While tummy tucks have traditionally benefited females, they are also available for those males who are looking for a more toned physique. The goal of any abdominoplasty, or tummy tuck, is to make the abdomen flatter. There are some subtle nuances in the procedure when dealing with men versus women.
While there are differences in a male versus female tummy tuck the overall procedure is the same. Tummy tucks are performed under general anesthesia in a Surgicenter. A long low incision is made and dissection is carried down to the abdominal fascia (connective tissue). Dissection is carried out above the muscle layer, along the fascia, starting at the pubic bone, going until the top of the abdomen. The muscle is usually tightened with permanent sutures. Once this step is complete, the extra skin and fat is excised and the incision is closed with dissolving sutures. Although it is common for other surgeons to place drains by the incised area, Dr. David Berman uses progressive tension sutures, which removes the need for drains. Patients undergoing a tummy tuck will often request that liposuction of the flanks and love handles is also performed in conjunction with the tummy tuck procedure, avoiding the need for general anesthesia a second time. The final step of the tummy tuck is simply to place Steristrips over the incision, along with some gauze, and a surgical garment for mild compression. The patient will return home within 1-2 hours. The patient can shower regularly just 30 hours post procedure and should be able to return to work in about 10 days, though it is even possible to have enough strength to start working again just a week later.
Although the procedure is similar for both men and women there are differences in the procedure. Men and women store their fat differently. Men are more prone to holding their fat internally or viscerally. The fat is behind the abdominal muscle and is not amenable to any type of liposuction or fat removal. This male fat storage is dangerous and cannot be treated by a tummy tuck or liposuction. For those men with the classic “beer belly”, where the fat is stored behind the abdominal muscle, with very little subcutaneous fat, the only option is to rely on a good, strict, healthy diet and exercise, with the emphasis on dieting. Males considering a tummy tuck should contact Dr. Berman to discuss their options.
A second difference between male and female tummy tuck is superficial but equally as important to take into account. Men generally will not wear bathing suits or other garments as low cut as women. It is possible to make the incision higher on a man versus a woman. More abdominal skin can be removed with a higher incision. Regardless of gender though, if the pubic area has become lax, the incisions should be made lower in order to tighten up the pubic area. The lateral incision can be angled to fit a bathing suit or other garment, though that is more commonly done for women.
Many of the women who request a tummy tuck, have had children. This will often cause the fascia, the layer over the muscle, to stretch and lose its tone. Even with exercise, the abdominal wall will not revert to its original tautness and remain stretched out. Luckily for men, they do not get pregnant and will generally still have good tone in their fascia, unless they have had large amounts of visceral fat. For this reason, it is less common to have to tighten the abdominal fascia while doing a tummy tuck on a male. Incidentally, if a woman would like to have a tummy tuck before getting pregnant and having children, Dr. Berman will do the tummy tuck but not tighten the fascia. This will result in a faster recovery and less of a tight feeling post-operatively.
Finally, male blood vessels tend to be larger than those of women which can lead to a higher risk of bleeding or hematomas post-operatively. Additionally the male opening for the naval will be larger in size than for women.
Both men and women can benefit from having liposuction performed on their flanks and love handles at the time of surgery. Women will more often request additional areas for liposuction, including the hips, medial thighs, etc. It is not uncommon for patients to undergo Smartlipo in the office a few days before their tummy tuck so that the patient does not need any liposuction at the time of surgery. This will decrease the amount of general anesthesia required and lower the risk of DVT, blood clots and pulmonary emboli. Whether male or female, a call to Dr. Berman can be your first step towards greater self confidence and a permanent solution to loose and saggy skin and losing those last few unwanted pounds.