Endoscopic Tummy Tuck
The reason you have not seen much about Endoscopic Tummy Tuck surgery is because it is rarely done.
The ideal candidate for this procedure is the rare woman who has a muscle separation without skin excess and looseness (nor ugly stretch marks she wishes to exchange for a transverse scar).
In these cases, only a muscle tightening (plication) is required and various methods and instruments were devised to enable this operation.
The vast majority of post-pregnancy women DO have loose and or stretch mark covered skin and need MORE than just muscle tightening.
Performing this procedure on them would leave the loose skin behind and result in a substandard result. (Peter A. Aldea, MD, Memphis Plastic Surgeon)
Endoscopic tummy tuck has limited applications
A classic tummy tuck removes excess skin and fat and tightens lax muscles. If your problem is strictly limited to the muscle layer, an endoscopic tummy tuck may be the right choice. It tightens the muscle layer while limiting the scar.
Excess skin is not addressed. It can be combined with liposuction if there is excess fat. This is not appropriate for the typical tummy tuck candidate, where there is lax abdominal wall skin. It is most commonly performed in men with significant rectus diastasis, or separation of the abdominal wall muscles. I always look to limit scarring and the tell tale signs of having had surgery, but not at the expense of compromising the result.
Talk to a board certified plastic surgeon who is familiar with all of the variations of the tummy tuck to find the best approach for you. (Jeffrey Horowitz, MD, Bel Air Plastic Surgeon)
Endoscopic Tummy Tuck while a great idea, doesn’t tighten skin nor removes fat
I work with another surgeon in my practice who has a General Surgery practice and is always gung ho about doing things with a scope (he does a lot of laparoscopic surgeries).
We have discussed the possibility of doing “endoscopic tummy tucks” but we believe that this is best reserved for patients who have muscles that have separated due to pregnancy or age – called rectus diastasis. Sometimes, these patients (or their primary care doctors) think they have a ventral hernia.
These patients would be rather thin to begin with, but have a central “pooch” when they do sit-ups. Thus, this operation would be a muscle tightening procedure only. Endoscopic doesn’t mean no scars, it mean done with small scars. We haven’t found an ideal candidate for this procedure yet. Mainly because most of our patients would benefit from removal of excess skin and underlying fatty tissue in addition to muscle tightening.
This procedure would be at this time (message written 11/11/2009) would be considered a non-mainstream plastic surgical procedure. Please consult the opinions of your plastic surgeon in person if you are interested in this procedure. (Tammy Wu, MD, Modesto Plastic Surgeon)
Endoscopic tummy tucks (abdominoplasty)
In fact there are several different types of endoscopic tummy tuck:
- Endocorporeal Endoscopic Tummy Tuck (laparoscopic technique)
- Subcutaneous Endoscopic Tummy Tuck
In the former the muscle is tightened from inside the peritoneal cavity whereas in the latter it is tightened beneath the skin, In both instances, minimal if any skin is removed and the vast majority of fullness is managed with aggressive liposuction. (Otto Joseph Placik, MD, Chicago Plastic Surgeon)
Most think the endoscopic tummy tuck is not worth doing
Technically, an endoscopic tummy tuck exists, and I have done a few. It is done for people who really want to minimize the scar on the abdomen, and just want muscular tightening. From a surgical standpoint, the operation takes about the same time as a traditional tummy tuck, and therefore the price is about the same. From the patent’s standpoint, the recovery period is the same for both operations. The muscular repair is the painful part of a normal tummy tuck that requires such a long period of absence from strenuous activities.
Since it costs about the same as a regular tummy tuck, and has the same (uncomfortable and long) recovery period, most patients agree it is not worth skipping the benefit which removing all of that loose abdominal skin provides.
The skin removal gives added flattening to the abdominal wall, and helps with the hip contouring. Make sure you discuss the individual aspects of the operations with your selected surgeon before you decide to proceed – you don’t want to short change yourself! (Michael A. Bogdan, MD, FACS, Dallas Plastic Surgeon)
Endoscoping Tummy Tuck is okay, with limitations
Endoscopic tummy tuck indicates a tummy tuck through a small scar using special equipment. The only thing that can’t really be done well this way is skin tightening. If the muscular repair is the most important part and a mild-moderate degree will do, then you can have one of these. Most patients benefit significantly from skin tightening so I have had little interest in doing these. (John P. Di Saia, MD, Orange Plastic Surgeon)