By Christopher Chung, M.D.
Chief Medical Officer

AbEX is a Full Abdominal Sculpting procedure offered by Sono Bello.

For many patients interested in removing stubborn belly fat around the abdomen— whether through liposuction or through natural weight loss— an added step is often needed where the remaining loose and sagging skin also needs to be removed to achieve the desired body shape.

The AbEX procedure, combined with micro-laser liposuction, allows for maximum fat removal and removal of excess skin around the abdominal region.

Because the AbEX procedure does not use general anesthesia or require heavy downtime, many patients choose AbEX as an alternative to a more traditional tummy tuck.

Why Do People Choose the AbEX Procedure?

AbEX is a great surgical option for many patients interested in removing stubborn belly fat and tightening skin around their abdomen. The AbEX procedure is especially beneficial for people with both excess fat and skin. It is also ideal for people who do not want the added risk associated with general anesthesia.

When combined with TriSculpt the fat removal capabilities of micro-liposuction, the excess skin removal offered by AbEX is ideal for anyone who wants a trim and flat tummy.

Sono Bello custom tailors each procedure to the patient’s exact aesthetic and anatomic needs, including:

• TriSculpt: Volume Reduction resulting from fat (e.g., minimal skin excess or those patients not accepting of a scar)

• Limited AbEX: Volume Reduction + Moderate Skin (e.g., moderate skin excess – like a “mini-tuck”)

• AbEX: Volume Reduction + Maximum Skin (e.g., significant skin excess – like a full tummy tuck)

How Does the AbEX Procedure Work?

AbEX includes a more comprehensive approach to fat removal than a traditional tummy tuck procedure.

The AbEX procedure removes loose sagging skin from the upper and lower abdominal area, providing a trim and toned tummy for patients who choose micro-laser liposuction for fat removal.

When preceded by micro-laser liposuction, the AbEX procedure follows a fairly straightforward process for patients:

1. Preparation: The physician will administer localized anesthesia to the treatment area, which keeps the patient awake for the procedure. This is used instead of higher-risk general anesthesia or deeper sedation.
2. Fat Removal: Using power-assisted technologies with micro cannulas and gentle suction, the physician will effectively remove unwanted fat. A micro-laser is used to contour unwanted fat in problem areas, allowing the physician to shape remaining body fat to match the patient’s desired look.
3. AbEX Skin Removal: Excess abdominal sagging skin is removed to achieve a more toned and sculpted look after fat is removed and contoured.
4. Completion & Recovery: Once the procedure is complete, post-procedure recovery and healing begin.

What is the Difference Between AbEX and a Tummy Tuck?

Although AbEX is often seen as an alternative to a more traditional tummy tuck (also known as abdominoplasty), a few key differences could make AbEX a more desirable option for some patients.

• While both procedures specifically focus on skin removal around the abdomen, AbEX is also often paired with micro-laser liposuction to provide maximum fat removal alongside skin removal. Tummy Tuck usually includes only minimal fat removal.
• AbEX does not require muscle repair as part of the procedure. This is a common step in a traditional tummy tuck that could add to the overall recovery time required.
• AbEX serves a greater range of patients with a higher body-mass index (BMI) to undergo the procedure, allowing for a range of BMIs between 18 and 42. This is compared to a required BMI under 35 for a traditional tummy tuck procedure.
• The AbEX procedure uses localized anesthesia, offering a lower risk of complications compared to a traditional tummy tuck’s use of general anesthesia.

How Much Skin Can Be Removed With AbEX?

The exact amount of skin removed by the AbEX procedure depends on each patient’s unique physical makeup. Exactly how much skin can be removed will largely depend on the patient’s body shape, as well as the surgeon’s recommendation.

Generally, however, AbEX allows for maximum abdominal skin removal. Should the surgeon feel it is needed for an optimal outcome, belly button repositioning is done with AbEX resulting in an aesthetically pleasing belly button.

Is AbEX Permanent?

