Saturday, September 6, 2008

Endoscopic Abdominoplasty

Endoscopic abdominoplatsy: It's high-tech, it's slick, and it only requires tiny incisions. The downside: Only a select group of tummy tuck patients are ideal candidates.

Endoscopic abdominoplasty can be thought of as minimally invasive tummy tuck procedure. To understand the usefulness of this procedure you may refer to the earlier posts made on this blog regarding the basic goal of all tummy tuck procedures. As you may remember, the main goals are generally to thin, tighten, and flatten the abdominal contour. We'll, there are some patients that really obtain the majority of the tummy tuck benefit from the flattening or muscle plication part of the tummy tuck procedure. In order to accomplish this the soft-tissue on top of the abdominal muscles and fascia (see myofascial plication in the Muscle Tightening post) are elevated to allow access for muscle tightening to occur. Using traditional methods, in order for this to occur, an appropriately long incision near waistline is needed to provide enough space to visualize the soft-tissue elevation and muscle tightening process. When the muscle tightening process is complete the extra soft-tissue laxity is removed and the incision is closed. For most tummy tuck patients this lower waistline incision is needed in order to allow removal of the excess soft-tissue laxity withouth creating folds of tissue at the sides often referred to as "dog-ears". For individuals who have very little excess soft-tissue laxity, however, that still require abdominal muscle plication (myofascial plication) the length of this waistline incision is a big price to pay just to allow muscle plication to occur. It is for these specific group of tummy tuck patients that endoscopic abdominoplasty is a great tummy tuck technique.

The basic details of the procedure are as follows. Most patients still benefit from some for of liposuction of the abdomen. This is usually performed first in a thorough and even manner. Following this, a very small incision perhaps only 2-3 inches long is made within the hairbearing portion of the pubic hair. This incision, once healed is essentially imperceptible and of course completly hidden by even the smallest of bikini bottoms. A second incision is made within the belly button. Through these two incision and with the use of a tiny camera and special instruments, the soft-tissue is elevated from the underling abdominal wall and muscle thightening is performed. In this manner, a patient with laxity of the abdominal wall, frequently seen after pregnancy, can regain the shape and contour of their abdomen without the need for any visible scars. Within a month or two, these patients can be poolside in a tiny bikini with a well toned abdomen making everyone wonder how they regained their body so fast and so well after having a child. :)

All the best,