Abdominoplasty (Tummy Tuck)

Plastic surgery of the abdomen can accomplish many things that you cannot accomplish on your own – no matter how much you diet and work out. Dieting and working out may tone your muscles and help you lose weight, but they will not tighten your loose skin, nor will they tighten your loose inner girdle. A tummy tuck can give you a flat stomach by tightening your inner girdle. It also removes loose skin of your lower abdomen and tightens the skin of your upper abdomen. Abdominoplasty can also remove nearly all the fat of your lower abdomen as well as the stretch marks. In fact, there is practically nothing that pregnancy can do to your abdomen that a tummy tuck can’t improve.

Abdominoplasty does have limitations. (Here comes the bad news). It will not remove stretch marks of your mid or upper abdomen (but it will shift them lower on your abdomen). If you have a thick layer of fat in your upper abdomen, an abdominoplasty will not reduce its thickness. If you want lipo for this, you may be out of luck. Aggressive liposuction of the upper abdomen at the same time is ill-advised because it can interfere with circulation and cause complications. If your fat is very very thick, you may be advised by your plastic surgeon to avoid a tummy tuck completely because of a high risk of healing problems. In this case, you may be offered a panniculectomy, which involves removal of skin and fat only, with no tightening of your inner girdle (fascia).

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Abdominoplasty Scars

Will extend across the lowest part of your abdomen, just above your bikini line. You will (typically) have another scar around your belly button. These scars are commonly hidden by swimming suit. Many heal discretely, but others remain quite visible. Regardless, you are more likely to look (and feel) better with a flatter abdomen and scars than you are with a bulging belly.

The Inner Girdle

Everyone has an inner girdle. The inner girdle extends from your rib cage down to your pubic bone and from one side of your abdomen to the other. The inner girdle is made of the same stuff as gristle on a steak. It is situated between your rectus muscles and your abdominal fat. It is tough and serves to support the contents of your abdomen so that they don’t bulge outward. Surgeons refer to this layer as “fascia.” (FYI, a hernia is actually a hole in the fascia or inner girdle).

The inner girdle stretches during pregnancy to accommodate the enlarging uterus. After pregnancy, your muscles may regain tone (with some effort), but your inner girdle is not quite as resilient, nor as elastic. Often the inner girdle fails to regain its shape, even though your muscles may be toned. This is where a tummy tuck can really help. In a tummy tuck, your plastic surgeon will imbricate (tighten) your inner girdle to make it flatter. By the way, if your plastic surgeon explains that he is going to “tighten you muscles” during your abdominoplasty, just nod and smile. He is actually going to tighten your inner girdle but is too lazy to explain the difference (muscles are below the inner girdle and are never exposed during the operation).

Tummy Tuck /Abdominoplasty Recovery

Anesthesia is usually general, but an abdominoplasty can sometimes be performed under heavy sedation. Length of surgery is 1-3 hours. You may stay overnight for pain control. Discomfort is moderate to severe. The tighter your surgeon makes your inner girdle, the greater your discomfort will be. Anticipate 3-8 days of prescription pain medication. Bruising does not usually occur. Abdominal numbness is expected and will last for 6 months or longer. Bandages are removed in 1-4 days. Stitches are removed in 7 days. Drains will be placed at the time of surgery to prevent postoperative fluid collections, called seromas. They will be removed between 2 days and 2 weeks following abdominoplasty surgery. You will be presentable in a bathing suit within a month of surgery. Your abdomen will immediately look better in most one-piece bathing suits than it did prior to surgery. You may return to work in about 7-10 days, as long as your job requires no lifting or manual labor. If so, wait 4-6 weeks or get an excuse from your plastic surgeon so that you can be given a non-lifting job during that time. Driving may be resumed in 7-14 days, provided you have stopped taking prescription pain medication. Exercise may be resumed in 4 weeks. Your final result will be evident after your scar has matured, approximately one year.

Tummy Tuck Tips and Traps

*If you seek tummy tuck, wait until you have finished childbearing. Otherwise, your the benefits gained through abdominoplasty may be lost with another pregnancy.
*If you have an abdominoplasty, then your abdominal tissue will not be available for future breast reconstruction. Of course, you may never get breast cancer. And, if you do, you may not require a mastectomy. And, if your do require a mastectomy, other options are available for breast reconstruction.
*If your hips are wide, consider hip liposuction at the same time. Otherwise, tummy tuck alone may cause your hips to look larger.
*If you have thick abdominal fat, lax skin, and loose fascia, your surgeon may recommend both tummy tuck and abdominal liposuction. If so, you should favor performing them as separate procedures, at least three months apart. If these procedures are performed at the same time, you may be at high risk for significant healing problems. Although the term “healing problems” does not sound frightening, be aware that healing problems can result in further surgery, hospitalization, and larger scars.
*If you smoke, have poorly controlled diabetes, or are overweight, you will be at significantly increased risk for complications and probably should not have an abdiminoplasty operation.

Dean Plastic Surgery