What is a tummy tuck?

Many people have problems keeping their tummy area in shape. Some have tried dieting and exercise yet still do not get the results they want to have.

Commonly known as a Tummy Tuck, abdominoplasty involves the removal of excess fatty tissue and skin, resulting to a firm and smooth abdomen. The procedure entails the removal of excess abdominal skin, reduction of fat below the skin, and if necessary, tightening of the muscles of the abdominal wall.

Most people who undergo this treatment are those who have gone through pregnancies. Sometimes the old unsightly scars from a C-section, appendectomy, and stretch marks can be removed as well. A tummy tuck usually results in a more youthful, firm, and flatter abdominal contour.

However, do take note that abdominoplasty is not a substitute for weight loss. We highly recommend weight management programs for patients to maintain their weight and keep the body in its new shape.

Effects of a Tummy tuck

Abdominoplasty procedures provide significant and lasting results for patients who opt for them. The recovery period may be somewhat longer and the incision lines last for a greater period of time, but it efficiently removes protruding, sagging abdominal skin. The incisions are normally placed in the natural skin folds, and most are covered by undergarments or swimwear. The abdomen should remain firm and flat for many years unless there is a significant change in weight.

Abdominoplasty patients feel more confident about their appearance months after the procedure. It gives them more freedom to choose what to wear without worrying over unsightly bulges. Patients who maintain their exercise routines and healthy diets will benefit the most from abdominoplasty and will maintain their results longer.

Candidates for tummy tuck

Abdominoplasty (tummy tuck) can be beneficial to both men and women who have excess fat and loose skin of the abdomen. Doctors who perform this procedure carefully consider age, obesity, and overall health to evaluate if a person is a good candidate. The best candidates for abdominoplasty are those who are healthy and physically fit and who have maintained a stable body weight near their ideal goal with a disciplined program of diet and exercise.

Good candidates for Abdominoplasty have one or more of the following conditions:

An abdomen that protrudes and is not in proportion to the rest of the body
Abdominal muscles that have been separated and weakened by weight gain or pregnancy
Excess or flabby abdominal skin
Excess fatty tissue that is mostly concentrated in the abdominal area

Poor candidates for abdominoplasty are smokers, diabetics and those with uncontrolled obesity. Women who would consider this procedure should be certain that they will not become pregnant again in the future, as pregnancies cause abdominal stretching.

This procedure gives patients a definite improvement in their appearance, more self-confidence and also a motivation to live a healthier lifestyle to maintain these results.

Your Consultation

During the initial consultation, your board-certified surgeon will ask for a complete medical history and will conduct a careful examination to evaluate your overall health. Abdominoplasty patients undergoing a supervised weight-loss plan should be close to their target weight before opting for the operation.

Pre-operative and post-operative photos will be taken of every patient who wishes to undergo this procedure.

Antibiotics will be prescribed to prevent infection, and patients should avoid taking drugs with aspirin pre-surgery to minimize bleeding. You are also suggested to shower using an antiseptic soap on the night before or the morning of your surgery.

The tummy tuck Procedure

Abdominoplasty is done on an outpatient basis in an accredited surgical facility and under general anesthesia. A sedative may be given to you beforehand to help you relax. Abdominoplasty generally takes 3 to 4 hours, unless other additional procedures are planned in conjunction to this procedure.

Abdominoplasty is usually performed by making a gently-curving incision extending for a variable length between both hip bones and above the pubic area. The length of the incision depends on the amount of excess skin to be removed. A circular incision is then made around the navel. The skin is then lifted from the abdominal wall and elevated up to the ribs to reveal the abdominal muscle. Sutures tighten the loose, separated muscles, and any abdominal hernias are repaired as well. This gives the patient a firmer abdominal wall and narrower waistline.

After that, the skin is re-draped and tightened over the abdomen. Any excess skin and fat are then trimmed and removed, and the navel is put back its place through a new incision in the abdominal skin.

Often during the procedure, the existing stretch marks in the lower abdomen are removed and any more that may remain are flattened and improved. The incisions are then thoroughly closed with hidden sutures and surgical tape. Temporary suction drains are then inserted to eliminate fluid buildup, and firm elastic bandages or a surgical girdle are applied to the area to limit the swelling and bruising.

Abdominoplasty patients usually spend the night of the surgery in an aftercare facility. However, patients can go to their own homes under the care of a private-duty nurse or a responsible adult caregiver.

Our medical staff will be ready to discuss with you several alternative techniques of abdominoplasty depending on your condition.

"Mini" or Partial Abdominoplasty

This procedure is reserved for patients with minimal loose skin and excess fat deposits located primarily below the umbilicus. There would be no incisions around the umbilicus in this alternative.

Belt Lipectomy or Lower Body Lift

This procedure works better for patients who have excessive and lax skin on the flanks and hips in addition to the abdomen.

Liposuction or Suction Lipectomy

This procedure is done in circumstances where there is good skin elasticity and localized excess fat only. This is often performed in conjunction with either mini or full abdominoplasty procedures to remove additional unwanted fat deposits and enhance the overall contours of the waistline, hips and thighs.

Recovery

After surgery, you will awaken gently from anesthesia in the recovery room, with mild discomfort that is usually controlled by pain medication. Once you are fully awake, you will be transferred to the aftercare facility or to your home with a responsible adult caregiver.

