Abdominoplasty – Tummy Tuck – Abdominal Contouring

Women and men who have loose abdominal skin and fat that is concentrated in the abdomen can benefit from an abdominoplasty. Sometimes these conditions are inherited but in other instances, substantial weight loss may cause abdominal skin to become flaccid. Abdominoplasty also can tighten muscles that have been separated and weakened by pregnancy. The procedure may also improve the appearance of stretch marks, especially those located below the navel. An abdominoplasty does produce a permanent scar and its length depends on the extent of the skin laxity and the degree of surgery required to correct it.

If you’re considering an abdominoplasty, this will give you a basic understanding of the procedure and specifically when it can help, how it’s performed, and what results you can expect.

QUICK FACTS

IDEAL TUMMY TUCK CANDIDATE

Localized excess skin and fat of the abdomen
Protrusion or laxity of the abdomen
Weak abdominal muscles

TUMMY TUCK ADVANTAGES

Removes and tightens excess skin
Directly removes excess fat
Strengthens (plicates) and flattens abdominal muscles
Reduces regional fat with liposuction
Contours and sculpts abdomen and restores natural, youthful proportion

TUMMY TUCK TECHNIQUES

Classical abdominoplasty (usually combined with liposuction)
Mini abdominoplasty (usually combined with liposuction)
Extended abdominoplasty (usually combined with liposuction)
Liposuction abdominoplasty

TUMMY TUCK STATISTICS

Length: 2 to 4 hours
Back to Work: 10-12 days
Return to Exercise:
7 days (light cardio),
4-6 weeks (more strenuous)

Am I a good candidate for abdominoplasty?

You may be a good candidate for abdominoplasty if you have one or more of the following conditions:
excess or sagging abdominal skin an abdomen that protrudes and is out of proportion to the rest of your body abdominal muscles that have been separated weakened excess fatty tissue that is concentrated in your abdomen.

The best candidates for abdominoplasty are men or women who are in relatively good shape but are bothered by a large fat deposit or loose abdominal skin that won’t respond to diet or exercise. The surgery is particularly helpful to women who, through multiple pregnancies, have stretched their abdominal muscles and skin beyond the point where they can return to normal. Loss of skin elasticity in older patients, which frequently occurs with slight obesity, can also be improved.

Patients who intend to lose a lot of weight should postpone the surgery. Also, women who plan future pregnancies should wait, as vertical muscles in the abdomen that are tightened during surgery can separate again during pregnancy. If you have scarring from previous abdominal surgery, your doctor may recommend against abdominoplasty or may caution you that scars could be unusually prominent.

Abdominoplasty can enhance your appearance and your self-confidence, but it won’t necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.

Your Personal Consultation

Your surgeon will evaluate your health, determine the extent of fat deposits in your abdominal region, and carefully assess your skin tone. Be sure to tell your surgeon if you smoke, and if you’re taking any medications, vitamins, or other drugs. Be frank in discussing your expectations with your surgeon. If your fat deposits are limited to the area below the navel, you may require a less complex procedure called a partial abdominoplasty, also know as a mini-tummy tuck, which can often be performed on an outpatient basis. You may, on the other hand, benefit more from partial or complete abdominoplasty done in conjunction with liposuction to remove fat deposits from the hips, for a better body contour. Or maybe liposuction alone would create the best result. In any case, your surgeon will work with you to recommend the procedure that is right for you and will come closest to producing the desired body contour. During the consultation, your surgeon will also explain the anesthesia he or she will use and the type of facility where the surgery will be performed.

How will my plastic surgeon evaluate me for abdominoplasty?

Your plastic surgeon will examine your abdomen while you are standing as well as lying down. Your skin tone and the degree of loose skin in the abdominal region will be assessed. Your surgeon also will evaluate the amount of excess fat in your abdomen and the condition of your abdominal muscles. You should come to the consultation prepared to discuss your medical history. This will include information about any medical conditions, drug allergies, medical treatments you have received, pregnancies, previous surgeries and medications that you currently take. It is important for you to provide complete information.

Preparing For Your Surgery

Your surgeon will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins, and medications. If you smoke, plan to quit at least one to three weeks before your surgery and not to resume for at least three weeks after your surgery. Avoid overexposure to the sun before surgery, especially to your abdomen, and do not go on a stringent diet, as both can inhibit your ability to heal. If you develop a cold or infection of any kind, your surgery will probably be postponed. Whether your surgery is done on an outpatient or inpatient basis, you should arrange for someone to drive you home after your surgery, and to help you out for a day or two after you leave the hospital, if needed.

Types of Anesthesia

An abdominoplasty usually requires light general anesthesia, so you’ll sleep through the operation. Occasionally we use local anesthesia combined with a sedative to make you drowsy. You’ll be awake but relaxed, and your abdominal region will be insensitive to pain.

What are some variations to the common abdominoplasty technique?

There are many variations both to the design of the incisions and the technique itself. In some instances, it may be possible to avoid an incision around the navel. When the amount of loose skin is minimal and the excess fat deposits are located below the navel, a short horizontal incision is all that is necessary. This procedure is called a partial, or “mini,” abdominoplasty. Sometimes liposuction may be used alone, or in conjunction with abdominoplasty, to remove abdominal fat. Your plastic surgeon will discuss with you the particular method that he or she recommends for achieving the best result in your particular case.

