Lipo-abdominoplasty by Dr Bernard Beldholm

A Lipo-abdominoplasty (VASER Lipo-abdominoplasty) targets loose skin, fat & separated muscles

Excess skin, stubborn fat pockets and muscle separation are common after pregnancy or massive weight loss. These cosmetic issues can be difficult to treat with diet and exercise alone. This leads some patients to consider a tummy tuck with liposuction, also called lipo-abdominoplasty.

Every surgeon has their own way of performing tummy tuck or body lift surgery. Over the last few years, I have been performing VASER lipo-abdominoplasty, a technique based on my experience and also extensive research.
– Dr Beldholm

Content:

What is the Lipo-abdominoplasty?

This is a VASER liposuction based tummy tuck (VASER lipo-abdominoplasty) that is specifically designed for post-pregnant women and anyone who has lost a significant amount of weight. It specifically targets the three main concerns that happen after pregnancy or extreme weight loss:

  • Loose abdominal skin
  • Separated muscles
  • Resistant fat bulges

During the procedure, the excess fat on the abdomen and sides using VASER liposuction, a highly advanced liposuction technology. Next, an incision is placed across the lower abdomen. The tissues are dissected and the skin flap is lifted up to reveal the abdominal muscles, which are tightened with sutures if needed. Next, the excess skin is measured, marked and trimmed off before closing the incision. The goal is to leave the abdomen flat and taut.

Types of Lipo-abdominoplasty

Some patients have more excess skin and fat than others. With this in mind, Dr Beldholm offers three types of Lipo-abdominoplasty. Each patient receives a personalised treatment plan based on their unique aesthetic goals.

  • Mini Lipo-abdominoplasty
  • Full Lipo-abdominoplasty
  • Extended Lipo-abdominoplasty

Mini Lipo-abdominoplasty

Often women who’ve had a c-section complain about the skin hanging over the C-section scar. While it won’t repair ab muscle separation, the Mini Lipo-abdominoplasty is ideal for reducing superficial fat and removing a small amount of lax skin on the lower abdomen only.

Extensive VASER liposuction is performed on the full abdomen and sides. The scar is usually in the underwear line extending from hip to hip. The belly button is not re-positioned in this operation.

The operation can be performed as a day stay operation.

Full Lipo-abdominoplasty

This is the most common abdominoplasty that Dr Beldholm performs on both men and women. It’s effective for not just post pregnancy patients, but also those who’ve lost a significant amount of weight. It treats loose skin on the full tummy as well as muscle separation and excess fat.

The operation involves:

  • Repositioning the belly button
  • Tightening the rectus abdominis muscles
  • Extensive VASER liposuction of the tummy and sides
  • Tightening and removal of excess skin

The Full Lipo-abdominoplasty is normally performed as an overnight stay operation. There are no drains, and the majority of patients are able to go home the day after surgery in the afternoon. You will be able to have a shower in the morning and walk around. At 10 days, you should be able to stand up straight. If you have a desk-type job then you should be able to return to work at approximately two to three weeks after the surgery. Expect to wait approximately six weeks before returning to full exercise.

Extended Lipo-abdominoplasty

The main difference between the extended and the full Lipo-abdominoplasty is the extent of the lower abdominal skin resection, extending around the hips.

The Extended Lipo-abdominoplasty involves:

  • Repositioning the belly button
  • Tightening the rectus abdominis muscles
  • Extensive VASER liposuction of the tummy and sides
  • Tightening and removal of excess skin
  • The incision extends around the sides of the abdomen

The recovery is similar to the standard Lipo-abdominoplasty.

Lipo-abdominoplasty: Addressing Cosmetic Issues After Pregnancy and Weight Loss

Many people are dissatisfied with their appearance after bariatric surgery or giving birth. Dr Beldholm’s Lipo-abdominoplasty is designed to treat the three main cosmetic issues these patients tend to have.
Structure of the Skin

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Loose saggy skin

Whether you’ve had a baby or lost more than 40+ kilos, the skin can sometimes retract–but for some people usually only so much. Any loose skin that remains a year or two after giving birth or losing weight is usually permanent. In addition to being unsightly, excess skin on the abdomen can cause skin irritation for some patients.

How the Lipo-abdominoplasty tightens loose skin

Loose skin is excised from the lower abdomen and a scar is formed in the bikini line.

