Tummy tuck in Korea – Case of restoring sagging belly from repeated yo-yo dieting | Lesarts Plastic Surgery
Patient Registration Info
| Age | Weight | Height | BMI |
|---|---|---|---|
|
30s |
81kg |
167cm |
29 |
Surgical site
Abdomen, hip dip, mons pubis, L-Type, rectus plication, umbilical correction
4,500cc
Hip dip (Right: 180cc / Left: 210cc)
Although several body areas can change over time,
the abdomen is especially prone to sagging, wrinkles, and stretch marks
because of its structural characteristics.
People who have experienced obesity since adolescence
and repeated weight gain and loss as adults
often develop folded, loose abdominal skin
and reduced elasticity, which can cause discomfort.
These long-term contour issues and skin laxity
caused by weight fluctuations are often structural,
involving both abdominal muscles and skin layers.
For that reason, exercise or diet alone
may not bring complete improvement.
Today’s abdominoplasty (tummy tuck) case features
a woman in her 30s who had experienced childhood obesity
and continued to struggle with repeated weight gain and loss in adulthood.
Over time, she developed severe skin sagging
centered on the abdomen and visited our clinic for correction.
Even after losing weight, she was concerned about
loose lower abdominal skin, deep wrinkles,
and the collapsed contour around the navel,
as well as overlapping skin folds that appeared through clothing—
issues that did not improve despite her efforts.
Before abdominoplasty, examination revealed that the patient’s
upper and lower abdomen both showed significant loss of elasticity.
The sagging skin from the upper abdomen had descended under gravity,
causing lower belly drooping, navel distortion, and
multiple skin folds—clear signs of skin laxity.
This abdominal sagging made the body’s center area appear
heavier and less defined, disrupting overall body balance.
Palpation also confirmed rectus muscle separation,
resulting in weakened abdominal wall support.
Because of this, the abdomen could not remain firm internally
and appeared protruded and unstable from the outside.
This combination of skin laxity, fat accumulation,
and muscle loosening gave the midsection
an uneven and sagging contour.
Since the patient presented severe skin sagging,
rectus diastasis, and fat deposits,
a combined procedure including abdominoplasty,
rectus plication, and liposuction was planned.
1.L-Type Abdominoplasty
As the patient was unmarried, the surgery plan considered
future pregnancy possibilities.
Absorbable sutures were used for rectus muscle repair,
and wide skin excision was performed using an L-type incision
to lift the entire abdomen, including the upper section.
The navel, which had become deformed due to sagging,
was redesigned and repositioned for a natural balance.
2.Abdominal Liposuction
To enhance the slimming and tightening effects,
liposuction was performed simultaneously
to reduce overall abdominal volume
and refine the body contour.
3.Hip Dip Fat Transfer
The area connecting the waist and pelvis lacked volume,
making the lower body appear disconnected.
To restore balance, fat transfer to the hip dips was performed,
smoothing the curve from the flanks to pelvis,
and creating a naturally connected lower body silhouette.
We will now review and analyze
the results and body contour changes
based on photos taken before surgery,
and at 2 months and 8 months post-op.
Before abdominoplasty, the patient showed
significant loss of abdominal elasticity
caused by childhood obesity and repeated
weight fluctuations.
The lower abdomen had sagging skin folds
that overlapped above underwear,
and deep wrinkles formed across the midsection.
The rectus muscles were also stretched,
creating a collapsed abdominal contour
with no core firmness.
The connection between the waist and pelvis
lacked three-dimensional volume,
making the transition between upper and lower body
appear flat and indistinct.
However, at 2 months after abdominoplasty,
abdominal liposuction, and hip dip fat transfer,
the previously sagging lower abdominal skin
was visibly tightened, revealing
a smooth and firm abdominal line.
The rectus muscle correction area appeared stronger,
and the outer rib lines narrowed inward,
creating a slimmer and more defined shape.
Overall, recovery progressed stably,
allowing the patient to wear daily outfits comfortably
and show the abdomen naturally
with improved confidence.
As time passed after abdominoplasty,
the abdomen remained stable and well-supported,
even during posture changes,
with no signs of skin folding
or volume sagging.
Before surgery, the lower abdominal skin
had drooped downward, forming thick overlapping folds,
but after rectus muscle plication
and abdominal lifting,
the entire front abdomen became firm and smooth.
Now, the abdomen maintains a tight, stable shape
without any sagging or creasing,
showing a well-recovered and naturally refined contour.
Before abdominoplasty, the lower abdomen protruded forward,
causing the body’s centerline to collapse and limiting clothing fit.
After surgery, the waistline became more defined inward,
and the abdomen regained firmness and elasticity,
allowing the patient to feel both comfort and confidence in daily wear.
The incision line is positioned within the underwear line,
so there is no visible exposure during normal clothing wear.
Because abdominoplasty leaves a long incision scar,
healing varies by individual, and scar color differs depending on skin type.
For this reason, patients are advised to continue proper care,
including scar ointment, laser treatment, moisturizing,
and UV protection when exposed.
Fortunately, this patient’s upper and lower skin around the scar
has healed smoothly without irregularity,
showing a stable and healthy recovery process
with no abnormal reactions.
With continued follow-up appointments,
steady aftercare, exercise, and a balanced diet,
the surgical outcome is expected to mature beautifully
and achieve an even higher level of completion over time.
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