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High superior tension abdominoplasty (tummy tuck) with liposuction

What is a tummy tuck?

It is an aesthetic surgical procedure to create a flat stomach by eliminating excess skin and fat and by tightening the muscles and skin of the abdominal wall.

Why undergo a tummy tuck with abdominal liposuction and high superior tension?

Aesthetic concerns are most often the main reason to have a tummy tuck with abdominal liposuction and high superior tension, but it is also necessary to take into consideration the practical concerns and difficulties in finding suitable clothing and the psychological consequences apparent in daily life.

If liposuction is recommended in the event of a localized excess of fat, the abdominal plasty with high superior tension performed by Doctor Masson is suitable for people with loose abdominal skin, a generalized excess of fat, stretch marks, relaxed abdominal muscles or even an abdominal apron. This is often the case in women who have experienced multiple pregnancies or people who have experienced significant weight loss. The dermolipectomy then allows them to find a flat, harmonious abdomen, without excess skin or stretch marks.

What happens before the operation?

It is very important to meet a specialized surgeon practicing in a surgical environment (a hospital or clinic). It is the surgeon who will determine if the patient can undergo the procedure according to the state of their skin and general state of health. Partial coverage by social security in the context of a dermolipectomy following significant weight loss may be possible. It is the plastic surgeon who, after clinical examination during a consultation, determines whether the patient meets the essential criteria, namely that the skin of the abdomen must cover the pubis. After prior agreement with social security, part of the intervention can be paid for. A first consultation with the plastic surgeon takes place during which he explains the most suitable operating techniques for the patient considering an abdominoplasty.

A biological assessment and possibly a scan or an ultrasound need to be performed in case of a hernia or diastasis. Compression stockings to avoid phlebitis and an abdominal surgical belt will be prescribed. The examinations carried out must be presented to the anesthesiologist during a consultation at least 48 hours before the procedure. After a reflection period which is compulsory, a second consultation will be carried out and an operating date may then be set.

It is essential to plan to quit smoking before and after the operation as this will facilitate healing and avoid certain complications. It is also recommended to not take aspirin and anti-inflammatory drugs in the 10 days preceding the operation. The day before and the day of the procedure itself, an antiseptic solution such as Betadine or Hibiscrub will be used to cleanse the body. A fast of at least six hours is essential for the achievement of general anesthesia and, therefore, of the operation.

How does the tummy tuck with abdominal liposuction and high superior tension take place?

The abdominoplasty with liposuction and high superior tension by anchor points is performed under general anesthesia and requires one to two and a half hours of surgical time depending on the procedures to be performed.

The procedure almost always begins with liposuction in order to remove excess fat. The scar is horizontal and hidden in the underwear area. It is more or less long (miniplasty or not) depending on the skin to be removed. All the skin of the abdomen is removed in a plane respecting the lymphatics. The skin is then stretched down and meticulously sutured with absorbable threads.

Sutures are placed in the interior, under the skin and around the navel to reduce detachment and avoid significant traction on the scar (the high tension technique). Most often, all of the skin between the pubis and the top of the navel is removed. An incision is made at the navel to bring it out at the right level and give it a more youthful shape. It is often too large and its size is reduced. The pubis is automatically raised by the tummy tuck.

In some cases, the abdominal muscles (rectus) have been distended by a pregnancy and are too wide apart. This is called diastasis. It is visible with the patient lying with their legs raised from the bed, a curvature in the middle of the abdomen is created. This diastasis must be corrected during the intervention when it exists (diastasis correction). Sutures are placed in the sheaths surrounding the muscle in order to tighten the abdominal wall and to reconstitute the abdominals.

Hospitalization lasts one to two nights depending on the procedures accomplished and the level of pain felt.

What precautions are necessary during the post-operative recovery period?

It is compulsory to wear compression stockings for 7 days after the operation. Ten days after the operation, a daily injection of anticoagulant by a nurse (or yourself) is necessary to prevent the risk of phlebitis. Wearing an abdominal surgical belt day and night for 4 to 6 weeks after the intervention is essential, and sometimes for up to 8 weeks.

Dressings are to be made by yourself or by a nurse for the first week. No heavy loads should be carried for about 2 weeks. Practicing sport is prohibited for 6 weeks. Showering is authorized the day after the operation, but bathing is prohibited for 3 weeks. Time off work of 7 to 30 days depending on the professional activity needs to planned for.

What are the risks of the operation?

More or less significant pain depending on the patient operated and the amount of skin and fat removed, but the pain is generally well relieved by the painkillers prescribed by the surgeon. The risks of a tummy tuck with high superior tension are, among others, a hematoma, lymphatic effusion, a thromboembolic accident (prevented by anti-thrombotic stockings and injections of anti-coagulants), infection or necrosis (prevented by stopping smoking at least 1 month before the intervention, and without resumption afterwards), an alteration in sensitivity (generally this recovers within 3 to 12 months after the intervention), or a pathological scar depending on the quality of the skin (enlarged or keloid).


Dr Vincent Masson is a plastic surgeon with a post-graduate diploma in plastic, reconstructive and aesthetic surgery and a gold medal in surgery from the Paris Hospitals. He is a former senior registrar and attaché at the Hôpital Saint Louis.

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