Patients who have excess skin above and below the umbilicus, periumbilical hooding,
fat excess, and diastasis (muscle separation) or abdominal wall hernias are appropriate candidates for traditional abdominoplasty. Traditional skin excision and more extensive skin excision is required to deal with the supraumbilical (above the tummy button)skin excess. These patients should anticipate improvement of their appearance in and out of their clothes.
Patients with nominal excess skin above and limited excess skin below the umbilicus
are reasonable candidates for a more limited abdominoplasty. This approach is
most conducive in a patient with a high-riding umbilicus. The patient may have a
diastasis or even an umbilical hernia, which can be repaired through the limited approach.
The effect on umbilical position is an important determining factor to candidacy
for this approach. The limited skin incision combined with musculofascial
tightening with liposuction above and below the umbilicus will enhance the patient’s
appearance in and out of her clothing.
The fleur-de-lis abdominoplasty is appropriate for patients who require more aggressive
treatment for excess skin throughout the abdomen and trunk, particularly
at the upper pole of the abdomen and lower chest and back as well as at the waist,
hips, and thighs. The patient must accept the tradeoff of a full midline scar for a
more complete skin resection. This approach is also efficacious in a patient with abdominal
scars that could otherwise compromise the blood supply of a more traditional
abdominoplasty. It is generally used for people who have lost a significant amount of weight.
The reverse abdominoplasty is particularly relevant in patients with primarily or
residual excess upper abdominal skin. This approach can be sometimes be
combined with a Wise pattern type of breast surgery( uplift or reduction)