Examine your tummy. Dislike it? The cause of your dislike will be one or more of these three things:

  • Excess skin. Some lucky people have skin that will contract almost completely after pregnancy or weight loss. If this doesn’t happen sufficiently you will be left with saggy lower abdominal skin that no amount of exercise will fix. Stretch marks are evidence that the skin has stretched “beyond the point of no return”. (see mini-abdominoplasty and abdominoplasty). If the cause is a large weight loss then the excess skin may extend right around (see bodylift).
  • Excess fat. Many women have a thicker layer of fat on the lower part of their abdomen than on their upper abdomen and elsewhere.  This disproportion tends to persist even when weight is lost. This thicker layer is a source of discomfort when wearing fitting clothes and when bending over. (see abdominal liposuction)
  • Muscle separation in the midline. The two vertical muscles (rectus abdominis, the “abs”) begin life side by side in the midline. Pregnancy can separate them by several centimetres causing a loss of central support.  This may be associated with an umbilical hernia. Exercise will strengthen these muscles but not correct their separation. You will be unaware of this separation if it is small. Bend over, tighten your abdominal muscles and feel with your fingertips in the midline. Depending on the amount of covering(!), you may be able to feel the groove between the two muscles. The normal groove is only as wide as your fingertips.

All of these factors can be corrected with surgery under general anaesthesia.

Note: you need to distinguish between fat under the skin (subcutaneous fat) and fat inside the abdominal cavity (intra-abdominal fat). Men typically lay fat down intra-abdominally which gives rise to the male “pot-belly” – not correctable with surgery. Women usually have the opposite situation with subcutaneous fat predominating but you need to be aware that if your abdominal muscle wall is convex because of intra-abdominal fat, this will persist after abdominoplasty.

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