Stomach tucks
Our interest
in the shape of the body goes back a long way. It is clearly reflected
in clothing fashions, where emphasizing the bust and cinching in the waist
with corsets or girdles has been a recurring phenomenon for thousands
of years.
Body contouring by
surgery is mostly a phenomenon of this century, and the desire to improve
the appearance of the bust and abdomen has been the main driving force.
The only surgical remedy formerly available was to cut away the surplus
of skin and fat, and that was the only kind of aesthetic operation performed
on the stomach until the development of liposuction in the 1970s. Liposuction
is now a very important component of most body-contouring surgery.
When deciding what type of abdominal esthetic surgery to
recommend, in addition to the patients general
health the surgeon must consider skin quality, the thickness of the underlying
layer of fat and the condition of the stomach muscles. These are the only
structures that can be changed with a conventional stomach tuck. Some people
who request a stomach tuck have large stomachs but relatively little fat
beneath their skin. This type of stomach, with most of the fat inside the
abdominal cavity among the intestines, is more common among men, and in
these cases the only thing that will help is losing weight. Going into the
peritoneal cavity to remove fat is altogether too risky for the patient,
and the first consideration with aesthetic surgery is that the risk should
be minimal.
If, however, the stomach muscles are stretched, as sometimes after childbirth,
or if there is surplus skin, or a lot of fat between the stomach muscles
and the overlying skin, these things can be remedied. The type of surgery
needed depends on the characteristics of the skin. If the skin is firm and
elastic, and the surgeon judges it to be able to contract, the recommendation
will be liposuction alone. This may involve the entire abdomen up to the
ribs, and include the waist and hips. If the skin is loose and flabby and
does not appear to have much elasticity, and the patient’s problem is both
above and below the navel, the usual recommendation is a full stomach tuck.
If, however, most of the problem is below the navel, and the skin in this
area has poor elasticity, the recom-
