Tummy tuck / abdominoplasty

WHO IS A GOOD CANDIDATE?

Abdominoplasty, also known as a "tummy tuck," is a procedure for addressing excess skin and fat around the abdomen, as well as tightening abdominal muscles that have been stretched out after weight loss or pregnancy. Often, exercise alone will not eliminate the laxity of the abdominal wall that occurs after pregnancy or weight loss, because it is not the muscles themselves that have stretched out and become lax, but the connective tissue between the muscles that is now stretched. Additionally, each person's skin connects to the underlying tissue at set points and when excess fatty tissue forms around these points, we start to get more pronounced rolls of skin. No amount of exercise can make these connection points between the skin and the tissue move or loosen.

A "mommy makeover" refers to the combination of an abdominoplasty and breast procedure done at the same time.

THE PROCEDURE

Abdominoplasty is done in an outpatient ambulatory surgery center under general anesthesia. The procedure usually takes about 1½-2½ hours. A conventional tummy tuck consists of an incision just above the pubic area from hip to hip and also around the belly button. The original belly button is retained, but it is reshaped and repositioned. The abdominal muscles are sewn back together with permanent sutures. The skin over the abdomen is then raised to the level of the sternum and ribs then pulled tighter to remove any excess. Liposuction of the "love handle" area can also be done to give better definition to the waist. The patient will have 2 drains after surgery and be wrapped in an abdominal binder.

Other variations of a tummy tuck include an extended tummy tuck, reverse tummy tuck and mini tummy tuck. An extended tummy tuck means the scars extend outward toward the hip to remove excess skin there that some patients may have. A reverse tummy tuck involves removing skin in the upper part of the abdomen and leaves a scar hidden under the breasts. This is a good procedure for patients who are happy with the shape of their abdomen below the belly button, but have excess skin above the belly button and in the upper half of their abdomen. A mini tummy tuck has various definitions, but usually includes a slightly smaller scar in the lower abdomen and removal of excess skin. A mini tummy tuck can sometimes include muscle repair, moving the belly button, or liposuction of the love handles.

RECOVERY

Recovery from a tummy tuck is moderately difficult because everyday activity involves using the core muscles. Patients can shower after 24-48 hours. There will be 2 drains, the first of which is usually removed 1 week after surgery, and the other after 2 weeks. For 6 weeks patients cannot lift anything more than 5 lbs or do any high end exercise. Targeted abdominal exercises such as sit ups should be avoided for 3 months after surgery to avoid tearing the sutures of the muscle repair. An abdominal binder is worn 24/7 for 6 weeks to provide support and compression, although patients may choose to switch to spanx around the 3-4 week post op point. Final results for a tummy tuck are usually not apparent until at least 6 months after surgery.