdominus muscles (rectus diastasis) is repaired. A drain is placed, and the incisions in are closed. If the patient desires the excess tissue may be rotated beneath the breast for enlargement with their own tissue. The patient is placed in abdominal binder.

The procedure may be performed in a surgicenter setting as an outpatient. A pain pump, infusing local allows for minimal pain in the first 48 hours.

This procedure has been successfully performed at the time of other intra-abdominal endoscopic procedures such as tubal ligation, hysterectomy, cholecystectomy,etc.

Recovery - The patient is placed in a binder for one to three weeks and is told not to do heavy lifting or high reaching for approximately six weeks. This procedure gives a natural result with minimal scar. Optimal results are obtained after 3 months.

Return to Work - 1 week if no lifting is required.

Full Activity - 6 weeks.

Complications - Seroma (Fluid collection), bleeding, infection, decreased sensation, hernia, limited result and wound separation.