Tummy Tuck
A tummy tuck, also known as an Abdominoplasty, is a surgical procedure to improve the contour of the abdomen by removing excess abdominal skin and lower abdominal fat. The procedure also tightens the loosening of the abdominal wall muscles (diastasis recti) that results from pregnancy and/or weight changes. It is often useful for patients who have lost significant amounts of weight through diet, exercise, or surgical means such as Bariatric procedures. Ideally, this procedure is performed on a patient who is at a stable weight and does not plan to have future pregnancies.
A tummy tuck can frequently be performed in conjunction with other procedures such as Breast Lift, Breast Reduction, or Breast Augmentation. In which case, it is referred to as a “Mommy Makeover”. Liposuction is frequently added to this procedure to improve contouring to the flanks, back, hips, and thighs. Men who have excess abdominal skin may also seek out an Abdominoplasty surgery. A slightly different approach is used in order to ensure a more masculine figure after surgery.
The Procedure
An Abdominoplasty comes in several forms. A Full Abdominoplasty involves a lower incision from hip to hip and usually a diastasis repair (an internal tightening of the abdominal muscles that loosens after pregnancy and weight gain). This procedure involves complete elevation of the excess skin and fat of the abdomen, repair of the muscles in the abdominal wall, and removal of all excess skin and fat of the lower abdomen. The umbilicus remains in the same position, but requires relocation through the newly pulled down skin.
A Mini Abdominoplasty is performed when there is a small amount of excess lower abdominal skin only. This can frequently be performed with Liposuction and/or abdominal muscle tightening. Usually, the umbilicus location is not moved or slightly lowered during a Mini Abdominoplasty. Careful consideration during your preoperative consultation needs to be made before choosing this type procedure.
An Extended Abdominoplasty involves a longer scar usually extending almost to the back. This procedure is used for patients with significant skin and fatty excess that extends further toward the back.
A Fleur De Lis Abdominoplasty, or Fleur De Lis for short, involves a lower transverse scar like a full abdominoplasty but an additional vertical scar that goes from below the sternum to the lower scar, forming an inverted T. It is called a Fleur de Lis due to the fleur de lis pattern of skin removal. This is usually reserved for patients who have a very significant amount of excess skin in both the horizontal and vertical dimensions and who do not mind the additional scar.
A Circumferential Abdominoplasty (or belt lipectomy) is performed usually in patients with massive weight loss and involves an incision that completely encircles the body. The surgery is performed with a change in surgical position starting on the back and finishing on the front. This allows the benefit of elevating the buttock tissue to relieve sagging and also improve some degree of thigh laxity.
An abdominoplasty procedure can take anywhere from 1 to 5 hours depending on the type of abdominoplasty that is best for the patient. Though, it typically takes about 2 hours. Raleigh Plastic Surgery Center performs all types of Abdominoplasty surgeries in our AAAHC accredited surgical suite. Patients with pre-existing health problems or with excessive weight may have to have the procedure performed in a hospital. However, when the procedure is performed in our surgical facility the patient remains in the recovery room for at least 1 to 1 1/2 hours until they are comfortable enough to go home. Pain is managed intra-operatively with the use of long-lasting numbing medications, such as Exparel (when appropriate) which is injected into surgical sites during the surgery to provide postoperative pain relief. Oral narcotic medications are also often necessary.
The Recovery
An Abdominoplasty procedure typically requires about 2 weeks of recovery from most jobs, housework, and moderately strenuous activities. Strenuous exercise or heavy lifting is avoided for about 6 weeks. Drainless abdominoplasty is a potential option depending on the particular patient and procedure chosen. If drains are used, they are removed painlessly in the office about 1 week after the operation. You will see your surgeon typically at 1 week, 2 weeks, 6 weeks, and 3 months. The appointments will often be adapted to each particular patient depending on distance from office and comfort level. An abdominal compression garment is used to hold the dressings in place for the first week and then switched out to a lightly compressed garment. We counsel our patients to plan family help and assistance during the recovery since day to day activities are limited in the first week to 10 days. Driving is best avoided for the first week until patients are off of pain medications.
For more tips on how to create a post-op recovery space at home visit our blog!
FAQ
Q: Can Liposuction take the place of an Abdominoplasty?
A: Most patients who have skin excess and stretch marks are best served with an Abdominoplasty. Liposuction may be used to improve the result and decrease other stubborn areas. Liposuction alone is used to manage excess subcutaneous fat of the abdomen and may be a suitable surgical strategy if you have good skin tone to allow for proper retraction. If this is not present, excess loose skin remains and would be unsightly if not removed.
Q: Will I be able to wear a two-piece bathing suit?
A: The scars are made as low as possible and can be hidden in many two-piece bathing suit styles. However, there will be a scar that will never completely disappear and modifications of the desired bathing suit may be necessary. That being said, an effort is made to keep the lower side to side scar as low as possible to help prevent any visualization under most bathing suit bottoms or underwear. The belly button scar takes time to become less noticeable. An effort is made in surgery to help achieve a natural belly button appearance. Scar creams (silicone based) may be helpful in speeding this along to minimize the appearance of scars.
