Tummy tuck with muscle repair in Korea – 3 months waistline transformation | Lesarts Plastic Surgery
Patient Registration Info
| Age | Weight | Height | BMI |
|---|---|---|---|
|
30s |
53kg |
162cm |
20 |
Surgical site
Abdomen, Arm, Hip Dip Fat Transfer, S-Type, Rectus Muscle Plication
4,500cc
Hip dip (Right: 150cc / Left: 140cc), Above the navel (4cc)
Abdominoplasty is a lifting procedure
designed to remove sagging abdominal skin
that often develops after pregnancy or
rapid weight changes, restoring a firm waistline.
Many patients consider surgery when
severe abdominal skin laxity causes folds,
when the lower belly droops below the waistline,
or when bulges become visible above
pants or skirts.
Although it is often thought to be
a surgery for patients with larger body types,
even those with normal or slim builds
may experience localized abdominal sagging
and an undefined waistline, leading
them to seek abdominoplasty.
This is because issues such as
rectus diastasis, abdominal skin laxity,
and upper abdominal contour distortion
are not easily improved with exercise alone
and can appear in slimmer body types as well.
In today’s case, we will review a patient
who struggled with waistline imbalance
and loss of abdominal skin elasticity.
By comparing the before-and-after results
of abdominoplasty with rectus muscle plication,
along with additional contouring procedures,
we will examine how not only the abdomen
but also the overall body proportions
were improved.
The patient, a woman in her mid-30s,
had a history of delivering two children
via cesarean section.
After childbirth, she experienced
a weight gain of more than 15kg,
but maintained steady body management
afterwards through consistent effort.
At the time of her consultation,
she was keeping an overall slim body shape,
yet the loss of abdominal skin elasticity
and changes in the waistline
had not recovered.
In particular, excess skin sagged around
the lower abdomen, while the area above
the navel had less fat, creating an
uneven contour that stood out
when viewed from the side.
Although she regularly did strength training
and maintained muscle volume and body balance,
issues such as skin laxity and
rectus diastasis worsened with time.
Most importantly, when wearing tight clothing,
the waistline did not look smooth,
causing stress and discomfort,
which ultimately led her to decide
on abdominoplasty surgery.
Through consultation, we confirmed
that after two cesarean deliveries,
the patient’s lower abdominal wall
was significantly weakened, and
overall skin elasticity had decreased.
The rectus diastasis in the lower abdomen,
together with sagging skin,
was the main cause disrupting
the central abdominal line.
In the upper abdomen as well,
poor skin elasticity combined
with a thin fat layer left the surface
unable to settle smoothly,
resulting in visible wrinkling.
Although the navel was positioned
correctly at the stalk,
we considered the possibility of
its downward shift during abdominoplasty,
ensuring that no positional change
would occur after surgery.
Despite steady weight management
after childbirth through dieting,
the abdominal contour remained uneven
due to sagging lower abdominal skin,
rectus diastasis, and imbalance
between the upper and lower abdomen.
To correct these problems,
the following surgical plan was established:
- S-Type Abdominoplasty –
Focused on the lower abdomen,
where skin sagging was most severe
after cesarean deliveries.
2. Rectus Muscle Plication –
Although no separation was noted
in the upper abdomen,
the lower abdominal wall bulging
was corrected by suturing
the separated muscles inward
to restore abdominal support.
3. Fat Grafting Above the Navel –
As the upper abdomen had thin fat
and appeared sunken and wrinkled,
we planned fat transfer harvested
from the abdomen to this area,
to create a smoother connection
between the upper and lower abdomen.
4. Abdominal Liposuction –
While overall fat volume was not high,
liposuction was added to refine
the waistline and enhance definition.
5. Hip Dip Fat Transfer –
To improve the flat, hollow hip area,
fat harvested from the abdomen
was transferred into the hip dips,
creating a more natural and feminine
waist-to-hip curve.
With this combined surgical plan,
we aimed to restore abdominal firmness,
improve body contour balance,
and enhance overall proportion.
Below are medical photos comparing
the abdomen before surgery
and at 3 months post-op.
When reviewing the 3-month before-and-after photos
of abdominoplasty, we see that before surgery,
the lower abdominal skin sagged downward,
creating deep folds. The waistline was obscured,
making the upper and lower body ratio
look unbalanced.
The rectus muscles in the lower abdomen
were also separated, causing the abdominal center
to collapse and appear even more saggy.
Meanwhile, the upper abdomen lacked fat,
creating a sunken line that made the contour
look disconnected from the lower abdomen
in side views.
After abdominoplasty and rectus muscle plication,
the separated lower abdominal center
was tightened and reinforced, while sagging skin
was lifted into a smoother, firmer contour.
Additionally, with fat grafting above the navel,
the upper abdominal hollow was filled,
allowing the entire line to connect seamlessly
without irregularities.
With abdominal liposuction,
the flanks were also refined, creating
a slimmer and more sculpted
abdominal contour overall.
From the side view before abdominoplasty
and rectus muscle plication,
the abdomen projected forward irregularly,
creating an unbalanced silhouette.
After the procedures, the abdominal bulge
was clearly corrected, and the waistline
was reshaped into a flatter
and more defined contour.
However, in this patient’s case,
the incision site healed more slowly.
We provided continuous follow-up treatment,
explained appropriate scar management
at each stage, and advised that the scar
would gradually stabilize and fade
with the use of silicone sheets
and scar ointments.
This case highlights that abdominoplasty
is not simply about removing excess skin.
The surgery requires consideration of
internal structures, skin type, and body balance,
with a combination of surgical techniques
to achieve lasting results.
Since the procedure leaves a long scar,
the healing response and post-op care
must also be considered.
For this reason, continuous communication
and follow-up management with the surgeon
are essential before and after surgery.
Even if recovery is slower, as in this patient’s case,
steady step-by-step care ensures
satisfying results over time.
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