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Tummy Tuck (Abdominoplasty)

Along with toned legs and a tight butt, a lean midsection is a universal characteristic of a fit figure. Gyms are packed with people doing crunches to obtain a “six-pack,” and dieters nix carbs and sweets to lose the paunch. However, the abdomen is traditionally one of the most difficult areas of the body to tone through diet and targeted exercise. When conventional measures fail, abdominoplasty - colloquially known as a tummy tuck – is an option. This cosmetic surgery procedure eliminates excess fat and loose skin while tightening the abdominal muscles. The result is a sculpted midsection and a slim silhouette.

 The decision to undergo abdominoplasty should not be made casually. Gathering ample information about the procedure from a trusted source is the first step to making an informed decision. The second step is scheduling a personal consultation with a board-accredited, experienced plastic surgeon to discuss your particular needs and goals.

Procedure

The thought of tummy tuck surgery can be scary or overwhelming for someone who is not familiar with the procedure. DocShop breaks down the abdominoplasty procedure in detail to give you a better sense of what to expect. For information that pertains to your tummy tuck surgery specifically, such as the price of treatment, you should consult a cosmetic surgeon during an in-person patient consultation.

Anesthesia

Abdominoplasty surgery can be performed using either general or local anesthesia; most surgeons prefer that the tummy tuck be performed while the patient is completely sedated, for safety reasons. This is because when the patient is unconscious, the abdominal muscles are completely relaxed, allowing the surgeon to complete the procedure with greater speed and ease without being hampered by unexpected muscle or bodily movement. Localized anesthesia is used in occasional cases of mini tummy tuck surgery, which is a shorter and less invasive surgery.

The Tummy Tuck Procedure

Tummy tuck surgery takes several hours, depending on the type of procedure being performed. A partial abdominoplasty takes about an hour and half to complete, while other types of tummy tucks take two to five hours. Scarring is inevitable, though your surgeon will carefully plan the location of your incisions in order to minimize the visibility of your surgical scars. Follow your surgeon’s pre- and post-operative instructions closely to help minimize the size and darkness of your scars and increase the likelihood of a smooth and quick healing process for your incisions. The incisions are made to allow the surgeon to remove excess skin and tighten the abdominal muscles, producing a flatter, firmer abdomen.

Creating the Incisions

The number and length of incisions that are made by a tummy tuck surgeon will vary, depending upon the specific procedure being performed. There are different kinds of tummy tucks to address different kinds of aesthetic complaints. The mini tummy tuck, for example, involves a single, very small incision that is made below the navel. By contrast, circumferential abdominoplasty surgery requires an incision around the circumference of the waist line, since it involves the removal of loose hanging skin from the entire hip area, including the back. Traditional tummy tucks involve one incision along the front of the abdomen from one hip bone to the other. All incisions are carefully planned prior to surgery to improve the chances that the resulting scars will be easily hidden beneath underwear, bikinis, and other swim wear. You can speak with your surgeon about altering the position of your incisions, based on your body type and lifestyle preferences.

Naval Reattachment and Sculpting

Most tummy tucks involve changing the position of the naval in order to make the tightened skin of the abdomen appear more natural. To detach the navel, a second vertical incision is made across the abdomen’s central section. Depending on what your surgeon thinks will create a more appealing result, another small incision is made to either reattach your existing naval or artificially sculpt a new one. Naval reattachment and naval sculpting are surgical art forms, and surgeons more experienced with abdominoplasty surgeries will generally achieve better results.

Tightening of the Muscles

It is common for the abdominal muscles to become more lax as the patient ages. During abdominoplasty surgery, your cosmetic surgeon has the opportunity to tighten sagging abdominal muscle mass, as well as remove packets of excess fat and skin from the stomach area. Through the surgical incisions, the skin is separated from the abdominal walls. The abdominal muscles are pulled closer together and stitched into a position that will give them a more toned appearance. Tightening the abdominal muscles also tends to narrow the waistline.

