Abdominoplasty (Tummy Tuck)

“Abdominoplasty,” commonly referred to as Tummy Tuck is a surgical procedure designed to flatten the abdomen by removing excess skin and fat, tightening the muscles of the abdominal wall to achieve a smoother, flatter appearance. Tummy tucks can dramatically reduce the appearance of a protruding abdomen. The resulting scar is permanent but can be hidden below the bikini line.

A tummy tuck may dramatically tighten the abdominal muscles as well as remove sagging, excess skin and accumulated fatty tissue. as an added benefit of tummy tuck, not only will the abdominal region be firmer and flatter, but the waist will be smaller as well. Tummy tuck is usually long lasting if the patient follows a balanced diet and regularly exercises.


Procedure

Most tummy tuck procedures are performed under general anesthesia. Lately, ummy tucks are combined with Liposuction and can be performed under local ansthesia. In what many surgeons refer to as a full tummy tuck procedure, a surgical incision is made across the lower abdomen right above the pubic area. Following the creation of this initial incision, a second incision is made around the patient’s belly button as a means of loosening the surrounding skin. Next, the patient’s skin is separated from the wall of abdomen. Following this surgical maneuver, the surgeon pulls the loose abdominal muscles from the left and right flanks and sutures them together This action results in tighter abdominal muscles, creating a stronger, firmer abdominal wall as well as a smaller waist. Directly after the tightening and suturing of the abdominal muscles, excess skin is removed and a new opening is made in the correct position for the belly button.

It takes 2 to 5 hours. A partial tummy tuck may take 1 to 2 hours. Patients may go back to work 2 to 4 weeks. However fading and flattening of scars is between 3 months and 2 years.

FAQ

Abdominoplasty, also known as a Tummy Tuck or simply TT, is the surgery of the abdomen to remove the excess skin and fat that may accumulate after pregnancy, obesity or age. With a full abdominoplasty, benefits are also tightening of the abdominal muscles that may have become stretched out or lax over time. Even a new belly button can be obtained as a result! If you have an outtie or even an innie — the opposite can be acquired to go along with your new, taut stomach! This isn’t a simple procedure and you should definitely be aware of the risks and post-operative care and attendance that will be needed.
First and foremost, an individual must be in good health, not have any active diseases or serious, pre-existing medical conditions and must have realistic expectations of the outcome of their surgery. Communication is crucial in reaching one’s goals. You must be able to voice your desires to your surgeon if he/she is to understand what your desired results are. Discuss you goals with your surgeon so that you may reach an understanding with what can realistically be achieved.

You must be mentally and emotionally stable to undergo an cosmetic procedure. This is an operation which requires patience and stability in dealing with the healing period. There is sometimes a lull or depression after surgery and if there is already a pre-existing emotional problem, this low period can develop into a more serious issue. Please consider this before committing to a procedure. If the above describes you and you have the desire to rid yourself of loose sagging skin of the abdominal area, you may be a good candidate for Abdominoplasty. An ideal patient would have incredibly elastic skin. But, of course, we human beings are never ideal. But good elasticity certainly helps!

Normally women seek this procedure after pregnancy – although it is advised to wait until you are finished having children to have this procedure as the skin and muscles can get stretched out again as well as the dangers of your newly taut skin being unable to accommodate another pregnancy.
Also, if you are considering losing weight you should wait until after your desired weight is met. You may need additional surgery to remove the excess skin after you have lost the desired weight which would mean that the money spent on the previous abdominoplasty would be wasted and your skin can only be stretched so much.

The Abdominoplasty procedure is usually performed when a person is discontent with their appearance in the abdomen region. Although there is no normal age or time in one’s life (after 18), it is most often sought out after a woman has given birth and does not plan on having any more children. The reason that not having additional children is an important factor is that after the extra skin and muscle tissue is removed, the abdomen may not be able to accommodate another child. The skin could quite literally split. Although this probability will be individual-dependent. Mini tummy tucks are considered less invasive and are for minimal correction cases.
The surgeon will measure your abdomen and general torso region for an idea of an ideal abdomen size for you. Between pictures that you have brought in and with the information of how many children you have had, the two of you will set realistic goals on what is and isn’t possible with an Abdominoplasty. You must remember that no amount of surgery can restore your skin to its former condition.
The different techniques pertaining to Abdominoplasty consist of the different incision shapes and placement. Although most surgeons attempt to place the incisions in the most inconspicuous area, some surgeons may not, so please discuss this with your surgeon beforehand. Some surgeons go completely horizontal and straight across, some use a ‘V’ shape, some a ‘W’ shape and still others follow along the bikini line. In my opinion an incision following the bikini line is the optimum for concealment purposes although your body’s needs will determine the incision placement.
You are usually able to walk immediately after surgery and is in fact encouraged to do so 3 or 4 times per day for 1 to 2 minutes each time. However, you will more than likely not be able to stand up straight, more of a hunched over type of posture. The skin of the abdomen will be quite tight and you are usually instructed to remain bent over at least 45 degrees for the first 4 to 5 days after surgery. Patients will often note some back discomfort due to the 45 degree positioning for 4 to 5 days after surgery so ask your surgeon about muscle relaxants or valium.
The drains that have been placed will generally be removed 4 to 14 days after surgery. At the end of 4 days the patient may begin to straighten up and by six days post-op may or may not be fully straight. You should take it easy for at least two weeks after surgery. While the drains are in, you will be on bed rest with a very small amount of walking as outline above. However if your drains are in for an extended amount of time, you will of course not be expected to sit in bed all day. An abdominal pressure garment may be placed around you during one of your post-operative appointments and you may be instructed to wear this for 3 to 6 weeks.

