There are two concepts to grasp:
- How much skin is taken off.
- What is done to the abdominal muscles.
Let’s look at the first concept to start. In a full-abdominoplasty, patients generally have a significant amount of excess skin. To get a nice, tight result, all the skin from just above the belly-button (umbilicus) down to the level of the bikini line is removed. The belly-button is left in place, and a new hole is made for it in the skin that is pulled down. (see the drawing below). In a mini-abdominoplasty, only the excess skin below the umbilicus is removed. The umbilicus itself isn’t moved. The resulting scar is pretty similar, except that in a mini-abdominoplasty, there is no scar around the belly-button.
Now let’s talk about the second factor- what is done to the abdominal muscles. When there is pressure inside the abdomen, usually from a baby, the rectus muscles (the ones that give you a six-pack) stretch out. Here’s another great diagram:
You can see how the fascia -the tough connective tissue between the muscles- has stretched out. When this happens, no amount of crunches are going to give you a flat stomach. Instead, the space is pulled tight together using sutures. This is most commonly done during a full abdominoplasty. Sometimes if just the lower part of the belly has stretched out, a mini-abdominoplasty gives enough access to tighten up what has stretched out.
So- why the big difference in recovery and cost between the two? First, the full-abdominoplasty takes more time in the operating room, which means it costs more. In addition, because more skin is taken off, there is a slightly increased risk for problems healing. Drains are left in place to prevent fluid collections under the skin, and these stay in for 1-2 weeks. The part that really makes a difference, however, is the muscle tightening. This leaves patients feeling very tight, and very sore. Most patients can expect to be off work for at least a couple of weeks. And it will be at least six weeks before you’re cleared to start exercising again. A mini-abdominoplasty has a similar recovery, but you may not have drains in place, and you are often a little less sore.
Which one is right for you? The only real way to tell is to be examined by a surgeon with experience performing abdominoplasty.
Do you have any questions about abdominoplasty?