Skin Removal

After abdominoplasty surgery, particularly if you are lucky enough to have a very subtle scar, it may look like the loose skin around your stomach has been tucked into your body. It hasn’t. It has actually been removed. Following the tightening of the abdominal muscles, the skin is stretched downward, and excess skin is trimmed away. Sometimes liposuction is used to remove any unwanted fat pockets before the skin is pulled taut.

Eliminating Stretch Marks

Often, it is possible to eliminate or improve the appearance of stretch marks during the skin removal, depending on the location of the incision. Any stretch marks located slightly below the navel are often removed along with the excess skin while the remaining stretch marks often appear less prominent after tummy tuck surgery. This is because the stretching of the abdominal skin flattens the stretch marks, decreasing the degree to which they indent the skin.

Closing the Incisions

When the abdominoplasty surgery is complete, the skin is sutured together using surgical stitches. With the stitches in place, your skin cells will coalesce at the site of incision, closing the wound naturally over time. A surgical drain will also be inserted at the site of incision at the same time that the stitches are put into place. Surgical drains speed up the healing process and often alleviate pain from the buildup of fluids beneath the skin. As your body attempts to repair the damage to the surrounding cells, fluids build up and can cause complications during the tummy tuck healing process. Your surgeon may feel that a surgical drain is a necessary precaution. The surgical drain is usually removed before the stitches, about a week after surgery. The tummy tuck stitches will normally be removed in stages over a period of two weeks following surgery.

Visit the DocShop gallery to view abdominoplasty before and after photos.

Photo credit: Ramiro Morales, MD

Candidacy

Ideal abdominoplasty candidates should:

  • Be in good general health
  • Carry excess weight in the midsection
  • Have loose or droopy skin around the abdomen
  • Have healthy expectations of the surgery, which can be discussed with the plastic surgeon
  • Commit to maintaining the results with a stable diet and regular exercise

Ideal abdominoplasty candidates should not:

  • Smoke
  • Have serious medical conditions which could be compromised by undergoing a surgical procedure
  • Plan to become pregnant
  • Plan to lose a significant amount of weight
  • Be pressured into the procedure by someone else

Many people find that, no matter how much they diet and exercise, they cannot get rid of stubborn fat and excess skin in the abdominal area. A plastic surgery procedure known as abdominoplasty (tummy tuck) can help eliminate both the tenacious fatty deposits and the excess skin around the stomach that many people struggle with. A good candidate for the tummy tuck procedure is an adult who is not far from his or her ideal body weight, with an abdominal area that has not adequately responded to modification by diet and exercise. Many women opt to undergo a tummy tuck after pregnancy, when abdominal muscles tend to remain lax, and the skin over the stomach becomes stretched and saggy. However, while many people feel that they need to undergo plastic surgery to trim their midsections, a full tummy tuck is not always the ideal solution. Read on to learn more about what makes a person a good candidate for tummy tuck surgery, and consult a surgeon to learn more about the costs of tummy tuck.

Pregnancy/C-Section

Because of the way that pregnancy stretches the skin and separates the abdominal muscles, diet and exercise can be inadequate in tightening the abdominal area after childbirth. Muscle tone and skin elasticity may become poor, especially after multiple pregnancies. For many mothers who struggle to slim down after pregnancy, surgical treatment is often the most effective way to achieve the desired shape and tone. Tummy tuck surgery restores the pre-pregnancy figure, sometimes incorporating liposuction to remove the stubborn excess fat that can remain after childbirth.

If you have tried unsuccessfully to regain your pre-pregnancy figure through exercise and diet, we invite you to use DocShop to locate a premier cosmetic surgeon who can answer your questions about plastic surgery and determine whether a tummy tuck after pregnancy is right for you.

Significant Weight Loss

For people who have lost a significant amount of weight, the results of tummy tuck can do wonders for their overall health while having undesirable aesthetic effects on their bodies. Loose, sagging skin and overstretched abdominal muscles can make a person feel nearly as self-conscious about his or her body as before the weight was lost. Indeed, some people become so discouraged and disheartened that they lose the will to continue their healthy lifestyle, regaining the weight they worked so hard to lose.

