Individuals who have experienced significant weight loss often seek body contouring procedures to address excess, loose skin. The extended tummy tuck is a comprehensive surgical option designed to address skin laxity across a wide area of the lower torso. This operation focuses on the midsection and flanks, which are common areas where skin remains loose and hangs after substantial changes in body size.
Defining the Extended Tummy Tuck
The extended tummy tuck, also referred to as an extended abdominoplasty, is a more extensive operation than a standard tummy tuck. While a traditional abdominoplasty focuses primarily on the front of the abdomen, the extended version includes the flanks, hips, and often extends toward the lower back area. This is achieved through a longer horizontal incision that is placed low on the abdomen, extending past the hip bones toward the mid-axillary line.
The primary goals are a significant reduction in trunk circumference and the removal of a substantial “belt” of excess skin and fat. This operation also typically includes the tightening of the underlying abdominal muscles, known as rectus diastasis repair or plication, which helps to flatten the core. It is a common choice for patients who have experienced massive weight loss and have skin laxity that extends beyond the midline of the body.
How the Procedure Elevates the Lateral Thigh
The extended tummy tuck does provide a noticeable lifting effect on the upper leg, specifically the outer or lateral thigh. This occurs due to the biomechanical tension created by excising excess skin and fat from the flanks and hips. When the surgeon removes this circumferential tissue and closes the incision under tension, the remaining skin is pulled upward and laterally. This upward vector of pull is transmitted to the adjacent skin of the upper leg.
Patients with significant skin laxity in the hip and upper outer thigh area experience the most pronounced benefit. The procedure effectively tightens the skin of the lateral thigh, reducing the appearance of sagging. This lifting effect, which can sometimes extend to the anterior upper thigh, is an incidental benefit of the torso contouring. The extent of the lateral thigh lift is directly related to how far the incision is carried around the side of the body.
Addressing Medial Thigh Laxity and Limitations
The lifting effect of an extended tummy tuck is limited to the lateral aspect of the upper thigh, and it does not effectively address skin laxity on the medial or inner thigh. This limitation is due to the direction of the surgical pull, which is primarily upward and outward toward the hip incision line. The skin of the inner thigh sags vertically and requires a different tension vector for correction.
Patients with significant skin excess and droop on the inner thigh will typically require a separate procedure called a medial thigh lift or thighplasty. A medial thigh lift involves incisions in the groin crease, and often a vertical incision down the length of the inner thigh, to remove the skin and fat. An extended tummy tuck is not a substitute for a comprehensive thigh lift, but it can be combined with other procedures for a more complete lower body contouring. For individuals with severe, circumferential skin laxity that includes the buttocks and entire thigh, a full lower body lift, or belt lipectomy, which extends the incision completely around the torso, is often recommended.
Recovery and Post-Surgical Considerations
Recovery from an extended tummy tuck is more involved than with a standard abdominoplasty. Patients can expect the initial recovery period, where most discomfort subsides, to last approximately six to eight weeks. Throughout this time, movement is restricted to protect the long incision line and allow the surgically tightened tissues to heal securely.
Compression garments are worn continuously for several weeks to manage swelling and support the new body contours. Surgical drains are typically placed to prevent the accumulation of fluid, known as a seroma, and are usually removed within one to two weeks. Sedentary work may be resumed after two to four weeks, but strenuous activity, heavy lifting, and any movements that involve significant bending or twisting are restricted for at least six to eight weeks. Full resolution of swelling and scar maturation can take several months to a year.