Cosmetic Surgery Tips

Mini Tummy Tuck With Umbilical Float

Tummy tucks are one of the most popular cosmetic surgeries in the United States. If you’re thinking about getting a tummy tuck, but aren’t sure if you’re ready to go under the knife, take a look at mini tummy tucks.

Mini tummy tucks are less invasive than full-sized tummy tucks. They involve removing excess skin and fat around the belly button, as opposed to all of the skin around your waistline. This means that recovery time is faster and easier for patients who choose this option.

What Is a Mini Tummy Tuck?

A mini tummy tuck is an alternative to traditional tummy tucks that removes loose skin from around the belly button area without affecting any other parts of your midsection. It can be performed using local anesthesia or general anesthesia depending on how much time will be required for healing after surgery. Patients who have had this procedure done report minimal pain after surgery due to minimal scarring compared with standard procedures where there’s more involved with incisions into abdominal muscles and fat tissue removal from underneath these muscles which causes more discomfort during recovery but results in more dramatic looking results over time when healed properly fully healed properly fully healed.

This post features pictures of umbilical float and umbilical float abdominoplasty cost.

Mini Tummy Tuck With Umbilical Float

Standard Abdominoplasty With A “Floated Umbilicus”

This is an alternative procedure which is selected less frequently than a standard abdominoplasty with umbilical re-positioning, which was previously described. The indication for this procedure, in my opinion, is fairly limited, but when indicated, it gives excellent, natural results.

I restrict this procedure to the case where a patient has very little, if any, excess skin ABOVE the umbilicus. In such a patient, if you perform a standard abdominoplasty with umbilical re-positioning, then when pulling the abdominal skin flap towards the feet, the hole created around the umbilicus will not move very far below the original site of the umbilicus, ultimately requiring a vertical scar on the mid-lower abdomen. To understand this, you need to first understand how a standard abdominoplasty with umbilical re-positioning is performed. The below diagram details the results when you apply a standard abdominoplasty with umbilical re-positioning to a patient with very little upper abdominal laxity:

Figure 1 – Click to Enlarg

Left: Patient with mostly lower abdominal skin excess, the upper abdomen has little excess. Middle: Advancing the skin flap downward and removing the excess skin. The hole will lie somewhere between the umbilicus and the waist crease incision and may be visible above the waistband of clothing or a bathing suit. Right: The final result is shown. The excess skin has been removed, a new hole was created on the abdominal skin flap and the umbilicus (which remained attached to the abdominal muscles below) is now brought out through that hole and sutured to that hole. The previous umbilical hole is now closed as a small vertical incision which now lies midway between the umbilicus the waist crease incision. Note the scar across the waist crease of the abdomen with the small vertical scar on the mid-lower abdomen and the scar around the umbilicus. In these cases, sometimes a better choice is to “float the umbiliicus” which avoids both scar around the umbilicus and the vertical incision on the lower abdomen altogether. The tradeoff is a slightly lower umbiliicus, one without any scar around it, but this usually does not detract from the overall result of the procedure. Generally, the umbilicus will look natural as long as it is not lowered more than about 2 cm.

So here is the rationale for floating the umbilicus: We know that the problem with a standard abdominoplasty with umbilical re-positioning in a patient with little skin excess above the umbilicus to start with is that the hole created around the umbilicus will unfortunately not move very far down from its original location. So, let’s put that to our advantage. Now, lets say, OK, since the hole won’t move very far down, then let’s not create an incision around the umbilicus and therefore let’s not leave the umbilicus behind on the abdominal wall to re-position later (the very maneuver that creates the umbilical hole in the first place). So now, the umbilicus remains completely intact, with no scar around it (the very telltale sign of an abdominoplasty if you wear a bikini or expose your midsection) continuous with the abdominal skin flap. So, in other words, we make the incision at the waist crease, elevate the abdominal skin as we move upwards towards the chest. Then, when we encounter the attachment of the umbilicus to the abdominal wall, we detach the underside of the umbilicus from the abdominal wall and continue to elevate the abdominal skin flap up to the chest. This way, when you pull the abdominal skin flap towards the feet to get rid of the excess skin, the actual position of the umbilicus will move below its original location. However, if this new lower position is only a little lower, the overall appearance of the abdomen will be quite good, the slightly lower position of the umbilicus will probably not be noticeable and there is no tell tale scar around the umbilicus!

