Procedure: Improvement in abdominal contour by complete liposuction of the abdominal fat followed by release and trimming of redundant abdominal skin. Trimming of abdominal skin is limited to skin lying below the belly button.
Length: 1 to 2 hours of operative time.
Anesthesia: General anesthesia may be supplemented with epidural anesthesia.
Place of Treatment: Outpatient surgical suite or hospital operating room.
Side Effects: a) Numbness: Numbness is inevitable due to separation of the skin and underlying fat off of the abdominal muscles. Since the sensory nerves to the skin travel in the muscle layer prior to crossing over into the skin, they are unavoidably disrupted when elevating the skin over the lower abdomen. The nerves will regrow with time and patients do note return of sensation on average by six months following surgery.

b) Hypertrophic scar: Hypertrophic scar refers to the development of a thick scar in the skin. Based on the extent of redundant skin excised, patients may experience increased tightness surrounding skin incisions and may expect a longer period for incision redness to dissipate (on average 3 to 6 months). Treatments for hypertrophic scars are available and include: steroid injection, laser therapy, and silicone pressure therapy.

Risks: a) Deep vein thrombosis (DVT) may occur in the legs immediately following surgery. DVT refers to the clotting off of leg veins which may result in compromised blood flow return from the legs; a more critical consequence may develop from this clot if it is dislodged and travels to the lungs causing a pulmonary emboli. Although rare, pulmonary emboli are the leading cause of death following surgery. DVT’s are avoided with routine use of pneumatic compression boots during surgery and encouraging patients to walk as soon as possible following surgery.

b) Hematoma: Hematoma refers to the accumulation of blood in the early postoperative period which pools into a pocket. Hematomas provide a perfect medium for harboring growth of bacteria. So if you have an infection anywhere in your body, the bacteria will travel through the blood stream and grow in the hematoma; this can lead to an infection as well as an open wound. In order to avoid a hematoma, a single drain is placed in surgery so that any fluid accumulation can be drained. Drains are usually kept in place for one week.

c) Seroma: Seroma formation refers to the accumulation of plasma fluid in pockets created by surgical elevation of the soft tissue and disruption of lymphatic vessels. This fluid accumulates due to a low blood count and protein deficiency both of which may be present in tummy tuck patients. This fluid can be a nuisance to patients requiring several aspirations in the office prior to their resolution. More importantly, these plasma fluid pockets may harbor bacterial growth and result in a clinical infection. A single drain is placed in surgery that is very effective in preventing seroma formation. Consequently, seromas are more likely to occur following premature removal of drains.

d) Infection: An infection can occur after mini tummy tuck surgery. The infection will disrupt the incision line and may leave the patient with an open wound. Prolonged antibiotics are required to fight the infection and to prevent further extension of the infection. Infections are usually avoided by using drains which will prevent hematoma formation. In addition, infections are less likely in patients who don’t smoke cigarettes or in patients who quit smoking for at least 1 month prior to surgery.

e) Skin edge death/open wound: The skin incision can be disrupted if the skin edge dies or if there is local infection. This complication is best avoided by counseling patients on the terrible consequences of nicotine in cigarettes. Nicotine will literally clog all the small vessels found in the skin which are critical for the healing of the skin edge. Mini tummy tuck patients are usually mandated to quit smoking for at least 1 month prior to surgery. In addition, uncontrolled diabetes can lead to the undesired sloughing of the skin. Diabetic patients are urged to be vigilant about controlling their blood sugar levels prior to surgery. If patients develop an open wound, they will require prolonged local wound care with frequent dressing changes. Unfortunately, any delays in healing of the skin edges will compromise your aesthetic outcome.

f) Asymmetry in abdominal contour can occur and is secondary to several factors including: 1)Uneven skin redundancy that is hopefully improved following redraping, trimming, and repair; 2)Stretch marks are areas of the skin which have lost their elasticity and are prone to re-stretching. The surgeon attempts to remove as much of the stretch marks as possible. However, if there are stretch marks left and they are uneven (more on one side than the other), this will result in asymmetric restretching of the skin and a resultant asymmetric contour. Asymmetry in contour can usually be repaired with an in office minor revision.

