Abdominoplasty (tummy tuck)

What is a tummy tuck?

 A flat and well-toned abdomen is something many of us strive for through exercise and weight control. Sometimes these methods cannot achieve our goals.Also known as abdominoplasty, a tummy tuck removes excess fat and skin, and in most cases restores weakened or separated muscles creating an abdominal profile that is smoother and firmer.

Even individuals of otherwise normal body weight and proportion can develop an abdomen that protrudes or is loose and sagging. The most common causes of this include:

         Pregnancy

         Aging

         Significant fluctuations in weight

         Heredity

         Prior surgery

Tummy tuck surgery is a highly individualized procedure and you should do it for yourself, not to fulfill someone else's desires or to try to fit any sort of ideal image.

Abdominoplasty is a good option for you if:

         You are physically healthy and at a stable weight

         You have realistic expectations

         You do not smoke

Although the results of an abdominoplasty procedure are technically permanent, the positive outcome can be greatly diminished by significant fluctuations in your weight. For this reason, individuals who are planning substantial weight loss or women who may be considering future pregnancies may be advised to postpone abdominoplasty surgery.

What a tummy tuck won't do:

Tummy tucks are not a substitute for weight loss or an appropriate exercise program. Also, tummy tuck operations cannot correct stretch marks, although these may be removed or somewhat improved if they are located on the areas of excess skin that will be excised, generally the treated areas below the belly button.

How is it done?

Abdominoplasty generally takes up to four hours.  The operation involves the use of a general anesthesia and a hospital stay of two to four days.   An ellipse of skin between the pubic bone and the navel is cut out and the skin is lifted. Once the excess skin is removed, the skin above the navel is pulled down and stretched toward the skin below the pubic bone and is stitched together.  Excess fat may be removed and underlying muscles tightened at the same time. In some cases the skin is pulled down over the original navel and a new hole is made for it to come through.  After surgery, bandages and drainage tubes are put in place to support proper healing.

Risks & complications

Complications are infrequent and usually minor. However, as with any surgery, there are risks.

  • General complications of surgery include blood loss and possible transfusion, blood clots in the legs (Deep Vein Thrombosis or DVT) and chest (Pulmonary Embolism), chest infection and reactions to anesthesia.
  • Poor healing which results in conspicuous scars may necessitate a second operation.
  • Tissue loss along portions of the incision and infection which require antibiotic and in some cases hospitalization is possible.
  • Accumulation of fluid under the skin may require additional outpatient visits.
  • Patients may experience numbness after surgery that can occasionally be permanent.

Risks can be reduced by following the surgeon's instructions before and after surgery.

Alternatives

The surgeon may discuss alternative approaches to the Abdominoplasty procedure.  Liposuction may be used alone to remove excess abdominal fat. However, the main alternative to Abdominoplasty is simply to leave the abdomen as is.

Individual factors and personal preferences will determine the specific technique selected to smooth and flatten your abdomen.

How will I look and feel initially?

The day after surgery, you will be encouraged to get out of bed for short walks to promote blood circulation. Although you may not be able to stand up completely straight, it is best if you do not sit for long periods of time during the first several days. Straining, bending and lifting must be avoided, since these activities might cause increased swelling or even bleeding. You may be instructed to sleep on your back with a pillow under your knees.

Any surgical drains probably will be removed within a week following surgery, at which time your dressings may also be changed or removed. Depending on the abdominoplasty technique used, you may be instructed to wear a support garment for several weeks. Generally, stitches will be removed in stages over a period of approximately one or two weeks.

You will notice swelling and bruising, which is to be expected. The bruising and much of the swelling will disappear over a period of weeks. However, it may be months before all swelling subsides and you see the final result of your abdominoplasty. You may also notice some numbness over portions of the abdominal area, and this may persist for several months. Incisions will initially be red or pink in color. They will remain this way for many months following surgery and may even appear to worsen before they finally begin to fade.

When can I resume my normal activities?

It is important to realize that the amount of time it takes for recovery varies greatly among individuals. Depending on the extent of your abdominoplasty and your general physical condition, you may be able to return to non-strenuous work anywhere from one to three weeks after surgery. In many instances, you can resume most of your normal activities, including some form of mild exercise, after a few weeks. You may continue to experience some mild, periodic discomfort and swelling during this time, but such feelings are normal. Severe pain should be reported to your doctor.

Any sexual activity should be avoided for a minimum of two weeks, and your plastic surgeon may advise you to wait longer.

Abdominoplasty will enhance your body contour by making your abdomen firmer and flatter. You may find that you feel more comfortable in your clothing and are more confident about your appearance.

The incisions from the procedure will heal and fade over time. It is important to realize, however, that the incision lines will be permanently visible. In some instances, they will eventually be only faint lines. Certain individuals may have incision lines that are more noticeable. Fortunately, the incisions for your abdominoplasty are usually in locations concealed by most bathing suits and undergarments.

How long will the results last?

Unless you gain or lose a significant amount of weight or become pregnant, your abdomen should remain firmer and flatter for many years. However, gravity and the effects of aging will eventually take their toll. If, after a period of years, you again become dissatisfied with the appearance of your abdomen, you may choose to undergo a second procedure to restore a more youthful body contour.