Fat deposits on the hips, abdomen and waist area

Some women and (even some men) are not particularly happy with the shape of their waist, hips and abdomen. It is a common complaint from mothers and weight loss patients who consult Dr Beldholm, that even with exercising and weight loss, there are still stubborn pockets of fat that do not shift.

How the Lipo-abdominoplasty reduces fat deposits

VASER liposuction is used to remove fat from the tummy during Lipo-abdominoplasty. Dr Beldholm injects a wetting solution, then he passes the VASER probe into the skin through small incisions. The probe vibrates quickly and starts to break apart the fat with acoustic energy. Next, he extracts the fat cells with a suction cannula.

Abdominal Muscle Separation

Pregnancy is, no doubt, a beautiful thing. However, if you’re like a lot of women, it can take a toll on your body—and we’re not just talking about stretch marks or weight gain.

Unfortunately, with pregnancy comes a few other unwanted side effects, too. A big one is diastasis recti, or abdominal muscle separation. It is a pretty common condition for most women who have given birth. In fact, about two-thirds of all mothers experience this condition (Ref 21). It is not so much a problem for individuals who’ve dropped a drastic amount of weight.

Pregnancy puts an incredible amount of pressure on the stomach. When this occurs, the front muscles are unable to keep their shape. Although, you may not know the technical term for the condition, you likely know its main symptom. It’s responsible for that undesirable “pouch” that a lot of women would rather do without.

Diastasis recti is a separation between the left and right side of the rectus abdominis muscle.

This muscle covers the front surface of the belly area. This condition is commonly seen in women who have had multiple pregnancies. It is a result of the muscles having been stretched many times.

Muscle Separation Post Pregnancy

Tummy Pregnancy

How the Lipo-abdominoplasty repairs abdominal muscle separation

The Lipo-abdominoplasty brings the muscles together using permanent sutures.

Not just a tummy tuck with additional liposuction but a radically different tummy tuck

The VASER lipo-abdominoplasty, which the Lipo-abdominoplasty, is based on is a radically different concept to the traditional abdominoplasty. It is important to realise that this is not a classic abdominoplasty with some added liposuction.

The VASER liposuction is integral to the result and the recovery from this operation. The liposuction is used both to remove fat and to dissect the tissues. The internal dissection is carried out, not on the abdominal wall, which disrupts blood flow as well as lymphatics, but in a higher plane to avoid these structures.

No drains are required, and most patients only need to stay overnight in the hospital. There are many research reports that demonstrate both the safety and efficacy of these modern techniques (ref 1, 11).

Standard Tummy Tuck and Lipo Abdominoplasty

VASER liposuction takes this operation to the next level

Traditional liposuction is quite a simple procedure. Fluid containing local anaesthetic and adrenaline is injected into the area to be treated and a metal cannula is used to suck the fat out. This is still the most common method of performing liposuction today, and is also the most common method used with the lipoabdominoplasty surgery.

Over the last ten years or so, there has been a number of advancements in performing liposuction, such as the power assisted liposuction cannulas, laser liposuction and water jet liposuction. Many of these methods, in Dr Beldholm’s experience, add very little to the final result.

However, VASER (Vibration Amplification of Sound Energy at Resonance) liposuction, has made it possible to do more superficial removal of fat. Dr Hoyos and Dr Millard first described the VASER high definition liposuction technique in 2007 (ref 18).

“I have found that using VASER liposuction instead of the traditional liposuction for my Lipo-abdominoplasty improves the results significantly. It makes for a more defined abdomen than standard liposuction in my experience,” according to Dr Beldholm.

Liposuction Procedure

Fat injections with the Lipo-abdominoplasty

There is usually a significant amount of fat that is removed during the tummy tuck. The good news is that this fat is not necessarily wasted. For patients with small or empty breasts, Dr Beldholm may discuss injecting the excess fat to add volume without using a breast implant. It is possible to achieve approximately one cup size and fill out the upper pole area of the breasts with this technique.

