Repair the abdominal wall. Place the scar low.

A full tummy tuck treats the entire abdomen. It is intended for loose skin that extends above the navel and for muscle separation after pregnancy or major weight change.

Dr. Kao brings the upper skin flap down to the low incision and removes the excess. He pays close attention to flap thickness and to the contour of the mons pubis, thinning both where needed so the lower abdomen matches the rest. The navel is repositioned through a small incision around it.

Liposuction of the waist, hips and flanks may be added to refine the transitions around the abdomen. The amount and location are set by the patient's anatomy and fat distribution.

Recovery Swelling, bruising, tightness and temporary numbness are common early on. Temporary drains and an abdominal binder or compression garment may be used, and light walking is encouraged soon after surgery. Many patients return to desk work in about two to three weeks, with full activity over the following weeks once Dr. Kao gives clearance. Residual swelling can continue to settle for several months.

A mini tummy tuck is reserved for patients with good skin elasticity in the upper abdomen and a lower pouch below the navel. A limited amount of skin and fat is removed from the lower abdomen and the remaining skin is redraped.

Where the separation is confined below the navel, Dr. Kao may tighten the lower abdominal wall. The navel is generally not repositioned. If laxity or muscle separation extends above the navel, a full tummy tuck is usually the better choice.

Recovery Recovery is generally shorter than after a full tummy tuck. The practice notes that mini tummy tuck patients often return to work within seven to ten days and resume light activity within about two weeks.

Some patients have separated or weakened abdominal muscles but little loose skin. For them, an endoscopic approach repairs the abdominal wall without the long incision of a full tummy tuck.

Through small access incisions, placed where possible near the navel or low on the abdomen, Dr. Kao uses a slender camera to view the abdominal wall. He dissects up to the lower end of the sternum and places two layers of sutures to tighten the muscles. A small amount of skin is removed only if necessary.

After pregnancy the muscles may regain strength, but the stretched fascia often does not return to its earlier state. The Skinny Bikini Tuck™ Technique addresses that separation along its full length, from the pubis to the sternum, to narrow the rib cage and the waist.

Dr. Kao first shapes the waistline with micro-liposuction through a tiny incision. Through a small incision just above the pubic bone, slightly lower than a C-section scar, he uses an endoscope to reach the ribs and repair the diastasis recti from the sternum to the pubic area. Any excess skin is then removed along the incision.

No incision is made at the navel. It is intended for patients with loose abdominal muscles, excess fat and minimal loose skin. Patients with significant loose skin may still need a more traditional incision.

Recovery Swelling and bruising usually resolve over a few weeks. Strenuous activity is avoided for at least three weeks, and walking is encouraged in the first days to help prevent blood clots. Normal activities usually resume at about four weeks, once Dr. Kao approves.

Dr. Kao sees tummy tuck scars that sit too high, run too straight, are too thick or were closed under too much tension. Some patients still have to hold the abdomen in after their first operation because the muscles were not tightened enough.

Revision is more difficult than a first tummy tuck. Scar tissue, altered anatomy and the amount of remaining skin set the limits. A high scar can sometimes be lowered, but not always. In published cases Dr. Kao has recruited skin from above to lower the scar, tightened the abdominal wall, repaired a local hernia, removed a seroma capsule, sculpted the waist in 360 degrees and used fat grafting to improve thin skin and scar quality.

Every revision is planned within the limits left by the earlier surgery. Not every patient is a candidate for the same approach, and results vary.