Frequently following weight loss, the abdominoplasty sags and in some   cases the skin hangs down over the thighs. This causes discomfort and hygienic problems. There is also an embarrassment as far as dressing is concerned. This component is dealt with by freeing the skin up to the mid portion of the chest and bringing it down, excising all the skin from the umbilicus to the mons pubis. Sometimes the skin cannot come all the way down and the patient will have a little vertical closure in the midline above the mons pubis as well as the transverse scar.

Procedure:Flatten abdomen by removing excess fat and skin and tightening muscles of abdominal wall.
Length:2 to 5 hours.
Anesthesia:General or Local with Sedation
In/Outpatient:Either depending on individual circumstances and extent of surgery.
Side Effects:Temporary pain. Swelling, soreness, numbness of abdominal skin, bruising, tiredness for several weeks or months.
Risks:Blood clots, infection, bleeding under the skin flap, poor healing resulting in conspicuous scarring or skin loss. Need for a second operation.
Recovery:Back to work: 2 to 4 weeks. More strenuous activity: 4 to 6 weeks or more. Fading and flattening of scars: 3 months to 2 years.

Because of the laxity of the abdominal wall, most commonly the surgeon will tighten up the muscle container and give the patient a flatter tummy.