Is An Extended Tummy Tuck What I Need?

Q: Dr. Eppley, I am researching tummy tuck surgery and trying to see what can be done for me. I have attached pictures to help you see my severe abdominal overhang problem. I would like your professional opinion on which course of action would be best. 

A: It is important to realize that there are different kinds of tummy tuck surgeries depending on the nature of the abdominal problem. While traditionally divided into a mini and full tummy tuck, that historic classification by today’s methods is too simplistic. I divide tummy tuck surgery into six different types and levels which vary based on the amount of tissue removed, the location and extend of the incisions and whether liposuction plays an additive role in improving the result.

There is no question you would get tremendous benefit by an extended tummy tuck. (level 5) This is a tummy tuck where the removal of excess tissue wraps around the side of the waistline or encompasses about 300 degrees around the waistline. (it does not cross the midline in the back like a full circumferential body lift does) If you do not chase the excess skin around the waistline (a traditional or level 3/4 tummy tuck stops at the hip bones) you will be left with big dog ears of skin  and protruding tissue over the hips. In addition, it is important in any tummy tuck particularly when there is an overhanging abdominal pannus (apron) that a simultaneous pubic lift be done. This is often overlooked because it is hidden underneath the pannus but will become unmasked when the pannus is removed. Thus the excisional pattern of the tummy tuck should incorporate the design of a simultaneous pubic lift in its pattern. I have attached some picture showing a before and after an extended tummy tuck with a pubic lift. Note that the resultant tummy tuck scars wraps almost completely around the waistline.

Dr. Barry Eppley

Indianapolis, Indiana