Dr. Chartchai, Bangkok Thailand’s leading board-certified plastic and cosmetic surgeon.

 

ABDOMINOPLASTY / TUMMY TUCK

The abdominoplasty, also known as a tummy tuck, creates a tight, flat abdomen, and is one of the most common procedures performed in plastic surgery worldwide.

When performing an abdominoplasty, Dr. Chartchai removes excess abdominal skin and fat by means of an incision just above the pubic bone, similar to a C-section but longer.

 

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If you can easily grab excess skin, and pinch a large amount, it is likely that an abdominoplasty would provide a highly noticeable improvement. If, on the other hand, the skin feels very thick, and is not particularly loose, it is likely that an abdominoplasty is not the procedure of choice. In this case, liposuction may be more appropriate.

Dr. Chartchai may advise that you consider some liposuction with your abdominoplasty. This would allow him to add an element of body "sculpting" to the procedure, and to enhance your final results.

Stretch marks can often be removed during an abdominoplasty depending on where they are placed and how extensive they are.

The benefits of a properly performed abdominoplasty are remarkable. The loose flabby abdominal skin that you thought would never go away has gone. Your abdomen is once again flat, and you have a sleeker, more attractive figure. Your stretch marks are gone. Your waist is smaller. Your clothes fit much better.

What do you want to change?
Common complaints are: loose skin, excess fat, stretch marks (especially below the bellybutton), abdominal pouch below the naval, lack of a waist line, droopy buttocks, and disproportionately large waist compared to buttocks and/or breasts. All these complaints can be helped with abdominoplasty by use of different techniques

Types of abdominoplasty
Here are the 4 types of abdominoplasty that Dr. Chartchai performs.

The most appropriate procedure for you is determined during your consultation with Dr. Chartchai. He will assess your skin excess, skin quality, fat excess, fat distribution and body-type. Together, you will decide what procedure is best for you.

Mini abdominoplasty / Mini tummy tuck
The mini-abdominoplasty is the least involved variation. The incision is relatively short, staying within the pelvic bones. It is slightly longer than a C-section incision. It usually does not involve repositioning of the belly button. The best candidate for this procedure typically has redundant skin and an abdominal pouch below the belly button. The mini abdominoplasty is not meant for someone who has excess skin or fat in the middle or upper abdomen.

Standard abdominoplasty / Standard tummy tuck
The standard abdominoplasty is the most common abdominoplasty. If there is more than 1-2 inches of excess skin, a standard abdominoplasty is probably necessary. It does an excellent job in eliminating the abdominal pouch below the umbilicus especially in women who have given birth. In the process it produces a much flatter stomach.

In a standard abdominoplasty, Dr. Chartchai tightens the underlying muscles in 2 places to flatten the stomach and narrow the waist line. A bonus of the standard abdominoplasty is that any stretch marks below the belly button will likely be removed. A properly performed standard abdominoplasty will help create an hour-glass waist line.

With age, weight gain, or pregnancy the stomach muscles separate in the midline and create additional bulging. During the abdominoplasty, Dr. Chartchai tightens the stomach muscles by suturing them together in the midline. It is usually necessary to reposition the belly button because of the large amount of skin that is removed.

A standard abdominoplasty does not treat fat deposits in the flank area. These can be addressed with either liposuction or by performing an extended abdominoplasty .

If there is only a small or moderate amount of flank fat, liposuction may be the best course. If you have a significant amount of flank fat an extended abdominoplasty would most likely be best.

The standard abdominoplasty leaves a scar from hip to hip and requires repositioning of the umbilicus to avoid positioning it too low on the abdomen.

Extended abdominoplasty / Extended tummy tuck
When the redundant skin goes around toward the back, then there is no other way to remove it but to extend the excision to include this area. The extended abdominoplasty involves removing folds of extra skin and deposits of fat from the flank and back area (the love handles and upper hip).

No other procedure can produce such an impressive waist line even in patients who never had an attractive waist line in their youth. It makes the buttocks appear much more attractive and curvy, and the breasts appear larger.

The incision for the extended abdominoplasty goes to the back of the hip area. Dr. Chartchai's technique keeps the incision low so that even low-rise clothing can be worn without scar exposure. The down side of the extended abdominoplasty is the additional operating time necessary, the additional cost, and of course the longer scar.

Circumferential abdominoplasty
The circumferential abdominoplasty is a very aggressive procedure and is reserved for those patients with a significant amount of redundant skin usually after significant weight loss. For the patient with flabby hips and droopy buttocks, the hips and buttocks can be elevated surgically to give a sleeker, more youthful appearance. This is a most aggressive and complicated operation that will leave a circumferential scar.

Liposuction with an abdominoplasty
Dr. Chartchai will perform liposuction on the abdomen at the same time as the abdominoplasty being careful not to jeopardize the blood supply to the skin. In some patients limited liposuction is possible, if they do not smoke cigarettes.

If you have a significant amount of extra skin, liposuction can be done as one of multiple procedures provided your surgery is in a modern operating theatre in a fully accredited hospital. Dr. Chartchai performs these procedures only in such a setting.

Recovery time
Most people stay in the hospital 2-3 days after surgery. Bruising may exist for up to 3 weeks but may not completely go away for up to 6 months. If you are returning to a strenuous job, Dr. Chartchai may suggest you wait as long as 6 weeks before returning to work. After 4 weeks you may resume light exercise that doesn't work the abdominal area. It may be 8 weeks or longer until you have absolutely no pain and can go back to a regular exercise routine.

In the first 6-8 weeks, scars will become red and thick as the body heals. The scars gradually become thinner and less red. In about a year, they become quite light.

Complications
One of the most common and significant complaints of an abdominoplasty is a large scar. Any abdominoplasty, even a "mini" one, leaves long scars. The total length of a scar depends on the amount of redundant fat and skin you have within the flank area. Dr. Chartchai is careful to place his incisions below the bikini line or otherwise minimize the resulting scar. The final look of the scar depends on each patient's individual skin quality.

Another complication is a blood clot formation, which is more common with an abdominoplasty than with other cosmetic surgery procedures. You can minimize this event by wearing compression stockings or garments and making sure you stretch your legs immediately after the operation even while still in bed.

 

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