Abdominoplasty, known more commonly as a “tummy tuck,” is a surgical procedure to remove excess skin and fat from the middle and lower abdomen and to tighten the muscles of the abdominal wall. The procedure can dramatically reduce the appearance of a protruding abdomen. But bear in mind, it does produce a permanent scar, which, depending on the extent of the original problem and the surgery required to correct it, can extend from hip to hip.
Most tummy tucks are “Total Abdominoplasties”, meaning that the entire abdominal wall is freed up, and pulled down to tighten it. The muscles underneath are tightened as well, giving the abdomen a much flatter, firmer look. In some cases, a “mini-tummy tuck” can be done, where the scar is much smaller, and only the portion of the abdominal wall below the umbilicus (navel) is tightened. This option typically works for people with a fairly small abdomen, who have a little protuberance (small pot belly).
If you’re considering abdominoplasty, this will give you a basic understanding of the procedure, but it can’t answer all of your questions, since a lot depends on the individual patient. We encourage you to inform yourself fully about this operation before undergoing it, and ask us any questions or concerns you may have.
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.
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 us. As with any cosmetic procedure, the goal should be improvement, and not perfection.
Risks:
Thousands of abdominoplasties are performed successfully each year, and the large majority of patients are very happy with the outcome. Nevertheless, there are always risks associated with surgery and specific complications associated with this procedure.
Post-operative complications such as infection and 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. Skin necrosis (death of part of the skin) can occur, especially in smokers, and may require additional surgery.
There will always be a large scar, running from one pelvic bone to the other. Poor healing, which results in conspicuous scars, may necessitate a second operation. Smokers are strongly advised to stop, as smoking may increase the risk of complications and delay healing. This is not a complete list of potential risks and complications. Please read the consent form carefully.
Who Shouldnʼt Have the Surgery:
Patients who plan to lose large amounts of weight, who plan to become pregnant after the surgery, or those who have had prior extensive abdominal surgery are not good candidates for this procedure. Additionally, if you are a smoker, diabetic, elderly or have serious medical problems, this surgery may have too high a complication rate. Finally, if you are expecting this surgery to change your social status, improve your love life, or give you a perfectly sculpted body, your expectations will not be met and you should not undergo this operation.
Preparing for Surgery:
We 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 two weeks before your surgery and not to resume for at least two 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.
We will do your surgery in our outpatient surgery center, and you will be able to go home as soon as you are fully awake. However, you should arrange for someone to drive you home after your surgery, and to help you out for a day or two at home, as you will experience some post-op discomfort, and may initially have difficulty fully straightening up.
Anesthesia:
This procedure is fairly extensive, and therefore best done under general anesthesia (fully asleep). For a “mini-abdominoplasty”, local anesthesia (tumescent) along with conscious sedation (very drowsy but partially awake) may be an option. There is a sheet in this packet explaining the pros and cons of both types of anesthesia. We will decide together which would be best for you.
The Procedure:
An incision (cut) is made in the lower abdomen, from pelvis to pelvis, and excess skin and fat are removed; the abdominal muscles are usually tightened, and the umbilicus (navel) is relocated to a new position. The incision is then closed.
In an abdominoplasty, or tummy tuck, an incision is made in the abdomen (usually from hip bone to hip bone). Excess skin and fat is removed. The muscles may be tightened. The navel will be placed into the proper position, and the major incision closed beneath it.
Recovery:
You will have bandages, drains, compression stockings and an abdominal compression garment when you go home. You can change your own bandages at home, and we will instruct you in the care of the drains. Although you will be up and around right away, you will not be totally comfortable, or be able to carry out strenuous activities for a few weeks. We will provide you with a prescription for pain medications after your surgery, or you may elect to use a pain pump (see below.) You will have the abdominal binder and stockings on for about a week. You can drive as soon as you are off pain medications, and usually return to sedentary work in 2 weeks, and strenuous work in 3 weeks.
Pain Pump:
We offer implantation of a pain pump at the time of surgery if you desire. This pump delivers a continuous flow of anesthetic medication to the operated area, which you can control. The medication is not a narcotic, so nausea, constipation and addiction are not concerns. Since the first few post-op days could be uncomfortable, this is an attractive option for many patients. It adds about $400 to the cost of surgery, but most patients feel it is worth it. These pumps are typically kept connected for 5-7 days, after which they are easily and painlessly disconnected.
A Few Final Words:
This is a major operation, and you should carefully weigh all the risks against the benefits of the surgery. Please do not agree to this operation until you are fully satisfied that you have all the information you need to make a sound decision. You may want to discuss this with your family and your personal physician for their input. On the whole, however, this is a safe and satisfying operation with good long-term results, as long as you maintain a healthy diet and exercise regimen. Although there are significant risks, they are fortunately rare, and can frequently be avoided by careful attention to post- operative care and follow-up.