What Is Tummy Tuck Surgery (Abdominoplasty)?:
It is a sad but true fact that, for some people, all the crunches and high-protein diets in the world will not yield a “washboard” stomach. Age, hormone fluctuations, and pregnancy can wreak irreversible havoc on a once taut and trim belly. Abdominoplasty, commonly known as a “tummy tuck,” is a cosmetic surgical procedure designed to remove excess skin and fat from the abdomen, as well as tighten the underlying muscles so that the patient is left with as smooth and flat a tummy as possible.
Who Is a Good Candidate for a Tummy Tuck?:
The best candidates for abdominoplasty are non-smokers who are generally in good health and at a stable weight. Best results are achieved on patients who have excess skin and fat concentrated at the abdomen, and/or a protruding abdomen which is out of proportion with the rest of the body. Like liposuction, this surgery is not intended to achieve weight loss but improve body contouring. Of course, as with all cosmetic procedures, the ideal patient should have realistic expectations about the results of such a surgery.
Before a Tummy Tuck:
Your surgeon will almost certainly order some type of lab tests to confirm your health status before operating. He or she may also require that you adjust, cease, or begin taking certain medications in the week or two before your surgery. It is also very important that you avoid aspirin, many anti-inflammatory drugs, and herbal supplements in the 2 weeks prior to surgery, as all of these can increase bleeding. Talk to your surgeon about any prescription or over-the-counter products you are taking.
You will have bandages over your incision site, and will likely be given a compression garment or wrapped snugly in gauze to help minimize swelling. You may also need to go home with small plastic tubes in place to drain excess fluid accumulation. Most patients will need to return to the surgeon’s office to have stitches removed at a later date, although some less invasive methods may use dissolvable sutures.
Recovery & Downtime :
You will most likely experience an inability to stand completely upright for about a week following your surgery. This is normal and necessary for your incisions to heal properly. You also may experience a prolonged feeling of weakness in the abdominal muscles as they heal from the trauma of surgery.
Most patients can return to non-strenuous work after 1 to 3 weeks. Sexual activity should be avoided for a minimum of 2 weeks, and mild exercise can usually be resumed after 3 to 4 weeks. However, it is important to understand that this can vary widely, so follow your surgeon’s recommendations -- and listen to your body.
Risks & Complications :
As cosmetic surgery goes, a tummy tuck can be especially serious surgery. Risks and complications include, but are not limited to:
- unfavorable scarring
- excessive bleeding or hematoma
- skin loss
- blood clots
- numbness or other changes in sensation
- anesthesia-related risks
- skin discoloration
- persistent swelling
- fat necrosis
- asymmetry, recurrent looseness of skin
- deep vein thrombosis (blood clots in the legs)
- cardiac and pulmonary complications
- nerve damage
- unsatisfactory aesthetic results
- the need for additional surgery
Other Things to Consider:
Scar tissue from any previous abdominal surgery may limit the results you can expect from your tummy tuck. On the other hand, your surgeon may be able to incorporate the scar from a previous c-section into your new scar. In addition, stretch marks may or may not be able to be improved or even removed, depending on their location in relation to the location of the skin being removed during your surgery.
The average total cost for a tummy tuck is currently around $6200, although fees can range from $5000-10,000, depending in large part on where the surgeon practices. Total costs include medications and surgeon, anesthesia, facility, and lab fees.
Tummy tuck surgery is often done in conjunction with other surgeries to enhance a patient’s results. These complementary procedures can include liposuction and breast lift, breast augmentation, or breast reduction -- a trend known to some as the “mommy makeover.” There has also recently been an increase in the number of patients requesting a thigh lift, arm lift, or “full body lift” in order to deal with the excess skin left behind after significant weight loss.
How It’s Done:
- Anesthesia is administered.
Tummy tucks are most commonly performed under general anesthesia, although some patients will undergo only IV sedation (also known as “twilight sleep.”)
- Incisions are made.
The most common incision line for a tummy tuck is a hip-to-hip horizontal incision that lies somewhere between the pubic hair line and the navel. Many surgeons will customize the incision placement so that the resulting scar is hidden by the swimwear or undergarments most likely to be worn by the particular patient. If there is excess fat and skin above the navel, an incision around the navel may be required to achieve the desired results. Once the excess skin is removed and repositioned, the navel is then repositioned accordingly.
For some patients with minimal "give" to their skin, and whose excess fat is below the navel, only a smaller horizontal incision may be used (no incision around the navel). In cases of very mild degrees of excess skin and fat, some surgeons have had success with an endoscopic tummy tuck technique, which greatly minimizes scarring because of the smaller incisions used.
- Weakened or separated abdominal muscles are repaired.
Diastasis is the name for the separating of the two main muscle walls that make up the front of the abdomen. This is often caused by pregnancy, but is not always present. If it is a factor, these muscles will be reconnected by sutures. If not, sutures may simply be used to “tighten up” the abdominal muscles so that the end result is a flat stomach.
- Excess skin and fat is removed.
Once the surgeon determines the size and shape of the skin flap to be removed, it is surgically excised. The size and shape of the flaps depends on the amount and location of the protruding fat or excess skin.
- The navel is placed in its new location.
Actually, the navel remains attached where it is, but a new opening is created in the skin flap which is being stretched and repositioned following the removal of the excess skin. Then, the navel is pulled through the opening and sutured in place.
- Incisions are closed and bandaged.
Using a multi-layer suturing technique, the surgeon closes the incisions. If needed, drains will be placed at this time before bandaging the wounds.
For more information, watch this tummy tuck video from About.com.