 A “tummy tuck” (abdominoplasty) is a surgical procedure which tightens a lax abdominal wall and removes excess abdominal skin and fat. It may be reconstructive or cosmetic.
Cosmetic surgery is performed to reshape normal structures of the body in order to improve the patient's appearance and self esteem. Reconstructive surgery is performed on abnormal structures of the body, generally performed to improve function and may also be done to approximate a normal appearance.
This operation has been performed since the turn of the century. In 1910 a paper by H.A. Kelly (of USA) noted the positive outcomes of this surgery, ie weight reduction, personal comfort, conveniance and comfort in dressing, better pose in standing and walking, increased activity and markedly improved self esteem and self confidence.
It has also been found to improve chronic lower back pain due to functional incompetence of the anterior abdominal wall.
The structural defects of the anterior abdominal wall can be caused by permanent overstretching by one or more pregnancies, by marked weight loss following treatment for morbid obesity or even moderate obesity, by trauma or surgery to the anterior abdominal wall (including gynaecological surgery) and by abdominal wall herniae. Pregnancy and surgery can lead to separation of the two strap muscles, decreasing the efficiency of the abdominal wall.
The anterolateral abdominal wall is largely muscular and aponeurotic with overlying subcutaneous fat and skin. It consists of 2 “strap” muscles in front and 3 muscles anterolaterally, the external oblique, internal oblique and transversus abdominis muscles.
Weakness or laxity of these muscles prevents maximum force with contraction and so weakens the support of the lumbar dorsal fascia with resultant back pain. An excess of 10lbs (4.5kgs) of adipose tissue in the anterior abdominal wall adds 100lbs of strain on the discs of the lower back by exaggeration of the normal “S” curve of the spine.
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