About Tummy Tuck
Tummy tuck surgery, also known as an abdominoplasty.
A tummy tuck is a cosmetic procedure that is used to make the abdomen both thinner and firmer. Tummy tuck surgery or an abdominoplasty involves the removal of loose excess fat and skin and tightening muscles in the abdominal wall. It can also remove some, if not all, of the stretch marks in your lower abdomen. It is a popular procedure following pregnancy, massive weight loss or whenever a flabby abdomen with weak muscles impairs body contour.
How is it performed?
In this surgical procedure your surgeon will remove your loose abdominal skin and tighten up your abdominal muscles with sutures. The primary tummy tuck incision will be above the pubic mound from one hipbone to the other. In a full abdominoplasty another incision is made around your navel. In a mini-tummy tuck your surgeon will use a shorter incision. The surgeon will loosen the skin from your abdominal wall to your ribcage and then place sutures in the fascia of your abdominal muscles to pull them into a tighter position. This is the muscle repair portion of the surgery.
After your abdominal muscles have been sutured your surgeon will remove excess fat by liposuction or other methods. Your abdominal skin is then stretched down over your incision line and the excess skin is removed. Next your surgeon will mark the placement of your navel. Although the skin around your navel has been moved the navel almost always stays in the same place. Your surgeon cuts a hole through the re-draped skin and sutures it around your navel.
In a full abdominoplasty, the surgeon will often insert one or more drains to prevent fluid build-up which can cause pressure on the incision. The drain is a clear plastic tube placed through a very short incision below the main incision which leads out of the body to a small oval-shaped bulb. Each time you empty a bulb and before you close it again you will be asked to squeeze it to help drain the wound.
What are my options?
A personal consultation with your board-certified aesthetic plastic surgeon will determine the best option for you. Here are some different approaches:
- Full Abdominoplasty
In addition to the incision across the lower abdomen, a traditional tummy tuck involves an incision around the navel. Excess skin is removed, muscles are tightened and liposuction may be used to contour the abdomen. This surgery removes skin from above the navel down to the pubic area that has been compromised by pregnancies genetic laxity or obesity.
- Mini Abdominoplasty
A single incision is made in the pubic area which will be placed as low as possible and can range from a few inches to the entire span of your abdomen. Through this incision your surgeon will remove excess skin, tighten slack muscles and possibly use liposuction to further refine the area. The ideal candidate for a mini-tummy tuck has laxity and protrusion below the navel. A mini-tummy tuck is usually recommended for those who have always been in fairly good shape but cannot achieve their aesthetic goals with diet and exercise.
- Extended or High Lateral Tension Abdominoplasty
If you have excess skin in the love handles or hips your incision can be made longer to address this problem. The high lateral tension tummy tuck was one of the first procedures developed to address skin excess after significant weight loss or pregnancy. The technique uses a layer in the deeper tissue to support and maintain the repair. This procedure includes a tummy tuck in the front of the abdomen and transfers the lift over the hip to the side of the thigh to improve contour in this area, suspending and improving the hip and thigh. You can simulate the effect by grabbing the skin on the sides of your waist and pulling up.
Is it right for me?
If you have a significant amount of intra-abdominal fat surrounding your internal organs you may need to slim down before considering a tummy tuck. You are physically healthy. You must be in relatively good physical shape to tolerate this procedure.
Internal or external scars from any previous abdominal surgery may also affect your candidacy. If you are in good general health have a positive attitude and realistic expectations you are most likely a good candidate for this procedure. Tummy tuck treats stretched out abdominal skin. After surgery you will have a firmer flatter abdomen.
What result can I expect?
Barring another pregnancy or significant weight gain, your results should be permanent although plastic surgery will not prevent the effects of normal aging. Once the skin is tightened it will get a little looser as you age, but not much. However if you gain and then lose a large amount of weight after a tummy tuck, the abdominal skin could stretch out again negatively impacting the overall contour. Likewise, if you become pregnant your abdomen will loosen again. For this reason it is best to wait until after you finish having children to undergo a tummy tuck.
- Tummy-tuck surgery will restore a flat tummy.
- Repair effects of pregnancy
- You will have a scar (located in the bikini area).
- Another pregnancy may influence surgery results, so it is best to wait until you’ve finished having children before undergoing this procedure.
- Weight gain following abdominoplasty may negatively affect your surgery results.
As the anesthesia wears off you may feel dizzy disoriented and nauseated. These sensations should pass within a few hours although some types of oral pain medications may cause these symptoms to recur. If you return home the same day you will need someone to drive you. Depending on the extent of the procedure, you may be required to spend a night or two in the hospital recovering from surgery. Immediately following an abdominoplasty expect your abdomen to feel very sore or tender. Any pain you feel can be controlled with pain medications. Most tummy tuck patients require several days of bed rest even if they return home the same day as their surgery. Your incision site will be covered with a dressing to keep the area clean and protected. You will also be wearing a wide elastic compression garment to reduce swelling and provide support to the skin as it tightens. You will wear this garment for several weeks. Depending on the extent of your abdominoplasty you may have tubes in your incision to drain away fluid. You will be asked to empty the drains a few times a day and keep track of how much fluid comes out. Drains are usually removed from three to fourteen days after your surgery depending on how much fluid is coming out. If you have traditional sutures these will typically be removed within the first week or two (absorbable sutures will not have to be removed). Your surgeon should provide you with detailed instructions for managing your drains changing your bandages and showering during recovery. You will also be told whether you can put any ointment on your incisions to reduce discomfort. Common side effects experienced by abdominoplasty patients include redness bruising and swelling. These effects usually subside in one to three weeks as your body adjusts to the new contours and the incisions heal.
Recovery from a tummy tuck procedure occurs over a period of six months or more. In the first couple of days managing pain and avoiding complications is your top priority. The first week will be the worst and you will still feel like you are recovering for about two to three weeks.
After a few weeks regaining mobility and fitness becomes important. After several months, you can start evaluating the aesthetic outcome of your surgery. Discomfort typically drops down to a “nagging” level by five to seven days. You will likely go back for follow-up with your surgeon within five days. During this visit your doctor can remove the drains. Swelling should subside within five weeks. Call your surgeon immediately if you notice an increase in swelling, pain, redness, drainage or bleeding in the surgical area or if you develop fever, dizziness, nausea or vomiting. Other red flags include shortness of breath, chest pains and an unusual heartbeat. You should be up and walking the day after surgery, although slowly. It is important to walk to discourage swelling and to prevent blood clots in the legs. However, avoid strenuous exercise for four to six weeks because it can trigger unnecessary fluid retention in the treated areas. Plan to take about two weeks off from work depending on the physical demands of your job.
Limits & Risks
Fortunately, significant complications associated with tummy tucks are infrequent and the satisfaction rate is high. The overall complication rate is small if the operation is done by an experienced plastic surgeon operating in an accredited facility. All surgical procedures have some degree of risk. You can minimize the risk to you by carefully following the instructions and advice of your plastic surgeon before and after your cosmetic surgery procedure.
Some potential complications of all surgeries are:
- Adverse reaction to anaesthesia
- Hematoma or seroma (an accumulation of blood or fluid under the skin that may require removal)
- Infection and bleeding
- Changes in sensation
- Allergic reactions
- Damage to underlying structures
- Unsatisfactory results that may necessitate additional procedures.
- Blood clots in your legs or lungs