Extended Lipo-abdominoplasty: Step by Step Operation Guide


Dr Bernard Beldholm

Many women struggle to lose weight and muscle separation after giving birth. An extended Lipo-abdominoplasty (aka extended VASER Lipo-abdominoplasty) might be the answer.

Today, Doctor Bernard reveals the step-by-step process for performing this operation.

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What is an extended tummy tuck?

You might be familiar with a tummy tuck, but an extended tummy tuck is a bit different. An extended tummy tuck is for women who have extra fat and skin that extends around the abdomen to the hips after giving birth. Extended means that there is loose skin and fat on the patient’s sides in addition to the tummy area. Therefore, the incision is longer than a classic tummy tuck, extending around the hips. That way, all of the undesirable skin and fat can be removed in a single operation.

Excising skin on the side of the abdomen

Full tummy tuck vs. extended tummy tuck: What’s the difference?

The difference between a full tummy tuck and an extended tummy tuck is how far the incision goes around the tummy. Since it is a more extensive surgery, it takes about one hour longer to perform an extended tummy tuck than a full tummy tuck.

What do we mean by ‘Lipo’?

A Lipo-abdominoplasty means that there is extensive VASER liposuction in addition to cutting away fat and skin, along with tightening the rectus abdominis muscle if needed. This is an extensive surgery that improves upon the results of a normal tummy tuck by using the latest technology.

A Lipo-abdominoplasty has four benefits.

VASER liposculpture of the abdomen

Loose skin, separated abdominal muscles and unwanted fat on the abdomen and sides can be dramatically improved with this surgery.

Removes loose skin

Skin removed with tummy tuck

Extra loose skin is common due to weight fluctuations from pregnancy. Collagen and elastin in the skin break down over time, resulting in thinner, delicate skin that sags. Many women get pregnant around age 30, which is when the production of these essential proteins starts declining due to age.

When you are pregnant, the skin stretches to accommodate the extra mass. Upon childbirth, the tummy shrinks, but the skin has already been stretched. Therefore, it does not ‘snap back’ to where it was before. This causes loose skin, and fat that can be hard to lose after giving birth. Like a classic abdominoplasty, a Lipo-abdominoplasty trims away the extra skin.

Repairs separated ab muscles

Separated muscles diastasis recti

Ab muscles can separate or tear due to pregnancy. Also known as diastasis recti, torn or stretched abdominal muscles can cause weakness and pain. The connective tissue at the midline of the abdominal muscles has stretched and loosened by the third trimester. Sometimes, surgery is required to repair it.

While the condition is not dangerous, it can make life unpleasant. Diastasis recti causes a stomach bulge in some patients, as well as leaves a visible gap between the ab muscles. It can sometimes be easy to spot that the muscles have separated, particularly in thinner patients. Other women might not notice anything visually wrong at all, but the underlying muscle is still stretched. A tummy tuck can correct this.

In a Lipo-abdominoplasty, Dr. Beldholm tightens the abdominal muscles, giving patients a flat tummy and better core support.

Removes unwanted fat

OT fat canister

After pregnancy, there can be stubborn pockets of fat left behind. Diet and exercise do not always remove all the fat. Plus, motherhood makes it hard to find time to get in the gym. There are new cravings as well, and the body goes through dramatic changes during pregnancy.

Genetics also play a role since women tend to accumulate fat in specific areas like the lower abdomen and hips. An extended tummy tuck is designed to remove fat on the front and sides.

Smooths and refines the tummy with VASER Liposuction

VASER Lipo is an important step of Lipo-abdominoplasty. This is the step in which Dr. Beldholm shapes the tummy and removes fat.

Dr Beldholm has been using VASER instead of standard liposuction since 2016 with great success.

VASER is different from standard lipo. To start, a small hole is created in the skin. The VASER probe is then inserted and a fan technique is used to work it under the skin, reaching all the underlying fat and melting it. The probe vibrates at an extremely high frequency to melt the fat. Gentle suction then removes the fat from the body.

VASER is gentler, yet equally (if not more) effective. Since it causes less tissue damage, it may improve the speed of healing and reduce swelling and trauma.

Since it is a slower and gentler process than standard lipo, it takes more time to perform the operation.

Download our short guide: “11 Important abdominoplasty techniques that you need to know about”

9 steps to perform the perfect extended full Lipo-abdominoplasty

These are the 9 steps that it takes to complete the operation:

Step 1: Extensive VASER liposuction of the abdomen, waist and hips

Step 2: Making the cut and dissecting the underlying tissues

Step 3: Creating a tunnel in the midline to access the abdominal muscles

Step 4: Stitching (plication) of the rectus abdominis muscles to tighten them and bring them back together

Step 5: Tightening the skin as well as lifting the mons pubis area up to where it should be

Step 6: Tightening and trimming away loose skin

Step 7: Using tissue glue and plication stitches to bring muscles together

Step 8: Closing the skin. Drains are not needed with Dr. Beldholm’s technique

Step 9: Using special PICO dressings to speed wound healing.

Recovery and downtime

An extended Lipo-abdominoplasty requires an overnight hospital stay. Day 1 after surgery will leave you feeling a bit groggy from general anesthesia. The first day is not too bad in terms of pain since Dr. Beldholm performs the VASER tummy tuck using a powerful local anesthetic to reduce discomfort for the first 24 hours. Discomfort tends to peak on day 2, then gradually subsides over a period of two weeks or so.

Patients can get back to work in 3-4 weeks and resume driving in 2-3 weeks. It can take 6-8 weeks to get back in the gym. For more information about tummy tuck recovery, visit this link.

Dr. Beldholm in OT
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30 Belmore Rd
Lorn NSW 2320


This website contains adult content. You must be 18 years or over to read. All surgery carries risks. You should seek a second opinion before proceeding. Results vary from patient to patient. See our disclaimer.
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