Dr Yohann Derhy
Abdominoplasty is the most complete plastic surgery procedure for the tummy. It is indicated for patients who have excess skin on their belly (due to weight loss, aging, multiple pregnancies, etc.).
The “high superior tension” technique is a better developed version of the traditional tummy tuck and gives outstanding results for reshaping the abdomen, creating a natural-looking flat stomach. It treats the whole abdominal wall: skin, subcutaneous fat and the rectus abdominus muscle. I have used this technique every day for the last 15 years, while adding my own personal touches. Created by Dr Claude Le Louard and Dr Jean-François Pascal in 2000, this technique remains unparalleled in terms of the quality of its results and the rareness of any complications, compared with traditional abdominoplasty.
What does it have in common with traditional abdominoplasty?
Like all abdominoplasties, it involves removing the excess skin located between the pubic bone and the bellybutton. We then tighten up the remaining skin, pulling it downwards then stitching it. We create a new bellybutton. A long, low scar just above the pubic bone, hidden by the underwear, stretches from one side of the hips to the other, and there is a small circular scar around the bellybutton.
What are its special features?
The different thing about this technique is how the tension is spread across the abdomen. We apply great tension to the skin at the bellybutton – with stitches – to hollow out the stomach area. Underneath the bellybutton, we pad the area out with light tension to close the abdominal detachment, which drastically reduces any risk of weeping or bleeding.
It has major advantages compared with traditional abdominoplasty:
- A very low scar that is not pulled upwards because there is no tension on the scar
- The stomach area is nice and concave
- An attractive, natural depression above the bellybutton
- Mild after-effects following the operation
- It can be used to treat various types of abdomen, including those that might seem too unsupple for an abdominoplasty
My top tips for honing the result:
- Position the patient in a half-seated position during the operation to remove a maximum amount of skin. Since the skin is elastic, this avoids the risk of secondary sagging.
- Systematic liposuction to refine the abdominal wall and sculpt the outline of the abdominal muscles (abdominal etching). If required, I also perform liposuction on the back and love handles to slim the waist and/or back.
- I systematically tighten up the abdominal muscles to create a flat stomach and well-defined waist.
- I treat the scar with an URGOTOUCH laser at the end of the operation, for a proven 36% improvement in terms of scarring.
A better-developed technique, high superior tension abdominoplasty involves a real learning curve, and you need to spend a lot of time mastering its finer details. But this investment pays off, as it gives infinitely better results with fewer risks. Using an Urgotouch laser on the scars further improves the results.
Reference: Le Louarn C, Pascal JF. The high-superior-tension technique: evolution of lipoabdominoplasty. Aesthetic Plast Surg. 2010 Dec;34(6):773-81
Dr Yohann Derhy: Specialist in plastic, reconstructive and aesthetic surgery. Founder of 4Hoche Esthetics, former registrar at the Paris Hospitals: Saint-Louis Hospital (Plastic Surgery, Pr Servant), former junior doctor at the Paris Hospitals. Microsurgery, Paris VII. Legal compensation for bodily injury, Paris V. Member of the World Society of Anti-Aging Medicine (WOSAAM). Member of the French Society of Plastic, Reconstructive and Aesthetic Surgery (SOFCPRE). Member of “Expert-2-Expert”.