Permanent Fat Removal Disclaimer

AbEX is generally considered permanent in that skin (and, when paired with micro-laser liposuction, fat cells) are removed from the body and usually do not grow back.

However, it is possible that weight gain after the AbEX procedure could cause fat cells in the abdominal area to grow larger, which may lead to changes in body shape that could negatively impact the result of skin removal.

Additionally, pregnancy after the AbEX procedure can cause changes to the shape of the abdomen and could result in a return of excess, sagging skin. There is no contraindication to pregnancy after AbEX procedure.

How Safe is AbEX Skin Removal?

AbEX is designed to maximize safety for patients, providing excess skin removal with minimal risks and complications.

Because the AbEX procedure uses localized anesthesia rather than general anesthesia, the risks associated with anesthesia are reduced compared to a traditional tummy tuck procedure.

The greatest measure of safety and best possible results for AbEX is best determined by the skill and knowledge of your surgeon. That is why our board-certified/eligible Sono Bello surgeons, who pioneered and perfected this technique, are experts at safely and effectively providing the AbEX procedure.

What Are The Risks of AbEX?

Although the AbEX procedure has been carefully designed to minimize risks while providing the best possible results, no surgical procedure is without risks.

Infection, bleeding, blood clots, scarring, wound healing issues and contour irregularities are all potential risks with the AbEX procedure. However, these risks tend to be low provided patients are healthy, well-prepared for the procedure and follow suggested recovery recommendations.

Does AbEX hurt?

Modern liposuction is a relatively painless procedure, and the same principle applies to AbEX.

Because localized anesthesia is used during the AbEX procedure, most patients feel only minimal discomfort while undergoing AbEX abdominal sculpting.

After the procedure and during recovery time, there is typically some soreness and swelling in the affected area as incisions heal.

Who Is a Candidate for AbEX?

The AbEX procedure is designed to be highly flexible and to accommodate a wide range of patients. Because the procedure minimizes potential risks, it may be available for a wider range of individuals compared to a more traditional tummy tuck procedure.

That said, there are some factors that will help best determine whether a patient is a good fit for the AbEX procedure, including:

1. Anyone looking to remove abdominal fat and who may also require skin removal alongside liposuction.
2. Anyone who has recently lost a significant amount of abdominal fat (like through natural weight loss) and is living with excess, hanging skin.
3. Post-pregnancy changes result in pockets of stubborn fat and excess skin (Moms).
4. Patients with BMI between 18 and 42.
5. Healthy individuals who can accurately prepare for surgery and recovery time per a surgeon’s instructions.

The best way to determine whether a patient is a candidate for the AbEX procedure is to consult with a Sono Bello surgeon and discuss the best custom-tailored options.

Who Is Not A Candidate for AbEX?

Although AbEX is specifically designed to maximize its potential for a wide range of patients, not everyone is a good fit for the procedure.

There are several health and lifestyle factors that could make a patient a less-than-ideal candidate for AbEX, including:

1. Anyone with a BMI over 42
2. Pacemaker wearers
3. Those with uncontrolled diabetes
4. Anyone currently undergoing chemotherapy
5. Patients with severe heart/lung illnesses
6. Pregnant or soon-to-be pregnant individuals
7. Anyone on dialysis
8. Supplemental Oxygen requirement
9. Someone on an organ transplant waiting list
10. Patients taking blood-thinning medication
11. Patients with kidney or liver disorders

Patients who match any of these qualities should talk with their physician and their surgeon prior to scheduling the AbEX procedure to confirm whether they could be a candidate.

Prep & Recovery from AbEX

Key to a successful AbEX procedure (and achieving ideal results) is good preparation for the procedure, healthy recovery, and long-term care to maintain the patient’s desired body shape.

When it comes to preparing for, recovering from, and maintaining results after an AbEX procedure, there are a few simple steps every patient can take to maximize positive outcomes.

How Should I Prepare for AbEX?

As with preparing for any procedure, preparation for AbEX involves staying healthy, setting realistic expectations, and taking steps to minimize discomfort after the procedure is complete.