Plastic surgery procedures such as a tummy tuck can create a physique that better reflects the efforts someone has made to lose weight. Thousands of bariatric surgery patients or people who have experienced other means of significant weight loss have opted for tummy tuck surgery to address extra sagging skin or poor elasticity. Furthermore, body lift, arm lift, thigh lift, and butt lift procedures can be combined with abdominoplasty to achieve more comprehensive body contouring following significant weight loss.

The Aging Process

As a person ages, the skin loses some of its natural elasticity and the muscles gradually weaken. The aging process often has a pronounced impact on the abdominal region, resulting in a flabby, sagging midsection. For some, the loss of definition in the stomach area is a source of self-consciousness, as they begin to appear older and less fit than they feel. In such cases, a tummy tuck can have a rejuvenating effect on the entire body. Through the tightening and streamlining of the abdominal area, post-tummy tuck patients enjoy looking younger, healthier, and more vital.

According to the American Society of Plastic Surgeons, the majority of patients that underwent tummy tuck surgery in 2009 were 30 to 54 years of age.

  • 13-19: 0
  • 20-29: 11,435
  • 30-39: 39,602
  • 40-54: 47,074
  • 55+: 17,080

Genetics

The overall shape of one’s body and the areas where pockets of fat tend to accumulate are largely determined by genetics. For some people, the bothersome flab that gathers in the abdominal region may not be reflective of the true level of activity and fitness that someone engages in. Even a person in his or her 20s, 30s, or 40s may be genetically predisposed to stubborn abdominal roundness; fortunately, plastic surgery can address this. The best way to determine whether abdominoplasty will be effective in your particular case is to discuss your cosmetic goals and your medical and family history with a qualified plastic surgeon.

Visit the DocShop gallery to view abdominoplasty before and after photos.

Photo credit: Pacific Plastic Surgery

Benefits

If conventional diet and exercise fail to flatten your tummy, consider surgically treating the problem with a tummy tuck (abdominoplasty). Not only does tummy tuck surgery whittle your waistline by removing excess skin and fat, it dramatically improves – if not altogether eliminating – stretch marks. You’ll look great, and feel even better. Learn more about the benefits of abdominoplasty, and find a physician in your area to discuss the procedure with you in more detail.

Improved Appearance

The aesthetic benefits of tummy tuck surgery are very rewarding. Stomachs that have been stretched beyond the limits of natural repair, either by pregnancy or weight loss, see marked improvement in shape, tone, and contour. Tummy tuck surgery narrows the waist and creates the curves you desire. In many cases, stretch marks below the navel are removed along with the excess skin at the close of the procedure, while the appearance of the remaining stretch marks is often improved when the skin of the abdomen is pulled taut.

Enhanced Confidence

A protruding belly can compromise self-confidence, especially during warm weather months when bathing suits and skimpy clothing are par for the course. The results typical of tummy tuck surgery - slimmer midsection and contoured abdominal muscles - often dramatically boost self-confidence. 

Excess Skin Removal

The age-related reduction in skin elasticity inevitably causes loose, often saggy skin that is especially exacerbated by weight loss surgery or pregnancy. Tummy tuck surgery will treat this loose skin, preventing it from becoming a health problem. Excess loose skin can evolve into more than a vanity issue; large folds of skin can become infected with fungus. Removing these folds eliminates the health risk faced by many bariatric surgery patients.

Tighter Abdominal Muscles

Certain tummy tuck benefits affect not only how your abdomen looks, but also how it feels – firmer and tighter. After pregnancy, or sometimes simply as a result of age, the abdominal muscles can begin to separate at the midline of the belly. This muscle laxity not only reduces muscle strength, but can also produce an appearance of general abdominal sagging. This condition is known as rectus diastasis. Exercise can alleviate the problem in its earliest stages, but when the damage is severe, often it can only be corrected through surgery. Endoscopic tummy tuck surgery can tighten the abdominal muscles without removing excess skin – a solution that produces much less visible scarring.