Recovery: The recovery period for a mini tummy tuck can be as quick as 1 week following surgery.
Duration of Results: As long as patients watch their diet and keep an active lifestyle, they can enjoy a lifetime of an aesthetically pleasing abdominal contour and silhouette.

Do I have to take 1 month off of work to have a mini tummy tuck surgery?

The traditional tummy tuck involves tightening the abdominal muscles which is most painful to the patient in the postoperative period. In contrast, the mini tummy tuck avoids tightening of the muscle, instead focusing on optimizing the contouring of the overlying skin and soft tissues. The benefit of the standard mini tummy tuck is that you can recuperate within 1 to 2 weeks.

If I have had abdominal surgery can I be considered for a mini tummy tuck surgery?

Separation of the abdominal skin and underlying fat from the abdominal muscles is limited during mini tummy tuck surgery. As such, prior abdominal surgeries are typically not a contraindication to mini tummy tuck surgery. A physician evaluation can determine if a mini tummy tuck procedure would be jeopardized by prior abdominal scars.

Will I have any numbness following mini tummy tuck surgery?

Temporary sensory loss of the abdominal skin is a consequence of surgery requiring elevation of the skin and underlying fat from the abdominal muscles. This is because sensory nerves of the abdominal skin which travel around the torso within the muscle layers prior to penetrating the skin from beneath are disrupted during the skin elevation. Since undermining of the abdominal skin is limited during mini tummy tuck surgery, sensory loss is limited.

Will my silhouette be improved following mini tummy tuck surgery?

Liposuction of the lateral flanks is routinely performed during a mini tummy tuck procedure. Although the mini tummy tuck procedure results in narrowing of the mid waist due to the direction of skin re-draping, the lower waist (love handles) are also liposuctioned to improve the silhouette of the torso.

Where and how wide will my abdominal incision scar be following mini tummy tuck surgery?

The mini tummy tuck abdominal incision is placed over the pubic area (or below previous C-section incisions) and extends laterally following the bikini line. The placement of the incision may be altered by the presence of prior abdominal scars. Typically, patients are asked to wear their favorite underwear/bikini so that the incisions can be designed to be camouflaged underneath the garment. Scarring is avoided by minimizing the tension on the incision line; this is done by repairing the incision line in multiple layers, including repair of the superficial fascial system. This fascia refers to a thin, yet tough layer that is found beneath the underlying skin which when reattached during the skin closure will reduce the tension on the skin incision. Reducing the tension on the skin incision will ultimately result in an aesthetically pleasing scar line.

Am I a good Candidate for mini tummy tuck surgery?

In order to determine if you are a good candidate, your mini tummy tuck consultation will require evaluation of several items. First, the surgeon must assess degree of skin redundancy or flaccidity. This will determined the extent of the lateral skin incisions and degree of skin and underlying fat undermining. Next, attention must be given to extent of stretch marks. When limited to below the belly button, then the patient is considered an ideal candidate for a mini tummy tuck. When the stretch marks extend above the belly button, then a standard tummy tuck is needed so that the belly button can be released so that the skin above it may be removed. Finally, the abdominal muscle must be evaluated to gauge not only the tone of the muscle but also to rule out any hernias (holes or defects in the muscle). If the patient demonstrates poor abdominal tone or presence of a hernia, then a standard tummy tuck is needed to gain access to the muscles in order to repair/tighten the muscles.

What does mini tummy tuck surgery involve?

The mini tummy tuck procedure involves accurate marking of the abdominal area. While waiting in the preoperative area, the patient is asked to stand so that skin redundancy or flaccidity and areas of adiposity can be evaluated and the patient’s incision line can be marked. After induction of anesthesia, the entire abdomen is infiltrated with tumescent solution and liposuction performed; then, an abdominal incision is made down to the muscle, and the abdominal skin and underlying fat separated from the muscle all the way up to the belly button. The redundant skin is then re-draped, trimmed, and repaired. A small drain is placed to remove any oozing of blood during the first week following surgery. Contour garments are fitted to the patient following surgery so that the new abdomen can mold to the desired aesthetic shape.

How do I plan my mini tummy tuck surgery?

On your initial visit, the surgeon will evaluate your health status, determine the amount of skin redundancy and excess adiposity, and check your blood work. If you are a smoker, then you should quit for 1 month prior to mini tummy tuck surgery in order to allow your body adequate time to rid itself of any residual nicotine. Nicotine in your system results in shutting off of small blood vessels which carry nutrients to the skin; this event could be detrimental to your mini tummy tuck surgery resulting in an abdominal wound requiring weeks to heal.

