1. The first is men who have had massive weight loss and want to have loose or redundant skin and fat removed. It can be disappointing to lose a significant amount of weight, doing everything possible to look better on your own, and yet still have hanging skin. A tummy tuck can eliminate that skin, making a man look much better both in and out of clothes.
2. The second group of men who get tummy tucks is men who developed a separation between their abdominal muscles. Despite being thin and oftentimes having little fat between the skin and abdominal muscles, they joke that they can look pregnant. Some of the men also have an "outie" belly button.
This is related to some sort of a central weakness in the abdominal wall. These men tend not to have loose or excess skin. The procedure most frequently done for these men is an "endoscopic abdominoplasty." Since they do not need skin removed, there is no need for a significant scar. Just a small incision or two are made and, working through them, Dr. Teitelbaum can carefully and strongly tighten the separated muscles of the abdominal wall. This can flatten the stomach and give these men the physique that their overall amount of fat and condition should otherwise promote.
If the skin wraps farther around their sides, a larger procedure called a "belt lipectomy" is done to remove all the excess skin around the waist. If there is significant sagging of the buttock and thighs, then a "lower body lift" is done. Dr. Teitelbaum has performed these procedures on many men.
The concepts behind this type of tummy tuck are abstract and in this paper Dr. Teitelbaum explains them to other surgeons.
The distinction between a "lower body lift" and a "belt lipectomy" is subjective and will be answered differently by various doctors.
Essentially, a belt lipectomy involves a relatively straight incision all the way around the waist, removing loose skin in both the abdomen and lower back. But the belt lipectomy does not work to lift the buttock and thighs. The lower body lift (also known as a thigh/buttock lift) actually has a scar that for technical reasons is located a bit higher on the back than is the belt lipectomy.
While the belt lipectomy just removes the pinch of skin and fat around the waist, the lower body lift involves dissection down under the thigh and buttock and is primarily focused upon raising and lifting those tissues. The scars are very similar but will be different. The lower body lift is a longer procedure with a longer recovery because more work is done on the thigh and buttocks and the tissues need to be pulled a lot tighter in order to produce a durable lift of the thighs and buttocks.
It is actually unusual to do a tummy tuck on a man at his true goal weight. The procedure is usually done when a man's weight loss has slowed or come to a halt, even if he would like to still weigh a bit less. Oftentimes operating at that point creates a big enough improvement that the boost to his self-esteem helps him to go the rest of the way after the surgery. It is highly unusual for any remaining weight loss to require any sort of a revision.
A typical tummy tuck in a man who has lost a lot of weight requires a scar that goes just within the underwear line across his entire lower abdomen. But the scar needs to continue around the sides for as far as the looseness goes which he wishes to correct. There is also usually a scar around the belly button.
An endoscopic abdominoplasty involves a small incision in the pubic hair and another around the belly button. Through those incisions, and endoscopic camera is placed and the rectus muscles are sewn back together in order to create a flatter stomach. Sometimes liposuction is done at the same time to help further thin the stomach.
Dr. Teitelbaum has a niche in doing the so-called "endoscopic tummy tuck." With this procedure, the muscles of the abdomen are sewn together through a very small incision. The incision can be in the top of the pubic area or hidden around the rim of the belly button. This procedure was originally developed with women in mind, but it turns out there are very few women who have loose muscles who do not also have a lot of loose skin, and this procedure does not remove extra skin. As such, this type of tummy tuck is ideal for men who are thin but who have muscles that separated on their own, probably as a result of underlying weakness.
Dr. Teitelbaum has been doing endoscopic abdominoplasties on men for over fifteen years and is thrilled with the results. The problem these men have is related to a congenital weakness of their abdomens, and many have worked out hard their entire lives. Helping them to have the bodies they have strived for is what this procedures is all about.
Patients from throughout the United States and Canada, and as far away as Africa, the Middle East, Australia and remote parts of China have traveled to see Dr. Teitelbaum for this procedure. Even a plastic surgeon aware of Dr. Teitelbaum's expertise in this issue traveled from far away to have his endoscopic tummy tuck performed by Dr. Teitelbaum personally.
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