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Tummy Tuck Articles 1

Goals of Tummy Tuck

Dr. Kenneth Hughes performs many tummy tuck surgeries in Los Angeles and Beverly Hills.  The tummy tuck should improve the contour of the abdominal wall and recreate a natural-appearing belly button. In addition, the anatomy of the muscular layer should be reestablished in an attempt to prevent recurrence of hernias or diastasis. Finally, minimizing morbidity and postoperative disability is a mainstay of preoperative and operative management.  The tummy tuck can be performed as a standalone procedure or as part of a mommy makeover or body lift.

The History of the Tummy Tuck

The tummy tuck was first described in the 19th century and focused on the removal of redundant skin for repair of large umbilical hernias. Kelly published one of the first reports on the use of abdominoplasty in the US with use of a large horizontal midabdominal incision in 1899. In 1916, Babcock proposed a vertical midline incision. The first lower abdominal transverse incision was advocated by Thorek in 1924.

The tummy tuck, also called abdominoplasty, as a distinct procedure did not gain popularity until 1957, when the modern version, including umbilical transposition and musculoaponeurotic plication, was described by Vernon. Subsequent refinement came with Pitanguy’s series of 300 patients and Regnault’s W technique. The advent of suction-assisted lipectomy in the early 1980s allowed further evolution in body-contouring techniques. Endoscopic surgery allows for more minimalist approach.

The Anatomy of the Tummy Tuck

The layers of the abdominal wall include the skin, subcutaneous tissue, musculofascial layer, and underlying peritoneum. The subcutaneous tissue consists of two distinct layers of adipose tissue, separated by Scarpa’s fascia. The superficial layer is typically dense and fibrous in nature, whereas the deeper layer is looser with a less organized septum. There are paired rectus abdominis that meet in the midline at the linea alba originate and attach to the pubis.

The lateral abdominal wall consists of three layers of muscle, the external oblique, the internal oblique, and the transverse rectus. The external abdominal oblique muscle is the largest and thickest of these abdominal muscles.