Abdominoplasty (Tummy Tuck)
Abdominoplasty, also known as a "Tummy Tuck," removes excess skin and fat from the abdomen surgically. An abdominoplasty or tummy tuck tightens the abdominal muscles that may have become stretched out or lax over time because of pregnancy, obesity or just due to age.
There are many reasons why someone may want to undergo an Abdominoplasty or tummy tuck. The most common reasons are after having had children or been pregnant or simply due to aging. Although it is considered major surgery, a tummy tuck is a very common procedure. However, you should be aware of all that is involved before undergoing such a surgical procedure.
Frequently Asked Questions (FAQ’s)
The information presented below is only for informational purposes. Your surgeon will talk to you about details regarding your specific procedure.
What is Abdominoplasty?
Abdominoplasty, also known as a "Tummy Tuck," removes excess skin and fat from the abdomen surgically. An abdominoplasty or Tummy Tuck tightens the abdominal muscles that may have become stretched out or loose over time because of obesity, pregnancy or just due to age. Even though this is a common procedure, it isn't a simple procedure and you should be aware of the risks and post-operative care that will be needed.
Who is an ideal candidate for Abdominoplasty?
An individual must be in good health and not have any diseases or serious, pre-existing medical conditions and be at their ideal weight to undergo an abdominoplasty. In addition, the individual must have realistic expectations of the outcome of their surgery and be mentally and emotionally stable to undergo any surgical procedure. Communication with your surgeon is very important and you must be able to voice your concerns to your surgeon if he/she is to understand what your expectations are. Discuss you goals with your surgeon so that you may reach an understanding as to what can realistically be achieved. As with any type of surgery, a tummy tuck requires patience in dealing with the healing period. There can sometimes be a lull or depression after surgery and if there are already medical or emotional issues prior to getting a tummy tuck, this lull can develop into a more serious issue. Please consider this and other issues before deciding to go through with a tummy tuck.
Typically, women seek this procedure after pregnancy – however they are advised to wait until they have finished having children, because the skin and muscles can get stretched out again as well as the dangers of the newly taut skin being unable to accommodate another pregnancy. For those that are considering losing weight, you should wait until after your desired weight is met because you may need additional surgery to remove the excess skin after you have lost the desired weight.
How is the procedure performed?
Some doctors use general anesthesia, while others use local anesthesia along with sedatives to make the patient sleepy. The surgery can take anywhere from two to five hours depending on the amount of work required. Most of the time, the surgeon will make an incision in the lower abdomen just above the pubis or can make a long incision from hipbone to hipbone. A second incision is made to separate the naval from the surrounding tissue and then the skin and fat is then dissected off of the abdominal muscles all the way up to the bottom of the rib cage. Sometimes, sutures are placed on the muscles of the abdominal wall to tighten one side of the abdomen to the other and thereby make the abdomen more firm. The skin above the belly button is drawn down to the pubis and sutured into position. A new hole is placed in the skin and the belly button is positioned in and stitched into place. Finally, the incisions will be sutured together, dressings applied and a temporary tube may be inserted to drain excess fluid from the surgical site.
What should I expect post-operatively?
For the first few days, your abdomen will most likely be swollen and you may feel some pain and discomfort. You are usually able to walk immediately after surgery and are encouraged to do so 3 or 4 times per day for 1-2 minutes each time. However, you will more than likely not be able to stand up straight as 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. You may feel some strain on your back due to standing in the 45 degree angle for a little while. 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.
Some stitches may be removed anywhere from five to seven days after the surgery and any temporary tubes that are used to drain excess fluid can be removed five to fourteen days post-op. Any deeper stitches will come out in two to three weeks. You should take it easy for at least two weeks after surgery as you will be on bed rest and advised to do a very small amount of walking. An abdominal pressure garment may also 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.
Is there much pain associated with Abdominoplasty?
The amount of pain from this procedure varies from patient to patient. During the procedure, you may feel some discomfort depending on the type of anesthesia used. Patients will often note some back discomfort due to the 45 degree positioning for 4-5 days after surgery however muscle relaxants are sometimes given to alleviate muscle spasms and for relaxation.
How much scarring can I expect from an Abdominoplasty?
Like most surgeries, there may be some scarring. In fact the scars may be quite severe depending upon the amount of skin needed to be removed and your body's ability to heal. Most surgeons will use lesser scarring techniques that leave a well-hidden horizontal or slightly bowed scar. This is something that should be discussed with your surgeon prior to undergoing the procedure.
Is there a lot of swelling involved with an Abdominoplasty?
As with most surgeries, there is a bit of swelling involved with an Abdominoplasty. You must take into account that in an Abdominoplasty a lot of tissue is removed, so swelling is expected.
When will I be able to see the results?
You will notice a difference after the swelling diminishes. You must realize that the underlying tissues have been cut and that an Abdominoplasty is considered a very invasive procedure. So, give your body time to heal and you will reap the many benefits of the procedure.
What are the risks?
As with any surgery performed under anesthesia, there are risks primarily because of the anesthetic and because of the fat and its surrounding tissues potentially becoming necrotic (dead tissue). If the fat becomes necrotic from a lack of blood supply, the fat tends to turn orange-ish clear and some may drain from the incision; although this is very normal. There will be fat damage, fluid retention, and blood-tinted drainage.
If the tissue becomes necrotic, or you have a lot of fat cells, you must have the tissue removed before a major infection develops. This is extremely rare and you should take precautions such as not smoking and use proper wound care.
Another risk of Abdominoplasty is pulmonary thromboemboli. A thromboembolus is a blood clot that can break free and travel to the lungs resulting in pulmonary thromboemboli. This can result in the patient having trouble breathing, cardiac arrest or coma. Pulmonary thromboemboli can happen within three weeks of the surgery but will most likely show symptoms such as shortness of breath and fatigue within the first 72 hours. However, you should be aware that pulmonary thromboemboli can occur suddenly, without warning.
Is an Abdominoplasty permanent?
Although not permanent, a tummy tuck can last for many years and if there are no large weight gains, or pregnancies after the procedure then the changes will be relatively permanent. Certainly some relaxation of the tissues can reoccur but not to the extent prior to surgery.
When can I return to work?
Most of your recovery will depend on your physical condition. Most people can return to work after two – three weeks, which other can take longer to recuperate. Exercise will help to reduce swelling, lower the chance for blood clots and tone muscles quicker. The scars may appear to worsen during the first few months as they heal, but that is completely normal.