The beauty of a “mini-abdominoplasty” is that there is no scar around the umbilicus. The same holds true here. The difference is that the indication for a “mini-abdominoplasty” is when there is no excess skin above the umbilicus AND the abdominal muscles are not lax in the upper abdomen. With a “mini-abdominoplasty”, neither excess upper abdominal skin nor muscle weakness can be addressed. However, with a standard abdominoplasty with an umbilical float, both problems can be addressed. A word of caution: if you underestimate the degree of excess upper abdominal skin, then the umbilicus will end up a lot lower on the abdomen then you want and you will need to accept some upper abdominal skin excess by re-attaching the umbilicus higher than it would naturally lie with the abdominal skin flap pulled down at proper stretch.

There are other alternatives here. You can perform a standard abdominoplasty with umbilcal re-positioning and make the waist crease incision a lot higher and then there will be no vertical scar. Of course, the waist crease incision will now span across the lower abdomen considerably higher than the waistline of your clothing. Or, you can sit the patient up to permit the removal of more skin so as to encompass the hole around the umbilicus and close the wound with the patient in the sitting position. This will place the wound under a great deal of tension, increasing the risk of wound separation, loss of lower abdominal skin and significant wound healing complications and a few weeks until the patient can stand upright, not to mention a flat, shapeless abdomen. Well, I didn’t say that these were good options, did I???

The blue ellipse indicates the proposed amount of skin to be removed. The lower solid blue line is where the initial incision is made. The dotted blue line is the proposed upper portion of the skin excision (removal). This can vary upwards or downwards depending upon how much skin excess exists. In this procedure, there is no incision made around the umbilicus. The umbilicus remains undisturbed and remains attached to the abdominal skin. This is why there will not be a circular hole in the skin flap. The yellow area shows the extent to which the abdominal skin is elevated off the abdominal wall going upwards to the chest. As the umbilicus is encountered during the skin elevation, it is simply detached from the underlying abdominal muscles, just as the rest of the abdominal skin is detached. Depending whether or not there is a horizontal excess of skin, the skin can be elevated as a narrow tunnel (left) which preserves more blood supply to the abdominal skin (preferred when possible) or as a wider tunnel (right) when necessary so that the skin can properly re-drape over the muscles during the healing phase.

Step 2

When selecting this procedure, it is critical to be able to estimate about how far the umbilicus will descend as the abdominal skin is pulled downward. It is acceptable for the umbilicus to be a little bit lower than it started. It is essential that there is not too much inferior displacement or the umbilicus will be too low in the pelvis, and this does not look good. Generally, a simple rule of thumb is to divide the abdomen into thirds from the bottom of the Xiphoid process (lower portion of the breastbone) to the pubic tubercle (pubic bone at the lower abdomen). If the umbilicus lies between the halfway point between these two landmarks and the junction of the middle and lower thirds, then the umbilicus should be in an acceptable position. Nothing is a hard and fast rule, but this works in most cases. It is really a judgment call based upon the experience of the surgeon.

The abdominal skin is elevated off the abdominal wall all the way up to the chest, the abdominal musculature is revealed. The site where the underside of the umbilicus was detached is apparent.

The abdominal wall musculature is tightened using a special running suture. The muscles are brought together in the midline.

The completed repair of the abdominal musculature is shown. Prior to tightening the muscles, the level of the attachment of the umbilicus is marked with a surgical marker (upper arrow) and the new site of attachment, slightly lower, is marked in a similar fashion (lower arrow).