The sooner preparation for the AbEX procedure starts, the better positioned each patient is to achieve and maintain their ideal body shape.

Before embarking on the AbEX procedure, every patient should:

• Set your expectations. Patients should clearly envision their expected results. The AbEX procedure when combined with TriSculpt laser liposuction is designed to remove maximum amounts of fat and excess skin, so the procedure can be custom-tailored to each patient’s needs.

• Maintain stable body weight. Major fluctuations in body weight can complicate the planning and the AbEX procedure itself and so it is best that the patient’s weight be relatively stable before moving forward.

• Prepare for downtime during recovery. Patients should expect 5-10 days of rest and healing after the AbEX procedure. Light walking is encouraged, but heavy lifting or strenuous activities should be avoided to minimize injury.

• Stock up on tools to help minimize swelling during recovery. Materials like poise pads, disposable towels, ibuprofen, and compression garments can all help reduce swelling and clear normal drainage from the surgical area.

• Ask a friend or family member to provide transportation. Most AbEX patients recover quickly, but the first 24 hours can be uncomfortable. It’s required that each patient has someone to accompany them to the procedure, to take them home, and to stay with them for a day or so after the procedure is complete.

• Drink plenty of fluids, eat protein, & avoid caffeine for 48 hours before the procedure. A well-hydrated patient who has eaten plenty of good protein will be best positioned for maximum success during the AbEX procedure.

How much does AbEX cost?

The actual cost of the AbEX procedure is different for each patient, and is determined by each patient’s specific body and goals.

A few major factors are considered when determining the cost of AbEX for each patient, including:

• Body Mass Index (BMI): The amount of fat a patient has on their body plays a role in determining the amount of fat to be removed during the AbEX procedure. As opposed to a traditional Tummy Tuck, which is usually limited to only patients with a BMI less than 32, AbEX is available for patients with a minimum BMI of 18 and maximum BMI of 42.
• Promotions & savings: Sono Bello often offers promotions or savings for the AbEX procedure, which can help lower cost for patients.

Sono Bello offers multiple financing options and payment plans for patients, and payment for the AbEX procedure can be arranged to fit the patient’s budget.

For all patients, the best way to determine the cost of AbEX for each patient is through a free consultation with a Sono Bello patient care consultant.

What is Recovery from AbEX Like?

Because the AbEX procedure does not include adjustments to stomach muscles, patients can expect a much faster recovery process.

Our patients are typically back to normal activities in 5-10 days and back to working out in 3-4 weeks. In contrast, Tummy Tuck patients typically will take 3-4 weeks to resume normal activities with a prolonged period before strenuous working out can be done.

Due to its minimally invasive nature, most patients should relatively straightforwardly recover from the AbEX procedure. However, there are several important steps each patient should take after surgery to ensure maximum success and the best possible results.

1. Rest for around 72 hours after the procedure.
2. Return to normal activities in 5-7 days and to working out in 3-4 weeks.
3. Use compression devices for about 3-6 weeks post-op to encourage healing and proper contour development.

What Results Should I Expect After the AbEX Procedure?

Once an AbEX procedure has been successfully completed, most patients will see results immediately to as little as one month after the procedure is complete. This often includes a slimmer abdomen, tighter skin in targeted areas, sagging or hanging excess skin removal, and a toned belly.

Patients can expect well-healed scarring at the surgical site, usually from laser liposuction coupled with skin excision. Sono Bello surgeons are trained to take their time when removing excess skin in order to get the best-looking incision possible. But everyone heals differently. Although scars are permanent, they can fade over a period of up to two years.

Here are some things you can do to make sure you will have a favorable scar:

1. Always keep your incision clean.
2. Apply sunscreen to the wound after it has healed.
3. Use the Mepitac Scar Tape given to you at your 1-month post-op appointment.

It is also important that each patient maintain a healthy lifestyle to keep their body contoured to their ideal look and shape. Factors like post-surgical weight gain or pregnancy could impact the result and cause re-expansion of fat cells or skin in the targeted area.