Most people do not think of cosmetic surgical procedures as medically necessary. In other words, cosmetic procedures are only done for aesthetic reasons to enhance certain features of the body, rather than to correct for an illness, injury, or deformity to the body. While it is certainly true that there are certain instances in which cosmetic surgery can be performed for medically necessary reasons, such as a breast reconstruction following a mastectomy as a result of breast cancer, the majority of the procedures are still done strictly for aesthetic reasons.
Interestingly, many of those cosmetic procedures that are now done for aesthetic purposes were, in fact, originally done for medically necessary reasons. Some excellent examples of these include rhinoplasties (nose jobs) and facelifts, both of which came out of a need to address disfiguring injuries that soldiers suffered in wartime. Even tummy tuck procedures, which are now designed to remove excess skin and tighten loose muscles following dramatic weight loss, can trace some of their beginnings back to efforts to treat abdominal injuries in soldiers. Below is a brief history of the tummy tuck procedure.
Late-19th to Early-20th Centuries
The actual origin of abdominoplasties goes back to surgical treatment of umbilical hernias, in which abdominal tissue causes the navel to protrude too far out. In some cases, patients also had excessive abdominal skin and fat. In the first attempts at what we now know as abdominoplasties, French surgeons in the 1890s found that by removing this excess skin and fat, they could more easily access the herniated abdominal tissue. In addition, this procedure dramatically improved the abdominal body contour. The procedure rapidly spread to the United States, where the first such procedure was performed in Maryland in 1899.
There were a number of advances that took place in the early part of the 20th century. By 1909, surgeons were able to leave the navel intact by not making the incision in that spot. The procedure was further refined in the 1920s so that the internal umbilical structure remained intact.
By the middle of the 20th century, the abdominoplasty procedure still needed a great deal of refinement. There was often significant scarring, and the incision site had yet to be agreed upon. The next major advancement, as noted above, came with reconstructive surgical techniques needed to treat soldiers injured during WWII. These advances included minimizing scarring, as well as discovering new, less invasive techniques.
The latter half of the 20th century saw a number of techniques for performing abdominoplasties improve by leaps and bounds. Suturing techniques improved, particularly in ways to not distort the abdominal tissue. The combination of liposuction (to remove stubborn pockets of excess fat) and abdominoplasty was also introduced at this time. This was also when abdominoplasties clearly established themselves as a procedure that could be done for aesthetic purposes, rather than only to correct for abdominal hernias.
Today, the majority of abdominoplasty patients undergo surgery for aesthetic, rather than medically necessary reasons. It is clear that this procedure has come a long way from its initial beginnings, in terms of both intent and safety.