Abdominoplasty is a common aesthetic procedure, and it has a high satisfaction rate among patients. There are many different body shapes, types, and body mass index categories that undergo abdominoplasty. There are patients who are elite athletes and there are patients who rarely go to the gym. The most common reason for undergoing abdominoplasty is excess skin of the lower abdomen and the other common reason is that the lower abdomen is lax and simply does not get any tighter with exercise.
In the athletic group of patients, one question that is frequently asked post-operatively is, “Will I get my six-pack back that I had in my twenties?” The answer is that this is very possible. It is usually easier for patients who had six-pack abs earlier in life than those who are trying to get a six-pack abdomen for the first time.
Attaining a defined abdominal wall is the combination of a strong abdominal core, rectus muscles, external/internal obliques, and transversus abdominus as well as a lean subcutaneous tissue. The abdominal wall strength can be improved with core strengthening exercises. This is often best with a combination of isometric exercises such as plank, kettlebell carries, etc. as well as those exercises that bring your abdominal wall through a variety of muscle lengths under different tensions. Weight training as well as spin classes that focus on abdominal core can keep the rectus and obliques under tension for great periods of time and can have significant impact on core strength. As the muscle gets stronger and muscle mass increases the muscle has a greater potential to show through the abdominal wall skin.
The leaner the abdominal wall skin is, meaning the lower the percentage of subcutaneous fat of the abdominal wall the greater the potential for the muscle to “show through” the skin. Therefore, the best way to obtain or ‘re-gain” the six pack post-abdominoplasty is to increase the muscle mass of the core musculature and decrease the subcutaneous fat of the entire body or that skin above the rectus muscles.
Decreasiing the subcutaneous fat can be accomplished surgically with liposuction. However, in the great majority of women who have regained their abdominal six-pack, there is almost invariably an increase in muscle mass as a result of their training. The results from abdominoplasty can take up to two years to completely improve as the swelling resolves. During this time, strict attention to resistance training to gain muscle as well as those core exercises that keep tension over time on the core muscles as well as a range of weight resistance on the core muscles can help build a six-pack post abdominoplasty.
Implants can be repositioned after weight training. Certain patients who perform significant pectoralis major exercises such as bench press, dips, dumbbell bench press, etc. can laterally displace their mammary prosthesis. I these patients, capsulorrhaphy can be performed to reposition the breast implants.