Results

Under the proper conditions, the results of an abdominoplasty surgery can last for many years. Exactly how long you maintain your abdominoplasty results depends on how well you take care of your body following surgery. Living a healthy and active lifestyle will prolong your tummy tuck benefits, for at least a decade after your initial surgery and probably longer.

Among the most important tummy tuck results are a flatter, more toned abdominal area and a smoother body contour. As with many other cosmetic surgery procedures, a tummy tuck can benefit a patient by improving self-image and self-confidence. It is, however, important to keep in mind the aesthetic limitations of the procedure. Communicating openly with your surgeon during the planning stages of your abdominoplasty can help ensure that you have realistic expectations and that your surgeon has a clear idea of the results you expect. Selecting a cosmetic surgeon who is experienced in performing tummy tuck procedures and following all post-surgical recovery instructions will decrease the likelihood of complications that could result in more conspicuous tummy tuck scars.

Tummy Tuck Scars

Post-surgical tummy tuck scars are unavoidable. The length and location of incisions, which depend on the type of tummy tuck surgery you undergo, will determine how visible and extensive the resulting scars will be. Tummy tuck scars range from a single small scar produced by a partial abdominoplasty to the more noticeable tummy tuck scars that circle a patient’s abdomen after a circumferential tummy tuck procedure. Most abdominoplasty surgeries involve a scar from hip to hip and a scar around the navel. The larger the amount of skin you would like to have removed during the tummy tuck procedure, the longer the scar will be. Although tummy tuck scars can be fairly prominent, they are placed so that they are easily hidden by a person’s underwear and swimsuit.

By selecting a qualified cosmetic surgeon to perform your abdominoplasty and carefully following post-surgical care instructions, you can help to ensure that your scarring will be as discreet as possible. Even so, the success of your body’s tummy tuck recovery process usually has a greater effect on the visibility of your scars. Note that smoking may lead to larger tummy tuck scars, in addition to the higher risk of developing complications after the surgery. If you smoke, it is very important that you quit for two weeks before and at least two weeks after your abdominoplasty. Exposing yourself to cigarette smoke causes the blood vessels in your skin to constrict, decreasing the amount of oxygen being delivered to the skin cells. This, in turn, will slow the body’s immune response.

The general rule regarding tummy tuck scars is that the longer and more difficult the tummy tuck recovery process, the more noticeable the tummy tuck scars will be. Most tummy tuck scars become lighter and flatter with time, but they may appear to grow more noticeable before they begin to fade. This is a common experience for many abdominoplasty patients, and although you should feel free to contact your surgeon if you are concerned, it is usually just a natural step in the healing process. Tummy tuck scars never completely disappear. In the latter stages of the healing process, your cosmetic surgeon may recommend a cream or ointment to use on your scar.

Visit the DocShop gallery to view abdominoplasty before and after photos.

Photo credit: Pacific Plastic Surgery

How Long Do Results Last?

Unless an individual who has undergone tummy tuck surgery gains a significant amount of weight or becomes pregnant, the results of the surgery will last for many years. Over time, the aging process will naturally reverse some of your tummy tuck results. Your abdominal muscles, for example, will likely regain some of their laxity in the years following surgery. The best way to maintain the results of your tummy tuck surgery for a longer period is to exercise regularly and eat a balanced diet.

Risks

Informed patients are the best type of patients – they are usually the happiest with their tummy tuck results when carefully research their procedure and have an idea of what to expect. Part of this research includes tummy tuck candidates exploring the risks, in addition to the benefits. Though the risk of complications during and after tummy tuck surgery is small, it’s still important to consider all possibilities, including an unfavorable outcome.

The best way to decrease your risk of complications is to have your surgery performed by a qualified and experienced plastic surgeon, and follow all pre- and post-operative guidelines. Your surgeon can foresee potential complications and take steps to lessen the possibility of these occurring.

The most common risks include:

Bad Reaction to Anesthesia

General anesthesia, used during abdominoplasty surgeries, is considered slightly more risky than local anesthesia. It can cause an unpleasant or unexpected reaction; however, a qualified anesthesiologist should be able to identify emerging problems before they become worse.

