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Tummy Tuck

Abdominoplasty, otherwise known as tummy tuck, restores tone, contour, and function to the abdomen.





John Q. Cook, M.D.

Chicago 312-751-2112
Winnetka 847-446-7562

The Whole Beauty® Institute is lead by Chicago plastic surgeon John Q. Cook, a recognized leader in body contouring.

In 20 years of practice, Dr. Cook has developed a reputation for his innovative techniques that refine and rejuvenate the body form in ways that preserve each patient’s unique natural identity. He offers body contouring with tummy tuck surgery at his Chicago and Winnetka centers to help patients achieve a more proportioned figure and improved self-confidence.

The abdominoplasty or tummy tuck is a powerful surgery. Once an operation that was merely concerned with tightening skin, the abdominoplasty procedure has advanced to a point where it allows for individualized solutions for many different body types. The shape of the abdomen prior to abdominoplasty reflects each person’s genetic predisposition, previous habits of nutrition and exercise, and major life events such as pregnancy and large weight fluctuations. The shape of the abdomen after the abdominoplasty procedure is similarly determined by each patient’s subsequent choices and life events as well as the plastic surgeon’s choice of technique.

There Is No Single Technical Solution to Abdominal Contour

For an abdominoplasty to be successful, the surgeon must analyze the different components that shape the abdomen: skin tone, fat distribution, strength of the abdominal muscles and intra-abdominal fat. Each of these components will vary with the individual patient, so it follows that there is no single technical solution. The surgeon serves his patients best if he has a variety of techniques that can address the individual variations of body form.

The plastic surgeon must obtain an understanding of the events that brought the abdomen to its current shape. Has the patient gained or lost significant weight and, if so, how many pounds does the weight fluctuate? Was there one major fluctuation or many? What is the patient’s pattern of exercise? For women, have there been any pregnancies, or are any pregnancies planned for the future?

Dr. John Q. Cook and his entire team at the Whole Beauty® Institute are committed to a holistic approach to body contour surgery. If we understand the circumstances that brought the patient to his or her current shape we will be able to design a custom plan in which individualized surgery, nutrition, and exercise unite to provide an optimum long-term result.

The Three Goals of Abdominoplasty (Tummy Tuck) Surgery

When Dr. Cook performs your individualized analysis, he will do so with three goals in mind:

  1. Restore and Optimize Tone

  2. Restore and Optimize Contour

  3. Restore and Optimize Function


Restore and Optimize Tone

Each abdomen is toned differently. Dr. Cook will carefully analyze the tone of the different regions of the abdomen, flanks, waist and hips, since this will influence aspects of the abdominoplasty technique. The surgical approach will be different for a person whose main concern is a loss of tone in the lower central abdomen than for the person who has loose skin that extends around the waist and even into the back area.

The tone of the deep fascia and muscles of the abdomen is also very important. Large weight fluctuations or pregnancy may cause the deep anchors of the sit-up muscles to give way, so that the muscles drift away from the midline. This is known as a diastasis of the muscles.

Patients may notice a gap in the central abdomen when the muscles are tightened in a sit-up. Unfortunately no amount of exercise can correct this gap. As the muscles gap in the center and drift to the sides, patients often experience a sensation that the abdomen is not fully supported. Often an excess curvature of the lumbar spine (lordosis) will develop, which in turn produces back discomfort. A well-performed abdominoplasty will help to correct this.

While the abdominoplasty (tummy tuck) procedure will help the tone of the core muscles, there is much that each patient can do to prepare the muscle and deep breast layers for the procedure and to maintain the long-term benefits of the surgery. We will help you to design a program of core muscle strengthening to prepare you for the surgery, since this will give Dr. Cook the best structure to work with and also make your recovery much easier. A balanced exercise program will also help you to maintain an optimum result.

Restore and Optimize Contour

For an abdomen to be beautiful it needs to be more than tight; it needs to have a beautiful contour or shape. Dr. Cook provides each patient who is considering abdominoplasty (tummy tuck) a detailed assessment of the factors that will contribute to a beautiful contour. These factors include the distribution of tone in the abdominoplasty procedure, the distribution of fat in the classic compartments of the abdomen, flanks, and hips, the effects of deep structural tone on waist definition, and the patient’s own patterns of nutrition and exercise.

Many abdominoplasty techniques leave the patient with an abdomen that is tight in the middle but loose on the sides. The overall visual effect is disappointing in a way that is similar to that achieved by a face lift that is pulled tight in the wrong direction.

In order to avoid this Dr. Cook uses a variation of the high lateral tension abdominoplasty technique as pioneered by Dr. Ted Lockwood. In this technique the distribution of tone is shifted in an oblique direction with significant benefits to the flanks, waist, and upper thighs. We describe this technique more fully later in this section of the website.

The fat of the abdomen, which lies between the skin and the deep fascia and muscles, is arranged into a number of compartments. The relative distribution of fat in these compartments varies from person to person and is largely influenced by genetics and by whether that person was heavyset in his or her early years. An accurate map of these compartments will serve as a guide for the sculpting of these compartments during the abdominoplasty procedure.

