The Corset "Trunk-Plasty"

This procedure is often best for massive weight loss patients who want the best abdominal contour possible and are willing to have extra scars in order to get it.  While the Fleur-de-lis has a corset effect, the corset effect of the Trunk-plasty is even more dramatic.

Like the Fleur-de-lis abdominoplasty, there is the traditional, lower horizontal scar, a midline vertical scar, and also a horizontal scar that is just under the breasts or chest, making the appearance of the letter I. 

The overall skin removal is much greater than in the Fleur-de-lis. (See Red Shaded area in Figure below) By making a horizontal incision along the bottom and the top, a sort of “open book” is created.  These upper and lower incisions are extended slightly along the sides of the body toward the back. The skin at the sides of the abdomen and some of the back skin (Purple Shaded area below) is then pulled forward like a corset around the body (pull is in the direction of the Green Arrows below).

The Corset Trunk-plasty after massive weight loss

Similar to other abdominoplasty procedures, the rectus abdominis muscles (figure below) are tightened in the midline of the abdomen (see abdominoplasty post above for details). 

Repair of separated Rectus abdominis (Abs) muscles

The corset trunk-plasty not only addresses the excess skin along the lower abdomen, but also the sides of the abdomen/waist and the upper abdomen, creating a very good contour. It typically also improves excess skin in the back and that extra “roll” just below the side of the breasts.  

Traditional Abdominoplasty or "Tummy Tuck"

The traditional tummy tuck procedure is performed by excising the skin and fat from the belly-button down to the pubic bone (red arrows in Figure below). This skin and fat is removed and the Green Shaded area is then undermined, meaning the skin and fat here is lifted up to the level of the ribs. This allows all of the Green Shaded skin to be pulled downward and sutured to the lower portion of the incision (So the 2 purple lines can be sutured together). 

Abdominoplasty

While the Green Shaded area is lifted, the underlying abdominal muscles (the Rectus Abdominis) are exposed. These are your “6 pack” or Abs muscles and they are often stretched so that instead of being side-by-side, they are separated in the midline. This commonly occurs due to age, pregnancy, or previous weight gain/loss or a combination of all of these things. (See Figure below) These muscles can be tightened to bring them back into the midline. After this tightening with stitches, the Green Shaded skin is pulled down.

Rectus Diastasis

An incision is made within the Green area for your belly-button to be placed in its new home.

The resultant scar is typically hidden within the underwear line (Blue Line in the Upper Figure)

This procedure works well for those that have lost moderate amounts of weight or who have lost larger amounts of weight but have had strong skin retraction. It is also commonly used as part of a ‘Mommy Makeover’ after having had children. The ‘Mommy Makeover’ is a breast augmentation +/- breast lift and a tummy tuck.