What happens during the actual procedure?
The abdominal skin is lifted and we are careful to preserve the umbilicus (belly button). The skin is lifted to the xiphoid (lower chest) area. Great care is taken to ensure that the blood supply to the skin is preserved. The loose skin below the umbilicus is then removed. Next, the abdominal wall and muscles are tightened with suture and then the skin is pulled down to the inferior incision (pubic bone). The new spot for the belly button is marked and skin is removed. The belly button is then secured by sutures. We usually try to make the umbilicus about 1.5 cm in diameter. We place drains through the pubic area below the skin and over the abdominal wall.
We very often also perform liposuction to remove the fat that collects above the hips, aka love handles. and remove additional skin in that area, if needed. The liposuction is done carefully such that the blood supply to the remaining skin is not damaged. The incision is closed with absorbable sutures and then dressings are applied.