Abdominoplasty, Mini-Abdominoplasty- What’s the Difference?

Today I’m going to try to explain another confusing issue- what exactly happens during a mini-abdominoplasty (tummy tuck) vs. in a full abdominoplasty.  This will also give you an idea of which procedure might be appropriate for you.

There are two concepts to grasp:

1. How much skin is taken off.
2. 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?