Some patients develop excess skin and soft tissue as the result of normal aging, pregnancy, or weight loss. There are multiple procedures available to help patients who have this problem and would like it improved. Common areas of complaint are the abdomen, breasts, upper arms and thighs.
The abdomen is addressed with abdominoplasty or panniculectomy. Abdominoplasty or “tummy tuck” involves making a lower abdominal incision, generally from hip to hip (picture a C-section scar but much longer). The skin and fat of the abdomen is dissected off of the abdominal wall up towards the rib cage. If required, the abdominal wall is tightened with sutures. The skin and fat of the abdomen is then pulled downward tightly, excess skin is removed and the abdominal wound is closed. The umbilicus (belly button) is often repositioned depending on how much the skin of the abdomen is moved, resulting in a scar around or just inside the belly button as well. The goal is tightening of the soft tissue of the abdomen as well as the abdominal wall if needed. Panniculectomy refers to the removal of the ”pannus” which is the skin and fat that hangs over off of the abdomen in some patients. The goal of panniculectomy is not cosmetic, but aimed at the improvement of symptoms due to the overhanging abdominal tissue. Tightening of the abdominal wall is typically not performed with this operation, and the scar is similar to that described for abdominoplasty.
Brachioplasty and thighplasty are operations to tighten the skin of the upper arm and thigh respectively. With brachioplasty, incisions are usually placed on the inside of the arm, where they cannot be seen with the arms at rest at a person’s sides, but can be seen with the arm lifted, such as when waving good bye. Scars are typically kept above the elbow, but may be carried across the axilla onto the chest wall depending on patient desires. Thighplasty typically involves incisions along the inside of the thigh and/or the groin creases.