Some swelling and discoloration are normal but generally this is minimal. Of course this is dependent upon the individual.

The amount of pain associated with this procedure is quite variable. Some patients note a moderate amount of discomfort and for some it is more intense. But certainly there is some discomfort. Patients will often note some back discomfort due to the 45 degree positioning for 4 to 5 days after surgery. Valium is sometimes given to alleviate muscle spasms of the back and for relaxation and a sleep aid, in general.
This is not a scar-free surgery; in fact the scars may be quite severe depending upon the amount of skin needed to be removed, your body’s ability to heal, if you scar well, the skill of the surgeon and the technique utilized. Most surgeons choose to offer their patients lesser scarring techniques that leave a well-hidden horizontal or slightly bowed scar which can be covered by a standard bikini. Be sure to discuss the incision types, techniques and placements with your surgeon at your consultation. Ideally, no scar would be wonderful, but that isn’t possible — yet.

There is a bit of swelling involved with an Abdominoplasty. You must take into account that Abdominoplasty is surgery and with this type of surgery and depending upon the case, a lot of tissue is removed.

Abdominoplasty is a very slow-to-heal-completely procedure. While the drains are in, the patient will be on bed rest with a very small amount of walking as outlined above. An abdominal pressure garment may be placed around you during one of your post-operative appointments and you may be instructed to wear this for 3 to 6 weeks. Most patients can and do return to work after 2 weeks. You simply should not have to sit at a desk for 8 hours after having had an Abdominoplasty.

After the swelling subsides and the drains are taken out you will start to see a difference. You must realize that the underlying tissues have been cut and that an Abdominoplasty is considered a very invasive procedure. Give your body time to heal and you will reap the many benefits of the procedure.
Of course, as with any surgery under anesthesia, there are risks that primarily are the sole responsibility of the anesthetic. Please see our Anesthesia Section for more information.
here are more risks with Abdominoplasty due to the fat and its surrounding tissues becoming necrotic (dead tissue). If the fat becomes necrotic from lack of blood supply, the fat tends to turn orange-ish clear and a little may drain from the incision. Although this is very normal to have fluid this color drain from the incision. There will be fat damage, there will be fluid retention, and there will be blood-tinted drainage.
If the tissue becomes necrotic, or you have a massive die off of fat cells that’s a completely different story. You must have the tissue removed before a major infection develops, possibly causing gangrene. This is extremely rare and taking precautions can certainly make a difference. Such as not smoking, proper wound care and proper surgeon selection with a sterile, accredited surgical suite or accredited hospital.
Sometimes Liposuction is part of the Abdominoplasty procedure. Even with the ultrasonic technique, patients have been known to receive actual burns from the ultrasonic technique. The fat is actually melted within the body by ‘exciting’ the fat molecules with high frequency radio waves and is suctioned out. There may be asymmetry, hyperpigmentation (permanent dark spots) from the bruising. Major blood loss is a factor is some cases. As is hematoma and infection. Just remember, Abdominoplasty or Liposuction is NOT the way to lose weight.

Another risk of Abdominoplasty is pulmonary Thromboemboli. A thromboebolus is a blood clot and this blood clot can break free and travel to the lungs resulting in pulmonary Thromboemboli. This can put a patient into adult breathing distress and subsequently into cardiac arrest or coma — leading to the patient becoming ‘brain dead’ shortly thereafter or in a vegetative state from loss of oxygen to the brain. Pulmonary Thromboemboli can happen within three (3) weeks of the surgery but will most likely show symptoms of shortness of breath and fatigue within the first 72 hours. However, pulmonary Thromboemboli can occur suddenly, without warning. Most patients with P.E. collapse and begin rapid deterioration after attempting to climb a flight of stairs. Please see our Abdominoplasty Risks Section for more information.

This procedure can last for many, many years. If there are no large weight gains, and no pregnancies after the tummy tuck then the changes will be relatively permanent. Certainly some relaxation of the tissues can reoccur but not to the extent prior to surgery.

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