Endoscopic Tummy Tuck

An endoscopic tummy tuck allows a surgeon to tighten and reshape the muscles of the abdomen in patients who require very little or no removal of abdominal skin. This results in a flatter stomach without the typical longer incision of a standard tummy tuck / abdominoplasty. An endoscopic tummy tuck, also known as endoscopic abdominoplasty, utilizes a small camera and other instruments to tighten/reshape the abdominal muscles (including above the belly button). This type of procedure can be carried out by using a variation of the mini tummy tuck technique or by a couple of small incisions to shape the abdominal muscles.

Am I a Good Candidate for an Endoscopic Tummy Tuck?

GOOD CANDIDATES for an endoscopic tummy tuck are:

• Patients with a small abdominal pooch and little excess skin
• Women with loose abdominal muscles that are usually due to pregnancy
• Patients with good skin elasticity
• A patient who wants a tummy tuck but does not want a large abdominal scar
• Male or female patients who want a flatter, better contoured abdomen

The following patients are NOT GOOD CANDIDATES for an endoscopic tummy tuck:

• Patients who are overweight or obese
• Patients who have significant excess abdominal skin and fat
• Women who plan to become pregnant after the procedure

How is an Endoscopic Tummy Tuck Performed?

An endoscopic tummy tuck can be performed under general anesthesia or local anesthesia with IV sedation. The surgeon will make several small incisions along the pubic bone as well as in, or around, the belly button. These small incisions are 2 to 6cm and allow the scars to be barely visible or easily concealed. An endoscope, which is a lighted tube with a camera attached to the end of it, will be inserted through the incisions. The surgeon will use long, slender instruments, specifically designed for endoscopic surgery, to tighten the abdominal muscles by suturing them at the midline. This will restore a toned appearance to the abdominal muscles. Liposuction may be used to remove fat and contour the abdomen before closing the incisions with sutures. A modified version of this procedure allows a very small amount of skin to be removed but a classic endoscopic tummy tuck generally involves no skin removal.

Alternative Tummy Tuck Methods

An alternative to the endoscopic tummy tuck for treating fat with loose skin is a mini tummy tuck. A mini tummy tuck addresses the entire lower abdomen and serves to remove excess fat and skin. The procedure involves making an incision along the pubic region and then lifting the skin. Excess fat is removed via liposuction or by simply excising it. The skin is pulled taut and any extra skin is trimmed. The abdominal muscles may need tightened depending on their condition.

A traditional tummy tuck can address excess fat and skin on the entire abdomen including the upper and lower region. However, this procedure requires a long incision which runs along the pubic area from hip to hip. Along with the removal of excess tissue, the abdominal muscles generally need to be repaired. A traditional tummy tuck also has a much longer recovery time.

What is the Cost of an Endoscopic Tummy Tuck?

The average cost of an endoscopic tummy tuck is $4000-$12,000. This price is comparable to the traditional tummy tuck despite the fact that it has a smaller incision and the procedure takes less time. The cost referenced above does not include any anesthesia fees, facility fees or other related expenses.

Recovery and Downtime

Endoscopic tummy tuck is less invasive than a typical abdominoplasty so the RECOVERY time is a bit easier and quicker. Patients can expect some bleeding, bruising, swelling and mild to moderate discomfort. A compression garment will be worn to minimize swelling 24 hours a day for the first few weeks or until the doctor advises otherwise. If drainage tubes are placed below the skin, at the incisions, patients will need to empty these tubes several times a day. The surgical bandages will also need to be changed two or three times a day.

Patients are advised to walk frequently to prevent blood clots and get plenty of rest. While the incisions are smaller with an endoscopic abdominoplasty, any muscle manipulation will require the same DOWNTIME as a tummy tuck procedure. Nevertheless, patients are generally able to return to normal activities within one to two weeks. Strenuous activities or rigorous exercise should be avoided until cleared by the doctor.

Results

After an endoscopic tummy tuck, swelling and bruising can obscure the results. Because the incisions are shorter, the swelling will begin to resolve around 2 weeks post-op and then the preliminary results can be seen. As the body continues to heal, and the swelling subsides, improvements will continue to be made. It can take 3 to 6 months for all the swelling to fade and for the final results to become apparent. The results can last 10 years or more depending on the patient’s circumstances and lifestyle habits. Pregnancy and/or weight fluctuations can undo the muscle repair so patients should maintain a stable weight after a tummy tuck procedure. While the fat that is removed can never come back, neighboring fat cells can increase in size if the patient doesn’t uphold a healthy diet. To preserve the results, patients should maintain a stable weight by eating a healthy diet and exercising regularly.

Limitations of an Endoscopic Tummy Tuck

The limitations of an endoscopic tummy tuck include:

• The quality or laxity of the skin impacts the changes that can be made.
• The amount of skin that may be removed.
• The ability to tighten abdominal muscles depends on their condition.

The procedure requires skills that are not commonly performed during plastic surgery training. Therefore, fewer plastic surgeons have the experience or expertise needed to perform such a precise technique. Consequently, the surgeon may be considered a limitation for endoscopic abdominoplasty.

Risks of an Endoscopic Tummy Tuck

The risks associated with an endoscopic tummy tuck include:

• Bleeding or hematoma
• Blood clots
• Infection
• Seroma
• Poor wound healing
• Scarring
• Unsatisfactory results

Choose an Experienced Surgeon

An endoscopic tummy tuck is a minimally invasive option for patients who wish to undergo a tummy tuck to improve their abdominal contour but do not want an exaggerated scar. Because it is not performed by many surgeons, patients need to do their research in order to find an experienced and qualified surgeon to perform the procedure.  It is crucial that the patient choose a surgeon who performs endoscopic abdominoplasty often. Furthermore, the patient should personally meet with the surgeon for a consultation to determine if he, or she, is a qualified candidate for this type of tummy tuck.

Written by Cosmetic Town Editorial Team - SP

Based on an exclusive interview with Joubin Gabbay, MD in Beverly Hills, CA