Blood Clots

Blood clotting is the body’s natural way of controlling the amount of blood that is lost after an injury, but depending on their location, they can be dangerous. If a blood clot forms inside a blood vessel, it may complicate your circulation. If a blood clot travels to your lungs, brain, or heart, the result can be deadly.

Decreasing Your Risk of Blood Clots

There are several things you can do to decrease the risk of blood clots, prior to surgery. First, be completely honest in your medical history and other information you provide to your doctor. Be sure to give your doctor a list of all medications you take prior to the surgery. This will help your doctor determine if you are at an increased risk of developing blood clots following surgery. If you take birth control pills, you may want to discontinue their use during the preparation and recovery from tummy tuck surgery - talk to your doctor about this possibility before doing so.

After surgery, and during your recovery, most surgeons advise using compression stockings, pre- or post-operative leg massage, and short walks within a day or two of your surgery. Gentle movement is helpful and will speed your recovery, but too much exertion or vigorous activity can be detrimental.

Infection

Tummy tuck patients are at risk of developing an infection during and immediately following their surgery. A clean, sterile, and relatively warm operating room lessens the risk of contracting an infection during the surgery. Contrary to popular opinion, a patient in a cold operating room is actually more likely to experience an infection than a patient in a room-temperature or slightly warm operating room.

After surgery, the risk of infection increases if the surgical wound is not properly cared for. Your surgeon will have specific instructions for removing/changing bandages, exposing your wound to water, and keeping it clean. Note that it is normal to have some bleeding and leakage after surgery, but if the surgical wound is unclean, the risk of infection rises. Most infections following tummy tuck surgery are the result of the patient’s failure to properly care for their surgical wound during their recovery.

Signs of an infection include:

  • Fever
  • Chills
  • Sweating
  • Pus around the incision area
  • A greenish tint to the liquid draining from your incision
  • Excessively steady drainage fluid

While an infection will prolong your tummy tuck recovery, they are treatable with increased drainage and antibiotics.

Tummy Tuck Drains

Most tummy tuck patients need drains after their procedure. The drains decrease the risk of seroma formation (i.e., fluid collecting between the muscle layer and the skin flap), which can cause infection. The drains create a point of exit for this fluid, reducing the risk of infection following tummy tuck surgery.

The drains are silicone tubes inserted into the abdomen through the tummy tuck incision or one or more specially made incisions. The tubes connect to bulbs that provide suction for excess fluid that accumulates during your recovery from surgery. The patient measures the drainage each day, keeping track of the amount and discarding it. The drains may be removed in as little as three to five days after surgery, though your surgeon may advise you keep them in for up to three weeks or more, depending on the amount of fluid that is draining. Some patients claim tummy tuck drains can be inconvenient, but physicians find them worth the inconvenience because they decrease the risk of infection.

Slow Healing

Each patient will heal at his or her own pace. That being said, young patients in good physical condition typically heal faster than older or less physically fit patients. Tenderness, bruising, pain, and swelling usually subside after about four to six weeks. Patients who experience significant discomfort after six weeks have passed are considered to be healing slowly.

The healing of the abdomen may proceed at different rates; the operation site may heal later than the outlining sections of the surgical wound. In rare cases, irregular healing may lead to skin loss. Areas of skin that are slow to heal may die and need to be surgically removed and replaced with a graft. Should a patient experience these complications, they may suffer more prominent scarring. Patients who are unhappy with their tummy tuck surgery results because of slow healing may consider surgical revision.

Factors that may slow the body’s healing process are:

  • Smoking or exposure to cigarette smoke - decreases the size of blood vessels, complicating circulation of oxygen to the skin cells
  • Infection – diverts the body’s immune resources away from closing the incisions

Visit the DocShop gallery to view abdominoplasty before and after photos.