Below are some recommendations for better recovery:

Go for short walks to promote circulation and to facilitate deep breathing. Even if you are not able to stand up straight, it is recommended that you do not lie in bed or sit for long periods of time during the first several days right after surgery.
It is necessary that you wear a support garment or girdle in order to limit swelling and fluid accumulation.
Sleep on your back with a pillow under your knees.
Straining, bending and lifting must be stopped to avoid increased swelling, bleeding or disruption of the surgical repair.

Your surgeon will see you in the office 24 to 48 hours after surgery. You will be given special instructions for showering and changing your dressings until the drains are removed, which is 7 to 10 days after the procedure. The sutures are removed in stages over a period of 5 to 14 days.

The speed of recovery depends on your physical conditions before surgery. Those who have stronger abdominal muscles usually recover faster.

A mild amount of swelling and bruising is normal during this first week after surgery. Take at least one to two weeks to recuperate before returning to non-strenuous work. Sexual activity should be avoided for a minimum of two weeks as well. In three to four weeks after surgery, patients may resume light to moderate exercise. You may experience numbness over portions of the abdominal area that persist for several months. The incisions may remain red or pink for many months following surgery before they finally begin to fade. Swelling may subside several weeks after the abdominoplasty procedure to see the final results of your improved abdominal contour.

Risks

Every surgical procedure has advantages and disadvantages. These must be considered by the patient when deciding whether the procedure is appropriate. Also, every operation has potential complications which can occur in a small percentage of patients even in the best of hands.

Advantages of Abdominoplasty:

It tightens and cinches stretched muscles.
It removes some excess fat.
It helps decrease stretch marks.
It has a long-lasting result.

Disadvantages of Abdominoplasty:

It leaves a long horizontal scar above the pubic hairline. Although in some cases, if the skin is not excessive, muscle tightening can be done endoscopically, without the horizontal scar.
It leaves a scar around the navel area.
The recovery time is 1 to 3 weeks.
It causes some temporary bruising, numbness and swelling.

Frequently Asked Questions

Q: Is there a greater risk if I am a smoker?

A: Yes. Abdominoplasty patients who are smokers have a higher risk for loss of skin, delayed wound healing, infection, pneumonia and blood clots in the leg veins which may result in pulmonary embolism and death. It is essential that you refrain from smoking for 3 weeks before and 3 weeks after the surgical procedure.

Q: What can be done to improve the appearance of scars?

A: The scars will fade nicely as time passes. If the scars become somewhat thick or red, your surgeon may recommend treatment with silicone gel strips or liquid or even laser treatment of the scars to lessen the redness. This is mainly the reason for your follow-up visits, so that the medical staff at your surgeon can note the progress of your wound healing.

Q: How long do I need to wear the binder or girdle?

A: The binder or girdle diminishes the amount of swelling and bruising in the abdominal area, especially after having liposuction together with abdominoplasty. It prevents accumulation of fluids under the abdominal skin, and helps to maintain the contour of your new abdomen. You should wear it continuously, 24 hours a day, 7 days a week (except while showering) for the first 3 to 4 weeks after surgery. After that, an additional 3 weeks of usage in the daytime is recommended.

Q: Why are drains necessary for Abdominoplasty?

A: Suction drains are used together with external pressure from an elastic abdominal binder or girdle to remove serum and blood fluids that usually accumulate between the abdominal wall and the underside of the tightened abdominal skin. The drains help by removing the fluids so that the skin can re-attach to the abdominal wall without further problems or delay.

Q: How long will my drains remain in place?

A: The drains, which are normally two, will remain in place until the daily volume of drainage decreases to a minimum. This is usually between 5 days and 2 weeks.

Q: When can I shower or bathe?

A: You may shower after the first office visit/dressing change, which is within 24 to 48 hours after surgery. Do not bathe or immerse the incisions or drain sites under water in a bathtub, pool, etc., until the drains have been removed and the incisions completely healed. Your surgeon’s medical staff will let you know when you can do so.

Q: When can I resume exercise?

A: Patients are encouraged to begin walking immediately after surgery. After a week to 10 days, you may walk on a treadmill, or have mild upper body weight training. Most patients can resume full, unrestricted exercise activities in approximately 4 weeks.

Q: When can I resume driving?

A: Most patients may resume driving 48 to 72 hours after the abdominoplasty procedure. However, do not drive if you are taking narcotic pain medication, sedatives or muscle relaxants.

Q: When can I start going back to work or doing my normal social activities?

A: Most abdominoplasty patients are able to return to work or resume normal social activities after 5 to 10 days. You should frequent breaks to stand and walk to promote circulation and deep breathing. Wear loose-fitting clothing to hide the drains and abdominal binder or girdle.

Q: What would happen if I become pregnant after Abdominoplasty?

A: When you get pregnant, your skin and abdominal wall will stretch. In this event, you may need to have additional surgery to regain the improvement if the abdominal skin becomes lax again.

Q: Does my insurance cover my fees for Abdominoplasty?

A: Abdominoplasty is a cosmetic procedure not covered by insurance. Only if there is a significant spreading of the abdominal wall muscles or a hernia, a portion of the surgical center and professional fees may be eligible for reimbursement.