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The “Contoured” Tummy Tuck That’s Just-Right for the Not-Too-Thin Candidate

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The “Contoured” Tummy Tuck That’s Just-Right for the Not-Too-Thin Candidate featured image
Getty Images / Image Used for Illustrative Purposes Only

For 20-plus-years, Houston plastic surgeon Christopher Patronella, MD has been perfecting and performing the “True Form Tummy Tuck,” an abdominoplasty surgery that takes, what he refers to as, the “two-dimensional tummy tuck approach” and concentrates heavily on contouring, sculpting and creating some subtle definition. Dr. Patronella recently sat down with us to share everything that goes into the surgery, and what someone who may be considering the procedure can expect.

In your opinion, who is the best candidate for this particular type of tummy tuck?
Essentially, the “True Form Tummy Tuck” can be performed in anyone who needs a tummy tuck. But, while I can do it on anyone, the best results are seen in those who are more fit, not overweight and not too thin—mainly because this procedure depends on a person’s own fatty tissue to achieve the contours that I seek. Not all fat is bad fat and having a little bit of a fat pad over the abdominal wall helps to create differential contours that give some slight variation in depths throughout. That’s really what creates that definition in an elegantly fit abdomen.

What makes this kind of tummy tuck different?
There are a number of steps to it. When I look at the tummy, I’m looking at the entire tummy. I’m not focused on the lower abdomen, the upper abdomen or the lateral abdomen alone. I’m looking at the tummy as one aesthetic unit—analyzation is so vital in creating a natural appearance and for the results to look uniform, balanced and harmonious. Sometimes, I’ll see a patient come in who’s had a mini-tummy tuck and they come in because it doesn’t look good, and the reason it doesn’t look good is because a mini-tummy tuck focuses entirely on the lower abdomen. While it might work in some patients, it’s not necessarily what works in every patient. If the lower abdomen is tightened thoroughly, but the upper abdomen is left without treatment, then there’s this unusual fullness of the upper abdomen with an imbalanced, excessively flat lower abdomen. That’s not really the way the natural abdomen looks, and it’s not really what people want.

I do a few mini-tummy tucks, but not very many because most women, particularly those who’ve had children, aren’t good candidates. They either have separation between the rectus muscles, which requires repair under the rib cage between the breasts to the lower abdomen above the pubic bone. It should always be done the whole way from the top to the bottom, otherwise, you’re going to have this relative protrusion.

What stimulated this whole thing was, about 20–25 years ago, I began questioning how we traditionally did things with the abdomen, with the tummy tuck. The way I learned it was, you remove loose skin and sew it together. There was really no elegance to that type of procedure, so I started to analyze what a nicely shaped abdomen looked like in, say, a Sports Illustrated swimsuit model. It really comes down to the changes in depths in the various areas of the abdomen; some parts are a little fuller, some parts are a little flatter, and there are lines—those muscular lines that a well-toned abdomen and a well-toned patient has. I started to incorporate ideas to recreate that during a tummy tuck. My goal was to make it look more natural. There were a lot of women who were coming in saying, “I fear a tummy tuck because I see my friends and it looks like a board. It looks like they had a tummy tuck.” That took me aback and I knew I had to do something to make the results better.

What kind of downtime can one expect?
About two weeks. It’s safe to say it’s two weeks before someone can drive.

What is the most typical hurdle that often stands in the way with anyone who might be interested in a tummy tuck?
Well, fear of pain, although, in general, most women who have had children overcome that pretty quickly because they’ve been there before. That’s number-one. Number two is the psychological hurdle of having to actually take the time off. The instinct to be a mother is very strong, and to care for children is very strong. Sometimes, I call it “mommy guilt,” a woman feels guilty for doing something for themselves and requiring someone to help them take care of their kids while they’re recovering. The third hurdle is the belly button. An ugly belly button or an artificial-looking belly button, ruins the whole thing. Aesthetically-speaking, that’s the thing that most women are really apprehensive about. But the goal is always for everything to look natural; those better, more natural results are clearly more satisfying to me and definitely more satisfying to patients.

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