How do I prepare for mini tummy tuck surgery?

Since your surgery will require general anesthesia, you must take several precautions prior to surgery. First, you will have to avoid eating and drinking after midnight on the day before surgery. This precaution ensures that your stomach is clear of digested foods that could potentially be aspirated and contaminate your lungs during induction of anesthesia. Since you will have anesthetic medications administered throughout the case, you will remain groggy for some time and will require a ride to and from the surgery center if you decide not to commit to an overnight stay on the premises. You should choose a caretaker who is conscientious and can spend the first few nights with you. As an alternative, patients may choose to have their mini tummy tuck performed with an epidural which will minimize grogginess but still require caretaker supervision.

What results can I expect after mini tummy tuck surgery?

Following mini tummy tuck surgery, patients can expect an improved abdominal contour, a more curvaceous silhouette, and a flat and firm abdomen. As your swelling resolves and when you stop wearing your girdle, you will find yourself buying a whole new wardrobe to fit your trim figure.

Where will my mini tummy tuck surgery be performed?

Since your surgery will require general anesthesia and/or epidural anesthesia, it must be performed in an operating room that is part of a hospital institution or outpatient surgery center. Patients may also be operated on in an in-house office based operating room, but it is of utmost importance for patients to make sure that the office facility has been accredited by a surgical accreditation body such as AAAASF.

What type of anesthesia will be used for my mini tummy tuck surgery?

Since your surgery involves removal of significant amounts of skin, you will require general and/or epidural anesthesia. This is because skin possesses a large number of sensory nerves (pain fibers) that would be triggered during trimming of the redundant skin; general anesthesia ensures that you do not sense firing of pain fibers. Infrequently, an epidural anesthesia may be administered to provide numbness to the lower abdomen. This will minimize the general anesthesia administered and help you have a smoother postoperative recovery with lower propensity for nausea and vomiting.

What should I expect after mini tummy tuck surgery?

When you wake up from anesthesia, expect to find a tight garment around your abdomen. Expect to wear this girdle for approximately 1 to 2 weeks! Although you will feel significant tightness, you are encouraged to walk as soon as possible in order to minimize risk of developing blood clots in your legs. Your caretaker will show you how to take care of your single drain which will remove any blood/lymphatic fluid collection in the early postoperative period. These drains are removed usually by one week following surgery. After the first week, you will feel more energetic and desire to return to your routine daily activities.

When will I be able to return to work following mini tummy tuck surgery?

For patients who undergo a standard mini tummy tuck, expect to return to work as early as 1 to 2 weeks following surgery. As opposed to the standard tummy tuck surgery, the mini tummy tuck uses a shorter incision, less undermining, and avoids detaching the belly button, all of which result in a shorter recovery period.

Are there any side effects associated with mini tummy tuck surgery?

There are several side effects that have been associated with mini tummy tuck surgery and these include:

a) Numbness: Numbness is inevitable due to separation of the skin and underlying fat off of the abdominal muscles. Since the sensory nerves to the skin travel in the muscle layer prior to crossing over into the skin, they are unavoidably disrupted when elevating the skin and underlying fat off of the muscle. However, numbness following mini tummy tuck surgery is minimized as the undermining is limited to below the belly button.

b) Hypertrophic scar: Hypertrophic scar refers to the development of a thick scar in the skin. Degree of scarring is dependent on the tightness or tension along the incision line closure. Since degree of undermining and amount of tissue removal is limited during mini tummy tuck surgery, patients do not typically experience poor scarring. In the even that scarring is observed several postoperative scar management treatments are available and these include: steroid injection, laser therapy, and silicone pressure therapy.