References

  1. Swanson E. “Prospective outcome study of 360 patients treated with liposuction, lipoabdominoplasty, and abdominoplasty.” Plastic & Reconstructive Surgery. 129(4):965-78, 2012 Apr.
  2. Swanson E. “Photographic measurements in 301 cases of liposuction and abdominoplasty reveal fat reduction without redistribution.” Plastic & Reconstructive Surgery. 130(2):311e-322e, 2012 Aug.
  3. Swanson E.”Comparison of Limited and Full Dissection Abdominoplasty Using Laser Fluorescence Imaging to Evaluate Perfusion of the Abdominal Skin.” Plastic & Reconstructive Surgery. 136(1):31e-43e, 2015 Jul.
  4. Saldanha OR; Salles AG; Ferreira MC; Llaverias F; Morelli LH; Saldanha Filho OR; Saldanha CB. “Aesthetic evaluation of lipoabdominoplasty in overweight patients.” Plastic & Reconstructive Surgery. 132(5):1103-12, 2013 Nov.
  5. Fuller JC; Nguyen CN; Moulton-Barrett RE.” Weight reduction following abdominoplasty: a retrospective case review pilot study.” Plastic & Reconstructive Surgery. 131(2):238e-244e, 2013 Feb.
  6. Drapeau CM, D’Aniello C, Brafa A, et al. “Italian Group on Surgical Infections in Plastic Surgery. Surgical site infections in plastic surgery: an italian multicenter study.” J Surg Res. 2007;143(2):393-397.
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  8. Samra S; Sawh-Martinez R; Barry O; Persing JA. ”Complication rates of lipoabdominoplasty versus traditional abdominoplasty in high-risk patients.” Plastic & Reconstructive Surgery. 125(2):683-90, 2010 Feb.
  9. Le Louarn C; Pascal JF.” The high-superior-tension technique: evolution of lipoabdominoplasty.“ Aesthetic Plastic Surgery. 34(6):773-81, 2010 Dec.
  10. Uebel CO. ”Lipoabdominoplasty: revisiting the superior pull-down abdominal flap and new approaches.” Aesthetic Plastic Surgery. 33(3):366-76, 2009 May.
  11. Epstein S, Epstein M, Gutowski K, MD, FACS. “Lipoabdominoplasty Without Drains or Progressive Tension Sutures: An Analysis of 100 Consecutive Patients.“ Aesthet Surg J (2015) 35 (4): 434-440.
  12. R Glen Calderhead, Won-Serk Kim and David B Vasily “Adjunctive 830 nm light-emitting diode therapy can improve the results following aesthetic procedures” Laser Ther. 2015 Dec 30; 24(4): 277–289.
  13. Kim, W. S. & Calderhead, G. R. (2011). “Is light-emitting diode phototherapy (LED-LLLT) really effective?” Journal for laser surgery, phototherapy and photobioactivation, 20(3): 205-215
  14. NCD Risk Factor Collaboration (NCD-RisC). “Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based”, www.thelancet.com Vol 387 April 2, 2016
  15. PITANGUY, VO, “Abdominal Lipectomy: An Approach to It through an Analysis of 300 Consecutive Cases.”, Plastic & Reconstructive Surgery: October 1967 – Volume 40 – Issue 4 – ppg 384-391
  16. Heller, Justin B. M.D.; Teng, Edward B.S.; Knoll, Bianca I. M.D.; Persing, John M.D. “Outcome Analysis of Combined Lipoabdominoplasty versus Conventional Abdominoplasty”, Plastic & Reconstructive Surgery journal: May 2008 – Volume 121 – Issue 5 – pp 1821-1829
  17. Sarah Epstein Michael A. Epstein, MD, FACS Karol A. Gutowski, MD, FACS, “Lipoabdominoplasty Without Drains or Progressive Tension Sutures: An Analysis of 100 Consecutive Patients”, Aesthet Surg J (2015) 35 (4): 434-440.
  18. AE Hoyos, JA Millard, “VASER-assisted high-definition liposuction”, Aesthetic Surgery Journal, 27(6):594-604, 2007 Nov-Dec
  19. Nagy MW1, Vanek PF Jr., “A multicenter, prospective, randomized, single-blind, controlled clinical trial comparing VASER-assisted Lipoplasty and suction-assisted Lipoplasty.”, Plast Reconstr Surg. 2012 Apr;129(4):681e-9e
  20. de Brito MJ; Nahas FX; Barbosa MV; Dini GM; Kimura AK; Farah AB; Ferreira LM., “Abdominoplasty and its effect on body image, self-esteem, and mental health.”, Annals of Plastic Surgery. 65(1):5-10, 2010 Jul.
  21. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5013086/

Disclaimer: Individual results vary. All surgery carries risks & you should seek a second opinion before proceeding. See full Disclaimer