The excess skin is elevated above the abdominal wall and pulled downward. Remember the umbilicus remains as part of the abdominal skin flap. The area of resection (removal) is indicated with a dotted line. There is no hole in the abdominal skin flap because there was no incision made around the umbilicus.

The final result is shown with the location of the scar across the waist crease of the abdomen. There is no scar around the umbilicus. The beauty of this procedure, like a mini-abdominoplasty is that the umbilicus remains unaltered, with no scar around it. However, this procedure differs from a mini-abdominoplasty in that a standard abdominoplasty with an umbilical float will address BOTH upper abdominal skin excess as well as muscle laxity, whereas a mini-abdominoplasty will not.

  • Standard abdominoplasty with “umbilical re-positioning”
  • Mini-abdominoplasty
  • Extended abdominoplasty
  • Circumferential abdominoplasty (“Belt-lipectomy”)

Prev Section: Standard Abdominoplasty With “Umbilical Re-Positioning” »
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SECTIONS – ABDOMINOPLASTY TYPES

  • Why Do We Need Different Types Of Abdominoplasty?
  • Standard Abdominoplasty With “Umbilical Re-Positioning”
  • Standard Abdominoplasty with a “Floated Umbilicus”
  • Mini-Abdominoplasty
  • Extended Abdominoplasty
  • Circumferential Abdominoplasty “Belt-lipectomy”
  • Flowchart – How to Select an Abdominoplasty Procedure

What the Heck Is a Floating Tummy Tuck?

What the Heck Is a Floating Tummy Tuck? img 1

A lesser known type of abdominoplasty, the umbilical float abdominoplasty or “floating tummy tuck” is specially designed for people who wish to relocate their belly buttons. A floating tummy tuck is also known as an umbilical float abdominoplasty, and unlike a traditional tummy tuck in which an incision is made around the belly button, a floating tummy tuck detaches the belly button from the abdominal wall and moves it downward. No incisions are made around the belly button.

Belly Buttons & Traditional Tummy Tucks

During a standard abdominoplasty, the belly button usually remains attached to the abdominal muscle wall through its stalk. Abdominal skin is pulled down toward the pubic area, excess skin is removed and stomach muscles are tightened through the incision made around the belly button. To complete the procedure, a small hole is made in the newly taut skin for the belly button to be brought through and sewn into place.

A floating tummy tuck is a procedure that detaches the belly button from the abdominal wall during a tummy tuck, moving it downward.

Belly Buttons & Floating Tummy Tucks

In a floating tummy tuck, the belly button is disconnected from the stalk that attaches it to the abdominal muscles below. A small incision is made in the lower abdomen in order for the stomach to be shaped and tightened. Because the belly button remains connected with the surrounding skin, as the skin is pulled down and tightened the belly button’s new position is lower on the abdominal wall.

Candidates For The Floating Tummy Tuck

Among abdominoplasties, floating tummy tucks are fairly rare. The best candidates for this procedure are individuals who need their stomach muscles tightened, have minimal skin laxity, whose belly buttons are in a relatively high position on the abdominal wall. A board-certified plastic surgeon with considerable tummy tuck experience can advise you on which approach is best for you.

Mini Abdominoplasty (Tummy Tuck) 

If you are considering a mini tummy tuck

Mini Abdominoplasty, known more commonly as a “mini tummy tuck,” is a major surgical procedure to remove excess skin and fat from the lower abdomen and to tighten the muscles of the lower abdominal wall. The procedure can dramatically reduce the appearance of a protruding abdomen. But bear in mind, it does produce a permanent scar, which, depending on the extent of the original problem and the surgery required to correct it, can extend from hip to hip.

If you’re considering abdominoplasty, this will give you a basic understanding of the procedure-when it can help, how it’s performed, and what results you can expect. It can’t answer all of your questions, since a lot depends on the individual patient and the surgeon. Please ask Dr. Rieger about anything you don’t understand. It is also recommended that you review the webpage on abdominoplasty for more information and diagrams.

