If You're Considering Abdominoplasty...
Abdominoplasty, known more commonly as a "tummy tuck," is a
major surgical procedure to remove excess skin and fat from the
middle and lower abdomen and to tighten the muscles of the
abdominal wall. The procedure can dramatically reduce the
appearance of a protruding abdomen. But bear in mind, it does
produce a permanent scar, which, depending on the extent of the
original problem and the surgery required to correct it, can
extend from hip to hip.
If you're considering abdominoplasty, this will give you a basic
understanding of the procedure-when it can help, how it's
performed, and what results you can expect. It can't answer all
of your questions, since a lot depends on the individual patient
and the surgeon. Please ask your surgeon about anything you
don't understand.
The Best Candidates For Abdominoplasty
The best candidates for abdominoplasty are men or women who are
in relatively good shape but are bothered by a large fat deposit
or loose abdominal skin that won't respond to diet or exercise.
The surgery is particularly helpful to women who, through
multiple pregnancies, have stretched their abdominal muscles and
skin beyond the point where they can return to normal. Loss of
skin elasticity in older patients, which frequently occurs with
slight obesity, can also be improved.
Patients who intend to lose a lot of weight should postpone the
surgery. Also, women who plan future pregnancies should wait, as
vertical muscles in the abdomen that are tightened during
surgery can separate again during pregnancy. If you have
scarring from previous abdominal surgery, your doctor may
recommend against abdominoplasty or may caution you that scars
could be unusually prominent.
Abdominoplasty can enhance your appearance and your
self-confidence, but it won't necessarily change your looks to
match your ideal, or cause other people to treat you
differently. Before you decide to have surgery, think carefully
about your expectations and discuss them with your surgeon.
All Surgery Carries Some Uncertainty and Risk
Thousands of abdominoplasties are performed successfully each
year. When done by a qualified plastic surgeon who is trained in
body contouring, the results are generally quite positive.
Nevertheless, there are always risks associated with surgery and
specific complications associated with this procedure.
Post-operative complications such as infection and blood clots
are rare, but can occur. Infection can be treated with drainage
and antibiotics, but will prolong your hospital stay. You can
minimize the risk of blood clots by moving around as soon after
the surgery as possible.
Poor healing, which results in conspicuous scars, may
necessitate a second operation. Smokers should be advised to
stop, as smoking may increase the risk of complications and
delay healing.
You can reduce your risk of complications by closely following
your surgeon's instructions before and after the surgery,
especially with regard to when and how you should resume
physical activity.
Planning Your Surgery
In your initial consultation, your surgeon will evaluate your
health, determine the extent of fat deposits in your abdominal
region, and carefully assess your skin tone. Be sure to tell
your surgeon if you smoke, and if you're taking any medications,
vitamins, or other drugs.
Be frank in discussing your expectations with your surgeon. He
or she should be equally frank with you, describing your
alternatives and the risks and limitations of each.
If, for example, your fat deposits are limited to the area below
the navel, you may require a less complex procedure called a
partial abdominoplasty, also know as a mini-tummy tuck, which
can often be performed on an outpatient basis. You may, on the
other hand, benefit more from partial or complete abdominoplasty
done in conjunction with liposuction to remove fat deposits from
the hips, for a better body contour. Or maybe liposuction alone
would create the best result.
In any case, your surgeon should work with you to recommend the
procedure that is right for you and will come closest to
producing the desired body contour.
During the consultation, your surgeon should also explain the
anesthesia he or she will use, the type of facility where the
surgery will be performed, and the costs involved. In most
cases, health insurance policies do not cover the cost of
abdominoplasty, but you should check your policy to be sure.
Preparing For Your Surgery
Your surgeon will give you specific instructions on how to
prepare for surgery, including guidelines on eating and
drinking, smoking, and taking or avoiding certain vitamins, and
medications.
If you smoke, plan to quit at least one to two weeks before your
surgery and not to resume for at least two weeks after your
surgery. Avoid overexposure to the sun before surgery,
especially to your abdomen, and do not go on a stringent diet,
as both can inhibit your ability to heal. If you develop a cold
or infection of any kind, your surgery will probably be
postponed.
Whether your surgery is done on an outpatient or inpatient
basis, you should arrange for someone to drive you home after
your surgery, and to help you out for a day or two after you
leave the hospital, if needed.
Where Your Surgery Will Be Performed
Many surgeons perform both partial and complete abdominoplasties
in an outpatient surgical center or an office-based facility.
Others prefer the hospital, where their patients can stay for
several days.
Types of Anesthesia
Your doctor may select general anesthesia, so you'll sleep
through the operation.
Other surgeons use local anesthesia, combined with a sedative to
make you drowsy. You'll be awake but relaxed, and your abdominal
region will be insensitive to pain. (However, you may feel some
tugging or occasional discomfort.)
The Surgery
Complete abdominoplasty usually takes two to five hours,
depending on the extent of work required. Partial abdominoplasty
may take an hour or two.
Most commonly, the surgeon will make a long incision from
hipbone to hipbone, ,just above the pubic area. A second
incision is made to free the navel from surrounding tissue. With
partial abdominoplasty, the incision is much shorter and the
navel may not be moved, although it may be pulled into an
unnatural shape as the skin is tightened and stitched.
Next, the surgeon separates the skin from the abdominal wall all
the way up to your ribs and lifts a large skin flap to reveal
the vertical muscles in your abdomen. These muscles are
tightened by pulling them close together and stitching them into
their new position. This provides a firmer abdominal wall and
narrows the waistline.
The skin flap is then stretched down and the extra skin is
removed. A new hole is cut for your navel, which is then
stitched in place. Finally, the incisions will be stitched,
dressings will be applied, and a temporary tube may be inserted
to drain excess fluid from the surgical site.
In partial abdominoplasty, the skin is separated only between
the incision line and the navel. This skin flap is stretched
down, the excess is removed, and the flap is stitched back into
place.
After Your Surgery
For the first few days, your abdomen will probably be swollen
and you're likely to feel some pain and discomfort which can be
controlled by medication. Depending on the extent of the
surgery, you may be released within a few hours or you may have
to remain hospitalized for two to three days.
Your doctor will give you instructions for showering and
changing your dressings. And though you may not be able to stand
straight at first, you should start walking as soon as possible.
Surface stitches will be removed in five to seven days, and
deeper sutures, with ends that protrude through the skin, will
come out in two to three weeks. The dressing on your incision
may be replaced by a support garment.
Getting Back to Normal
It may take you weeks or months to feel like your old self
again. If you start out in top physical condition with strong
abdominal muscles, recovery from abdominoplasty will be much
faster. Some people return to work after two weeks, while others
take three or four weeks to rest and recuperate.
Exercise will help you heal better. Even people who have never
exercised before should begin an exercise program to reduce
swelling, lower the chance of blood clots, and tone muscles.
Vigorous exercise, however, should be avoided until you can do
it comfortably.
Your scars may actually appear to worsen during the first three
to six months as they heal, but this is normal. Expect it to
take nine months to a year before your scars flatten out and
lighten in color. While they'll never disappear completely,
abdominal scars will not show under most clothing, even under
bathing suits.
Your New Look
Abdominoplasty, whether partial or complete, produces excellent
results for patients with weakened abdominal muscles or excess
skin. And in most cases, the results are long lasting, if you
follow a balanced diet and exercise regularly.
If you're realistic in your expectations and prepared for the
consequences of a permanent scar and a lengthy recovery period,
abdominoplasty may be just the answer for you.
