The tummy tuck or abdominoplasty is a surgical procedure that reshapes the abdomen by eliminating the loose skin and tissue that typically results after multiple pregnancies or massive weight loss. This may be combined with tightening of the muscles of the abdominal wall as well as liposuction if indicated. It can be limited as in a mini tummy tuck for patients who have excess tissue and skin only below the belly button or a full tummy tuck where the entire abdomen is addressed.
Who is a candidate for a Abdominoplasty?
Healthy, normal-weight patients who have loose abdominal skin +/- stretched out abdominal wall muscles are good candidates. This is typical after multiple pregnancies or massive weight loss. Those who are smokers or significantly overweight are poor candidates. If you don’t have excess skin and instead notice a defined fatty pocket or area, you may be a better candidate for liposuction alone.
How is the Tummy Tuck performed?
While under general anesthesia, an incision is made above the pubis from hip to hip (full tummy tuck) in addition to an incision that releases your belly button. The skin and fat layer is then lifted off the underlying abdominal wall, up to the level of the ribs. If there is stretching of the rectus abdominis muscles, it is repaired at this time with suture technique. With the back of the operating room table raised, the skin/fat flap that was elevated is then pulled down to determine the excess tissue to be removed. Once the excess tissue is removed, closure is performed usually with drains being placed underneath. A small new hole is cut out in order to bring out your belly button. This results in a scar at your bikini line and at your belly button area. With a mini-abdominoplasty, the lower scar is limited in length without any scar at the belly button.
What to expect after Abdominoplasty surgery?
You will be given instructions on drain care and will be wearing a compression garment for 4 weeks. For the first 5 days, you should walk slightly stooped over (bent at the hips). Sleep with your hips bent and your head elevated with several pillows. Stitches are placed underneath the skin during surgery so there is nothing to remove in the office. You may return to activities like a desk job after 1 week and regular or strenuous activity after 4 weeks. It is imperative that you avoid any strenuous activity including heavy lifting, straining, or climbing of multiple stairs immediately after surgery as this may increase your risk for bleeding. Although light activity is emphasized early on, do not stay in bed all day and night as this may increase your risk for blood clots. Take the prescribed pain medication provided to you only when you have pain. Avoid prolonged exposure of the scars to sunlight for 4-6 months and use sunscreen as necessary. You may use vitamin E cream and scar products beginning 3 weeks after surgery to optimize healing of your scars. Scars change in appearance and improve over time up to 12 months.
- Will a tummy tuck fix my stretch marks?
In addition to tightening and re-contouring your abdomen, a tummy tuck will eliminate the stretch marks located mostly below the level of the belly button. The stretch marks that are located higher up are improved, lowered but are not able to be included within the excision zone.
- Will a tummy tuck fix the area of excess at the mons?
If you have excess skin and redundancy at your mons, it can be tightened and fixed in conjunction with a tummy tuck. Be sure to ask Dr. Farris about this.
- Can I plan for pregnancy after a tummy tuck?
It is advised to perform your tummy tuck after you’ve completed your childbearing years. Pregnancy after childbirth will expand and stretch out the skin, diminishing the benefits of the procedure.
- When can I go back to work after a tummy tuck?
Most people are able to go back to work after 2 weeks, especially if their work does not involve any strenuous activity or heavy lifting.
- When can I exercise after a tummy tuck?
Generally, allow up to 4 weeks to heal before engaging in any strenuous activity including exercise.
- When can I have sex after a tummy tuck?
Just as with exercise restrictions, allow about 4 weeks to heal before engaging in any sexual intercourse.
- I’m currently losing weight with diet and exercise. Should I wait to have a tummy tuck?
You will achieve your best aesthetic result if your weight is stable at its lowest level. The procedure is best directed to eliminate excess skin, not so much the fat. If you have excess fat, you may not appreciate as good of a result. Therefore, wait to have your tummy tuck after your weight loss.
- What are the risks of a tummy tuck surgery?
A tummy tuck or abdominoplasty is considered a major surgery that offers tremendous benefits but also has potential risks as with any surgery. Risks for complications are low but include possible infection, bleeding, fluid collection, skin breakdown, opening of the incision, asymmetry, thick scars, hard small lumps, decreased sensation, loss of the belly button, blood clot formation and revision surgery.
- Do I have to stop smoking before a tummy tuck?
Absolutely! Cigarettes contain nicotine, which constricts small blood vessels, diminishing the blood supply to tissue. This is particularly important in flap like procedures such as a tummy tuck, where a flap of tissue is raised with a restricted blood supply. If nicotine is in your system, it would increase the risks of developing wound breakdown, tissue death and infection. You often hear the recommendation to stop smoking at least 2 weeks prior to surgery. I would recommend that you stop smoking even longer before surgery, like 2-3 months. The longer nicotine is out of your system, the better your chances are to heal without complications!
- Where are the scars located?
Scars are located very low at the bikini line from hip to hip depending on the extent of your tummy tuck. Also, you may have a scar around your belly button. These scars are well concealed and tend to heal well.
- What are the drains and binder for?
Since a large area is undermined with the raising of your tummy tuck flap, there is a tendency to have fluid build up after surgery. Drains are placed to collect this fluid as you’re healing and would prevent formation of fluid collections. At times, stitches are placed to close the space between the flap and underlying tissue, precluding the use of drains. However, these stitches tend to contribute to more postoperative pain. Having drains is far less painful. The use of a binder provides compression and helps reduce the swelling at your surgical site.
- Do I go home after a tummy tuck?
In most cases, you will be able to go home after your tummy tuck procedure and not require hospital admission. You will be provided with pain medications and detailed instructions.
- Do I stay in bed after my tummy tuck?
Do not stay in bed 24/7 after your tummy tuck procedure. Light activity like limited walking within your home is encouraged. Prolonged inactivity can lead to stasis of blood flow in your legs and contribute to the formation of blood clots (deep vein thrombosis). At the same time, do not engage in any strenuous activity like exercise or heavy lifting.