The Surgery technique

Abdominoplasty 1

Types of abdominoplasty incisions

A standard abdominoplasty usually takes two to three hours, depending on the extent of work required. Partial abdominoplasty may take an hour or two.

Initially the surgeon will make an incision just above the pubic area. A second incision is frequently made to free the navel from surrounding tissue. Next, the surgeon separates the skin from the abdominal wall all the way up to your ribs and lifts a large skin flap to reveal the vertical muscles in your abdomen. These muscles are tightened by pulling them close together and stitching them into their new position. This provides a firmer abdominal wall and narrows the waistline.

Abdominoplasty 2

The skin flap is then stretched down and the extra skin is removed. A new hole is cut for your navel, which is then stitched in place. Finally, the incisions will be stitched, dressings will be applied, and a temporary tube may be inserted to drain excess fluid from the surgical site. In partial abdominoplasty, the skin is separated only between the incision line and the navel.

Abdominoplasty 3

Extended abdominoplasty
This procedure is basically a standard abdominoplasty with the addition of recontouring of the hips, flanks and even the lateral thigh. Sometimes, there is significant excess skin of the hips extending onto the flanks, with ptosis (sagging) of the lateral (outer) thighs. This is usually the case after significant weight loss. In this case, a standard abdominoplasty will not address the skin excess over the hips. While a standard abdominoplasty will re-contour the central ninety percent or so of the abdomen, in these patients there will actually be an accentuation of the excess skin on the sides when the abdominal skin is advanced downward, creating a deformity which the lay public have termed a “muffin top”. The treatment is simply to adequately remove this additional excess skin through an extended abdominopasty.

Extended abdominoplasty

Mini (partial) abdmominoplasty
With the mini abdominoplasty, the main focus is on the lower abdomen. The incision is much shorter and the navel has no umbilical incision. In partial abdominoplasty, the skin is separated only between the incision line and the navel. Any weakness in the muscles of the abdomen is fully repaired (tightened).

Your Surgical Experience

Our goal and of the entire staff is to make your surgical experience as easy and comfortable for you as possible. Medications are administered for your comfort during the surgical procedure. If you are a smoker, you will be asked to stop smoking well in advance of surgery. Aspirin and certain anti-inflammatory drugs can cause increased bleeding, so you should avoid taking these medications for a period of time before surgery. Your surgeon will provide you with additional preoperative instructions. Abdominoplasty may be performed on an outpatient basis and there is usually an overnight stay. When surgery is completed, you will be taken into a recovery areawhere you will continue to be closely monitored. In many instances, small drain tubes will have been placed within the abdominal tissues to help avoid accumulation of fluids. Gauze or other dressings may be applied to your abdomen and covered with tape or an elastic bandage. Be sure to arrange for someone to drive you home and to stay with you for at least the next day or two.

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 discomfort and increased swelling. 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. You will notice swelling and bruising, which is to be expected. The bruising and much of the swelling will disappear over a period of 2-3 weeks but 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 especially in the lower abdomen. 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 may take 2-4 weeks to start feeling like your old self again. If you start out in top physical condition with strong abdominal muscles, recovery from abdominoplasty will be much faster. Some people return to work after two weeks, while others take three or four weeks to rest and recuperate. It is important to realize that the amount of time it takes for recovery varies greatly among individuals. In most instances, you can resume most of your normal activities 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. Exercise will help you heal better. Even people who have never exercised before should begin an exercise program to reduce swelling, lower the chance of blood clots, and tone muscles. Vigorous exercise, however, should be avoided until you can do it comfortably.

Your scars may actually appear to worsen during the first three to six months as they heal, but this is normal. Expect it to take nine months to a year before your scars flatten out and lighten in color. While they’ll never disappear completely, abdominal scars will not show under most clothing, even under bathing suits.

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

Your Cosmetic result after an Abdominoplasty

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.

Unless you gain or lose a significant amount of weight or become pregnant, your abdomen should remain firmer and flatter for many years and most likely there will be no need for any surgical intervention in the future.

The Risks and possible complications of an abdominoplasty

Fortunately, significant complications from abdominoplasty are infrequent. Anyone considering surgery, however, should be aware of both the benefits and risks. The subject of risks and potential complications of surgery is best discussed on a personal basis between you and your plastic surgeon. Some of the potential complications that may be discussed with you include bleeding, infection and reactions to anesthesia. Tissue loss along portions of the horizontal incision is a possibility when the abdominoplasty is very extensive or if you are an active smoker. This complication, which delays healing and prolongs recovery, is more common in patients who smoke or have medical conditions such as diabetes. Revisionary surgery is sometimes helpful in certain instances where incisions may have healed poorly. Following surgery, occasionally, fluid may accumulate under the skin. Removal of this serum is a painless process but may require several visits to the plastic surgeon’s office. You can help to lessen certain risks by following the advice and instructions of your plastic surgeon, both before and after surgery. Blood clots are rare, but can occur. You can minimize the risk of blood clots by moving around as soon after the surgery as possible. We utilize all preventive measures in order to reduce this risk as much as humanly possible.

Procedures combined with abdominoplasty

Abdominoplasty is most often performed as an isolated procedure or combined with Liposuction. For those individuals who desire additional plastic surgery enhancements, tummy tuck may be combined with breast augmentation, breast lift (mastopexy), liposuction, and facial rejuvenation procedures in selected cases. It is essential in most patients to keep the operative time limited to less than 5-6 hours in order to reduce the risk for blood clots.

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