Abdominoplasty
Tummy tuck is a major surgical procedure to flatten the abdomen by removing excess skin and fat from the lower abdominal region and tightening the muscles of the abdominal wall. Appropriate candidates for tummy tuck are men and women with fat deposits or loose abdominal skin that does not respond to diet or exercise, and women with slack muscles and skin due to multiple pregnancies. Older patients whose skin has lost its elasticity may also find improvement. Obese patients who plan to lose weight should postpone surgery.
For complete tummy tuck, the surgeon generally makes a long incision from hip to hip, just above the pubic region. A second incision releases the navel from surrounding tissue. The surgeon separates the skin from the abdominal wall up to the ribs, lifts the skin flap, and tightens the abdominal muscles by pulling them closer together and stitching them into position. Excess skin is removed from the flap and a new hole cut for the navel, which is then stitched into place before the incisions are closed. For a partial or "mini" tummy tuck, the incision is shorter and the navel may remain in place.
Tummy tuck may be performed in a hospital or outpatient facility, depending on the extent of the procedure and the individual patient. The duration of the procedure varies but typically takes from two to four hours. General anesthesia is preferred for this procedure.
For the first few days after surgery, you will probably experience pain, abdominal swelling, soreness, bruising and numbness of the abdominal skin. Reduced energy levels for weeks is not uncommon.
Patients will need to stay home from work for two to four weeks and should wait four to six weeks or more to resume strenuous activities. Scars will fade and flatten in three months to two years.
Results of abdominoplasty are permanent, barring major weight gain.
Procedural Steps
First, Anesthesia is induced
Medications are administered for your comfort during the surgical procedure. This procedure is usually done under general anesthesia.
The Incision
full tummy tuck requires a horizontally-oriented incision in the area between the pubic hairline and belly button.
The shape and length of the incision will be determined by the amount of excess skin. Once the abdominal skin is lifted, the underlying weakened abdominal muscles are repaired.
A second incision around the navel may be necessary to remove excess skin in the upper abdomen.
The upper abdominal skin is pulled down like a window shade. The excess skin is trimmed and the remaining skin is sutured together. A new opening for the belly button is created. The belly button is popped through to the surface and sutured into position.
Closing the incisions
I generally use mostly dissolving stitches below the skin. It takes a little longer, but I think that it leaves better scars.
Tummy tuck recovery
During your tummy tuck recovery, dressings or bandages may be applied to your incisions, and you may be wrapped in an elastic bandage or a compression garment to minimize swelling and support your abdomen as it heals following surgery.
Small, thin tubes are usually temporarily placed under the skin to drain any excess blood or fluid that may collect.
You will be given specific instructions that will include how to care for the surgical site and drains, your activity level, when you can shower and when to follow up in the office.
Tummy tuck risks and safety information
The decision to have plastic surgery is extremely personal, and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications of tummy tuck surgery are acceptable.
You will be asked to sign consent forms to ensure that you fully understand the procedure and any risks.
Tummy tuck risks include:
- Anesthesia risks
- Bleeding
- Infection
- Fluid accumulation (seroma)
- Poor wound healing
- Skin loss
- Numbness or other changes in skin sensation
- Skin discoloration and/or prolonged swelling
- Unfavorable scarring
- Recurrent looseness of skin
- Fatty tissue found deep in the skin might die (fat necrosis)
- Deep vein thrombosis, cardiac and pulmonary complications
- Asymmetry
- Suboptimal aesthetic result
- Possibility of revisional surgery
- Persistent pain
These risks and others will be fully discussed prior to your consent. It’s important that you address all your questions prior to surgery.