Photo credit: Kovanda Plastic Surgery

Reducing the Risk of Tummy Tuck Complications

Most tummy tuck surgeries go off without a hitch; when performed by an experienced plastic surgeon, the procedure is usually safe and free of complications. Here are some guidelines for reducing your risk of complications:

  • Follow all of your doctor’s pre- and post-operative instructions
  • If you are a smoker, stop smoking two weeks prior to the surgery
  • Do not smoke again until at least two weeks after your surgery to avoid stunting your healing
  • Avoid an overly stringent diet
  • Avoid overexposure of the sun to the belly area
  • Rest and nourish your body prior to surgery – eat a healthy, balanced diet and get plenty of sleep
  • If you feel sick on the day of your surgery, tell your doctor about your symptoms

Tummy Tuck Side Effects

Some side effects are to be expected following abdominoplasty surgery. While these unpleasant symptoms may cause some discomfort, they are not considered complications. Some of these side effects are triggered by your body’s own immune system to augment the abdominoplasty healing process. The most common tummy tuck side effects include swelling and pain. Your surgeon will explain in detail the side effects you should expect after tummy tuck surgery. Tummy tuck healing problems do not occur often, but you should contact your doctor right away if you experience a sudden increase in the severity of your discomfort, or any side effects that were not discussed prior to surgery.

Tummy Tuck Swelling

A tummy tuck procedure is not a simple cosmetic treatment; it is a major surgery. It is normal for a patient to experience some uncomfortable side effects after an abdominoplasty procedure. Tummy tuck swelling is to be expected in the days following your abdominoplasty. The degree of swelling depends on the type of procedure that was performed and on your unique characteristics as a patient. Your cosmetic surgeon will give you guidelines on how to minimize post-tummy tuck swelling. A compression garment or abdominal binder will help keep tummy tuck swelling under control, as will a regimen of gentle movement (to improve your circulation and help the healing process along).

Your abdominoplasty results, including a flatter, smoother abdomen, will become more obvious as tummy tuck swelling decreases. Talk to a qualified cosmetic surgeon to discuss your concerns about tummy tuck swelling.

Tummy Tuck Pain

One of the more common but manageable tummy tuck problems is post-operative pain. Your cosmetic surgeon can prescribe pain medication if you need it. When you wake up from the anesthesia, your abdomen may be swollen and painful; if you’ve undergone the surgery as an outpatient, you should be sure to take your pain medications as instructed rather than waiting until the pain sets in. Over time, the tummy tuck swelling and pain will lessen and eventually disappear. The rare complications of tummy tuck procedures include conditions that are often signaled by increased pain, so be sure to contact your surgeon if your pain level starts to escalate. Also, be sure to contact your surgeon if the pain does not lessen within six weeks of your tummy tuck surgery. Problems can occur if your incision is healing too slowly.

Tummy Tuck Bruising

In addition to abdominoplasty swelling and pain, it is common for patients to experience bruising in the treatment area. The bruising usually fade within two weeks of surgery.

More serious risks of tummy tuck surgery, including infection and blood clots can occur. Talk to your doctor about the possible complications of surgery, and contact your surgeon immediately if serious signs develop after surgery.

Visit the DocShop gallery to view abdominoplasty before and after photos.

Photo credit: Pacific Plastic Surgery

Cost

Tummy tuck cost varies according to several factors, including the needs of the particular patient, the specific type of tummy tuck procedure being performed, and the plastic surgeon performing the surgery. It can range in price from $3,000 to $10,000. Abdominoplasty is considered an elective cosmetic procedure. As such, it is not covered by insurance companies. However, most cosmetic surgeons have allied themselves with one or more financing companies and can offer reasonable payment options to patients.

Types

The increasing popularity of surgical body contouring has led to the development of various tummy tuck procedures that can be tailored to the amount of transformation necessary. In addition to the traditional tummy tuck, patients can choose from a mini tummy tuck to a more aggressive circumferential or extended version of the procedure, depending on the amount of excess skin and fat that needs to be removed.

Find an Abdominoplasty Surgeon in Your Area

If you would like to learn more about how a tummy tuck procedure can help you attain the figure you desire, please feel free to explore DocShop’s patient education pages and then use our online directory to contact a highly qualified abdominoplasty surgeon near you.

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