Abdominoplasty (Tummy Tuck)
Excess-skin removal and selected rectus-diastasis repair to reshape the abdomen after pregnancy or major weight loss
이 치료에 대해
Abdominoplasty removes redundant lower-abdominal skin and subcutaneous tissue, may plicate the rectus fascia when diastasis is present, and often transposes the umbilicus to rebuild abdominal contour. It is intended mainly for an abdominal skin apron, laxity, and fascial separation after pregnancy or major weight loss; lipoabdominoplasty adds selected liposuction.
This is body contouring, not weight-loss surgery, and is performed after assessing weight stability, future pregnancy plans, smoking, diabetes, and thromboembolic risk. It differs from panniculectomy, which may remove only a hanging pannus; liposuction or noninvasive devices, which mainly reduce fat; and the existing post-GLP-1 nonsurgical restoration concept. ISAPS recorded more than one million procedures globally and ASPS ranked it third in the United States in 2024, but global year-over-year volume declined, so it should not be portrayed as rapidly accelerating.
작용 기전
Through a long suprapubic incision, the abdominal skin-fat flap is elevated and redundant lower-abdominal tissue is removed. When rectus diastasis is present, the anterior fascial sheath—not the muscle itself—is plicated to restore abdominal-wall tension and contour. A full abdominoplasty preserves the umbilical stalk and brings it through a new skin opening. Progressive-tension or quilting sutures, drains, and Scarpa-fascia preservation may be used to manage dead space and seroma.
적응증
기대 효과
Skin excess and abdominal contour change immediately, but the main assessment is made after swelling settles over 3-6 months, and the long lower-abdominal scar matures over 12-18 months. A 2026 systematic review and meta-analysis reported 98.2% satisfaction, 2.4% hypertrophic scarring, and 1.58% umbilical problems, but these pooled estimates came from low-level, hypothesis-generating evidence. A prospective post-major-weight-loss study supports quality-of-life improvement at 6 and 12 months, but it was not randomized. Weight fluctuation and pregnancy can alter results, and the operation does not remove every stretch mark.
임상 근거
위험 및 부작용
A long lower-abdominal scar, pain, swelling, bruising, seroma, hematoma, infection, wound separation, delayed healing, skin or umbilical ischemia and necrosis, hypertrophic scarring, asymmetry, dog-ears, numbness, and chronic pain can occur. Deep-vein thrombosis, pulmonary or fat embolism, cardiopulmonary complications, transfusion, reoperation, and anesthesia risks are also possible. Smoking, obesity, diabetes, prior thrombosis, and extensive combined surgery increase risk; smoking cessation, VTE assessment, early ambulation, compression, and individualized chemoprophylaxis planning are essential.