Many patients seek body contouring surgery for looseness of the abdominal skin, particularly after childbearing or after massive weight loss.
Traditional abdominoplasty, i.e. tummy tuck, involves making an incision horizontally across the top of the pubic region and extending the incision laterally to the hip bones. The skin and fatty tissue are then elevated off the underlying fascia (the glistening white tissue) and muscle. The fascia and muscle are then flattened out with sutures that plicate the tissue. The extra skin is then pulled down and removed and the incision closed. This will flatten out the lower portion of the abdomen below the belly button but does not always flatten out the upper portion. For this problem, I have been working on a solution I call the upper abdominal lift.
I have to give my wife credit for the idea. Through an incision in the inframmary crease, beneath the breasts, I dissect down and grab the tough fascia layer. I then pull it up and suture it with permanent sutures, to the ligamentous tissue over the ribs. I then remove a small ellipse of skin. This flattens out the upper abdomen nicely and the results appear to be lasting. The scar is inconspicuous.
The procedure works great, especially if the patient is having breast surgery (either an augmentation and/or lift) done at the same time as the abdominal surgery.