Are there any risks associated with mini tummy tuck surgery?

a) Deep vein thrombosis (DVT) may occur in the legs immediately following any surgery. DVT refers to the clotting off of leg veins which may result in compromised blood flow return from the legs; a more critical consequence may develop from this clot if it is dislodged and travels to the lungs causing a pulmonary emboli. Although rare, pulmonary emboli are the leading cause of death following surgery. DVT’s are avoided with routine use of pneumatic compression boots during surgery and encouraging patients to walk as soon as possible following surgery.

b) Hematoma: Hematoma refers to the accumulation of blood in the early postoperative period which pools into a pocket. Hematomas provide a perfect medium for harboring growth of bacteria. So if you have an infection anywhere in your body, the bacteria will travel through the blood stream and grow in the hematoma; this can lead to an infection as well as an open wound. In order to avoid a hematoma, a single drain is placed in surgery so that any fluid accumulation can be removed. Drains are usually kept in place for 1 week.

c) Seroma: Seroma formation refers to the accumulation of plasma fluid in pockets created by surgical elevation of the soft tissue and disruption of lymphatic vessels. This fluid accumulates due to a low blood count and protein deficiency both of which may be present in mini tummy tuck patients. This fluid can be a nuisance to patients requiring several aspirations in the office prior to their resolution. More importantly, these plasma fluid pockets may harbor bacterial growth and result in a clinical infection. A single drain which is placed in surgery is very effective in preventing seroma formation.

d) Infection: An infection can occur after mini tummy tuck surgery. The infection will disrupt the incision line and may leave the patient with an open wound. Prolonged antibiotics are required to fight the infection and to prevent further extension of the infection. Infections are usually avoided by using a single drain which will prevent hematoma formation. In addition, infections are less likely in patients who don’t smoke cigarettes or in patients who quit smoking for at least 1 month prior to surgery.

e) Skin edge death/open wound: The skin incision can be disrupted if the skin edge dies or if there is local infection. This complication is best avoided by counseling patients on the terrible consequences of nicotine in cigarettes. Nicotine will literally clog all the small vessels found in the skin which are critical for the healing of the skin edge. Mini tummy tuck patients are usually mandated to quit smoking for 1 month prior to surgery. In addition, uncontrolled diabetes can lead to the undesired sloughing of the skin. Diabetic patients are urged to be vigilant about controlling their blood sugar levels prior to surgery. If patients develop an open wound, they will require prolonged local wound care with frequent dressing changes. Unfortunately, any delays in healing of the skin edges will compromise your aesthetic outcome.

f) Asymmetry in abdominal contour can occur and is secondary to several factors including: 1)Uneven skin redundancy that is hopefully improved following redraping, trimming, and repair; 2)Stretch marks are areas of the skin which have lost their elasticity and are prone to re-stretching. The surgeon attempts to remove as much of the stretch marks as possible below the belly button. However, if there are stretch marks extend above the belly button, then a standard tummy tuck surgery is a better alternative for you. If stretch marks are left and they are uneven (more on one side than the other), this will result in asymmetric restretching of the skin and a resultant asymmetric contour. Asymmetry in contour can usually be repaired with a revision in the office.

Is Mini Tummy Tuck surgery popular in women following pregnancy?

Women undergo several changes around their bellies during pregnancy that are undesirable. When the tummy expands to accommodate a growing baby, several unwanted changes are observed. First, the muscles covering the belly and overlying the internal organs expand and stretch around the baby. Following multiple pregnancies, the muscles may fail to shrink back to their pre-pregnancy state. This results in a bloated look that persists despite moms returning to their pre-pregnancy weight. In addition, women may notice stretch marks that extend up to and even around the belly button. Fortunately, moms who have had 1 or 2 pregnancies only and whom have not gained excessive weight, may avoid the permanent stretching of the muscles and stretch marks extending above the belly button; a Mini tummy tuck is ideal for these moms who demonstrate minimal to moderate post-partum changes.

Can a Mini Tummy Tuck procedure be performed in women prior to pregnancy?

Women who haven’t had children may demonstrate changes of their tummies that mimic pregnancy if they experience weight gain. These changes result in increased fatty deposition of the abdomen and increased abdominal girth but avoidance of extensive stretch marks and permanent stretching of the tummy muscles. These women ideal candidates for a mini tummy tuck surgery, which can address redundant skin. Mini tummy tuck is an ideal solution because it allows for improving abdominal contour without tightening abdominal muscles.

How is a Mini Tummy Tuck surgery performed?