It is important to note that some abdominoplasty techniques do not allow for liposuction to be carried out with safety during the procedure. This will significantly limit the power of the result. The high lateral tension technique maintains adequate blood supply to the undermined area of the abdomen so that liposuction can be an integral part of the procedure.

The tone of the deep fascia and muscles of the abdominal wall (the rectus and oblique muscles) manifests itself in the external shape of the abdomen. The beautiful contours of the mid body of a well-trained athlete are a direct result of the superb tone and function of the abdominal muscles. A more comic example is seen in the cartoon of the out-of-shape middle aged man at the beach who tightens up his abdominal muscles when a beautiful woman walks by.

We have already discussed how the tone of the abdomen is disrupted when a diastasis or gap develops between the situp muscles in the midline. Surgical repair of this disruption will actually tighten the waist and provide more of an “hourglass” figure.

One common shortcut of certain abdominoplasty techniques is a tightening of the muscles below the umbilicus, but a disregard for the muscles above the umbilicus. This reduces the work for the surgeon but at a distinct cost to the long-term result. Almost without exception, if the lower abdomen is tightened and the upper abdomen is ignored, the patient will be left with an unsightly upper abdominal bulge. Beware of so-called “mini” procedures; they usually produce mini results!

There is one important aspect of abdominal contour that no current surgical technique can impact. In some patients a major cause of abdominal disproportion is intra-abdominal fat, which lies deep to the muscles of the abdominal wall. When some patients gain weight they disproportionately store fat within the abdomen. This pattern of weight gain is determined largely by genetics, but also by nutritional factors. It is a particularly dangerous form of weight gain, since it seems to be accompanied by a significant increased risk of heart disease.

Once the patient commits to surgery, it can serve as a wonderful motivator to lose this dangerous fat before the abdominoplasty (tummy tuck) procedure. As the patient loses weight the skin will hang looser. While this might have discouraged the patient in the past, since he or she knows that the abdominoplasty will correct the loose skin, it will be easier to accomplish the desired weight loss. There is no question in our minds that for our patients who have used the abdominoplasty as a motivation to lose the deep intra-abdominal fat, the surgery has been a life-altering, even a life-saving procedure!

Restore and Optimize Function

A properly-toned abdominal wall is more than beautiful; it is a key element in the dynamic balance of the mid-body. The muscles of the front part of the abdominal wall help to maintain posture and proper position of the spine. When these muscles are weakened or altered in position, the spine tends to shift into a position of exaggerated curvature, which often results in back discomfort.

The importance of the anterior muscles is well known to physical therapists, who often work to strengthen and optimize the mechanics of these muscles in patients with back pain. The gap that develops between the rectus or sit-up muscles in the front part of the abdomen after significant weight fluctuation or pregnancy will derange the proper balance of the mid-body. Once the muscles are out of position, no amount of exercise will be able to restore completely normal function. Patients with a gap between the muscles often experience discomfort and a sense of being unsupported.

The abdominoplasty (tummy tuck) operation allows for these muscle to return to their normal position of function. The patient experiences a sense of better control of his or her abdominal tone.

Where does Dr. John Q. Cook perform Abdominoplasty Surgery?

Dr. John Q. Cook carries out the majority of his elective surgeries at a high quality outpatient surgical facility not far from the Chicago office. Dr. Cook has selected this facility because of the skill of the anesthesia team and the highly experienced staff who take care of our patients in the operating room and the recovery area. The specific anesthetic technique allows for an unusually quick recovery from surgery; in most cases, the post-anesthesia “hangover” is avoided.

Most of our patients who undergo abdominoplasty are met by our caregiver at the surgery center and brought to an elegant hotel in the same building as the surgery center. There are several advantages to this approach. The overall recovery is enhanced by the knowledge that an experienced caregiver is in charge for the first evening of recovery. With our hotel patients we utilize devices that gently massage the calves; this significantly reduces the risk of forming blood clots in the leg.

The majority of our patients will leave the hotel the morning after surgery and recover from surgery at home for the following days. Some patients prefer to stay at the hotel for several days, and this can be easily arranged. Since the hotel is close to the office, our clinical team will visit patients the morning after surgery at the hotel; this is much more convenient for the patient than coming to the office for the first visit after surgery.

In some cases, abdominoplasty can be combined with gynecological surgery or general surgery such as hernia repair. In this case the surgery will be at Rush University Medical Center. Dr. Cook will work in conjunction with one of his Rush colleagues in the Departments of General Surgery or of Obstetrics and Gynecology. Patients with this type of combined surgery will spend one or several nights at Rush University Medical Center, a leading academic medical center, widely recognized for the expertise of its medical and nursing staffs.

Regardless of where your surgery is performed, our staff will make sure that you are well prepared for the abdominoplasty procedure. We will help you to optimize your habits and physiology as you prepare for the surgery and will guide you through the recovery process.

Contact the Whole Beauty® Institute to Schedule an Appointment

Dr. John Q. Cook and the entire team of the Whole Beauty® Institute hope that this information has been helpful to you. Please contact us by email or phone for further information or to schedule an appointment with Dr. Cook at either our Gold Coast Office near Chicago’s Water Tower or our North Shore Office in Winnetka.