The best candidates for mini abdominoplasty
The best candidates for mini abdominoplasty are men or women who are in relatively good shape but are bothered by a lower fat deposit or loose lower abdominal skin that won’t respond to diet or exercise. A full tummy tuck is generally required if upper and middle abdomen loose skin and excess fat is present. See abdominoplasty to read about that surgery. The surgery is particularly helpful to women who, through multiple pregnancies, have stretched their abdominal muscles and skin beyond the point where they can return to normal. Loss of skin elasticity in older patients, which frequently occurs with slight obesity, can also be improved.

An long incision just above the pubic area is used to remove excess skin and fat from the lower abdomen. In a mini tummy tuck the incision around the navel is not present and the lower incision is generally shorter.

Skin is separated from the abdominal wall all the way up to the ribs in a full tummy tuck. In a mini tummy tuck the extent generally is just above the belly button.

In a mini tummy tuck the lower abdomen muscle fascia is pulled together and sutured, thereby narrowing the waistline and strengthening the lower abdominal wall.  Abdominal skin is drawn down and excess is removed.

Patients who intend to lose a lot of weight should postpone the surgery. Also, women who plan future pregnancies may consider waiting, as vertical muscles in the abdomen that are tightened during surgery can separate again during pregnancy. If you have scarring in the upper part of the abdomen from previous abdominal surgery, your doctor may recommend against abdominoplasty or may caution you that scars could be unusually prominent.

Abdominoplasty can enhance your appearance and your self-confidence, but it won’t necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with Dr. Rieger.

The surgery
Mini abdominoplasty usually takes two hours, depending on the extent of work required.

The belly button is not repositioned and so no scar is present around the belly button. The belly button may be stretched into a more youthful vertical oval shape.

To improve the appearance of incision scars, Dr Rieger uses a new skin closure technique that does not require old fashioned metal staples.  This new technique uses the INSORB® Absorbable Skin Stapler which represents a revolutionary new skin closure modality. The INSORB® Absorbable Staple is comprised of a co-polymer which is absorbed over a period of 4-6 weeks.In most cases only simple butterfly paper tapes (steristrips) are placed on the skin and in most cases no sutures require removal ! 

Compare the diagrams and photos in this album to the regular tummy tuck.

Mini Abdominoplasty with belly button float removes excess skin and fat in the lower abdominal area (below the belly button) and the abdominal muscles are tightened. These patients’ have small amount of excess skin just above the belly button so it is released underneath and floated down a few centimeters and fixed in a slightly lower position.

No scar is present around the belly button. The belly button may be stretched into a more youthful vertical oval shape. Compare the diagrams and photos in this album to the regular mini tummy tuck.

Finally, the incisions will be stitched, dressings will be applied, and a temporary tube may be inserted to drain excess fluid from the surgical site. Dr. Rieger places most of the stitches under the skin surface to improve the appearance of the incisions. In most cases only simple butterfly paper tapes or steri strips are placed on the skin and only two or three suture require removal ! 

All surgery carries some uncertainty and risk
Thousands of tummy tucks are performed successfully each year. When done by a qualified plastic surgeon who is trained in body contouring, the results are generally quite positive. Nevertheless, there are always risks associated with surgery and specific complications associated with this procedure.

Post-operative complications such as infection and blood clots are rare, but can occur. Infection can be treated with drainage and antibiotics, but will prolong your hospital stay. You can minimize the risk of blood clots by moving around as soon after the surgery as possible.

Poor healing, which results in conspicuous scars, may necessitate a second operation. Smokers should be advised to stop, as smoking may increase the risk of complications and delay healing.

You can reduce your risk of complications by closely following your surgeon’s instructions before and after the surgery, especially with regard to when and how you should resume physical activity.

Planning your surgery
In your initial consultation, your surgeon will evaluate your health, determine the extent of fat deposits in your abdominal region, and carefully assess your skin tone. Be sure to tell your surgeon if you smoke, and if you’re taking any medications, vitamins, or other drugs.