A mini tummy tuck involves making a low incision over the tummy which is positioned to fall below the bikini line. The length of the incision is chosen by the extent of redundant skin present. If there is redundant skin that extends to the flanks, i.e. the love handles, then the incision line must be made longer to get rid of the excess. Prior to making this incision, the entire abdomen is sculpted using high definition liposuction of the upper, middle, and lower abdomen. Next, the lower abdominal incision is completed and elevation of the redundant abdominal skin and fat is limited to below the belly button. Redundant lower abdominal skin is removed and the abdominal incision is repaired.

What is the difference between a tummy tuck and mini tummy tuck surgery?

The key difference between these two procedures is limiting the surgical dissection of the abdomen which results in shorter surgical time, quicker recovery, minimal pain, and an improved incision line healing.

How is the belly button affected?

An advantage of the mini tummy tuck surgery is minimal manipulation of the belly button. First, since the dissection is limited to below the belly button, the belly button does not require to be released or remade. Second, by virtue of pulling the abdominal skin, the belly button shape is often improved from a more aged horizontally appearing shape to a more tightened vertical shape. Finally patients may notice transposition of their belly button by less than a centimeter inferiorly which creates an illusion of a youthful abdomen.

How do you make sure that the feminine “silhouette” is recreated?

Unfortunately, many surgeons perform this procedure without attention to recreating a feminine silhouette. Although this procedure involves elevating, redraping, and trimming the redundant belly fat and skin, the vector of pull when redraping the skin and limiting the degree of lateral skin elevation is critical to creating a feminine silhouette. Specifically, the vector of pull should be in a medial oblique direction rather than directly inferior. In addition, by minimizing the skin elevation laterally, the pull created when redraping the skin will pull in the flanks, i.e. love handles.

How can the lower belly incision scar thickness be minimized?

In order to optimize healing and minimize the inferior tummy surgical incision line, the redraped skin is repaired in a manner to eliminate unnecessary tension. First, by virtue of limiting undermining and removing redundant, the mini tummy tuck surgery minimizing post-surgical tension of the incision line closure and subsequent scars. Furthermore, a special stitch is performed of an internal “fascial” layer that is tough like a “tendon” which relieves the tension on the skin closure. By utilizing multiple layers to repair the trimmed and redraped skin, the surgical incision line healing is optimized. Finally, the suture utilized for the skin closure today is far superior to those utilized even in the past decade. The internal sutures that are utilized today are retained for approximately three months, thus allowing for near complete healing of the incision line prior to being absorbed. Furthermore, external glue and tape that are maintained for one month prior to being removed further enhance incision line healing. Finally, Intense Pulse lasers are utilized in our armamentarium to treat the surgical incision lines as early as 4 weeks following surgery after removal of the external tape and glue.

How our patients feel about us:

Thank you for making me feel comfortable at all times... I am so pleased with the results . Many thanks and much appreciation for doing such a wonderful job (and paying such attention to detail) on both of my surgeries. Thank you to you and your staff for showing kindness and making me feel comfortable at all times. The quality of care and professionalism and concern demonstrated by you and your staff were outstanding.

Moj Laguna Beach, CA

I could not be happier... I was debating whether to have a procedure done and had even made appointments with a few different Cosmetic Surgeons. I never felt at ease until I met with Dr. Mowlavi. He genuinely made me feel comfortable and answered all my questions. I never felt pressured for any extra procedures (a problem at some other offices I visited). It has been a year now since Dr. Mowlavi did the procedure and I could not be happier... The results were better than I expected... The care I received prior and post the procedure have been better than any other experience I have had. I would recommend Dr. Mowlavi to anyone interested in having a procedure done. He is an amazing doctor and I am definitely going to go back.

Violette M. Ladera Ranch, CA

My tummy tuck results are amazing... Without a doubt best doctor and staff I have ever encountered! My tummy tuck results are amazing, I have my confidence back and feel great, Dr. Mowlavi is the best doctor I have seen in my life, in addition to his medical expertise, he is kind, patient, and extremely caring. Every staff member is professional, friendly and patient. I was very nervous about the procedure but Dr. Mowlavis professional, kind demeanor got me through it, his PA James was very knowledgeable, kind and professional. I was referred to him by my dermatologist to remove some lipomas on my back and feel so fortunate for that referral because that really changed my life. I look forward to enjoying the rest of my life feeling and looking my best, I do not hesitate in highly recommending Dr. Mowlavi...

Rosalie D. Dana Point, CA

Print Friendly