Be frank in discussing your expectations with your surgeon. He or she should be equally frank with you, describing your alternatives and the risks and limitations of each.

You may, on the other hand, benefit more from partial or complete abdominoplasty done in conjunction with liposuction to remove fat deposits from the hips, for a better body contour. Or maybe liposuction alone would create the best result.

In any case, your surgeon should work with you to recommend the procedure that is right for you and will come closest to producing the desired body contour.

During the consultation, your surgeon should also explain the anesthesia he or she will use, the type of facility where the surgery will be performed, and the costs involved. In most cases, health insurance policies do not cover the cost of abdominoplasty, but you should check your policy to be sure.

Preparing for your surgery
Your surgeon will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins, and medications.

If you smoke, plan to quit at least two weeks before your surgery and not to resume for at least two weeks after your surgery.

Avoid overexposure to the sun before surgery, especially to your abdomen, and do not go on a stringent diet, as both can inhibit your ability to heal. If you develop a cold or infection of any kind, your surgery will probably be postponed.

Whether your surgery is done on an outpatient or inpatient basis, you should arrange for someone to drive you home after your surgery, and to help you out for a day or two after you leave the hospital, if needed.

Where your surgery will be performed
Dr. Rieger prefers to perform the operation in a state-of-the art accredited outpatient surgery center. Dr. Rieger prefers to allow patient a 23 hour stay in the surgery center. The center combines state-of-the-art technology with an exceptional degree of confidentiality, personalized attention, convenience and affordability. These centers offer overnight accommodations with round-the-clock nursing care.

Types of anesthesia
 General anesthesia is usually selected, so you’ll sleep through the operation.

After your surgery
For the first few days, your abdomen will probably be swollen and you’re likely to feel some pain and discomfort which can be controlled by medication. Depending on the extent of the surgery, you may be released within a few hours or you may have to remain hospitalized for two to three days.

Your doctor will give you instructions for showering and changing your dressings. And though you may not be able to stand straight at first, you should start walking as soon as possible.

Surface stitches will be removed in seven days, and deeper sutures, with ends that protrude through the skin, will come out in two to three weeks.

Getting back to normal
It may take you weeks or months to feel like your old self again. If you start out in top physical condition with strong abdominal muscles, recovery from abdominoplasty will be much faster. Some people return to work after two weeks, while others take three or four weeks to rest and recuperate.

Exercise will help you heal better. Even people who have never exercised before should begin an exercise program to reduce swelling, lower the chance of blood clots, and tone muscles. Vigorous exercise, however, should be avoided until you can do it comfortably.

Your scars may actually appear to worsen during the first three to six months as they heal, but this is normal. Expect it to take nine months to a year before your scars flatten out and lighten in color. While they’ll never disappear completely, abdominal scars will not show under most clothing, even under bathing suits.

Your new look
Abdominoplasty, whether partial or complete, produces excellent results for patients with weakened abdominal muscles or excess skin. And in most cases, the results are long lasting, if you follow a balanced diet and exercise regularly.

Pictures Of Umbilical Float

Umbilical Float Abdominoplasty Cost

The average cost of a tummy tuck is $6,154, according to the most recent statistics from the American Society of Plastic Surgeons. This average cost is only part of the total price – it does not include anesthesia, operating room facilities or other related expenses. Please consult with your plastic surgeon’s office to determine your final fee.

A surgeon’s fee for tummy tuck surgery will be based on his or her experience, the type of procedure used and the geographic office location.

Most health insurance plans do not cover tummy tuck surgery or its complications, but many plastic surgeons offer patient financing plans, so be sure to ask.

Tummy tuck costs may include:

  • Anesthesia fees
  • Hospital or surgical facility costs
  • Medical tests
  • Post-surgery garments
  • Prescriptions for medication
  • Surgeon’s fee

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