There are some conditions of abdominal bulging and sagging that seemingly no amount of exercise can eliminate. The tummy tuck procedure, or abdominoplasty, flattens the abdomen by removing excess fat and skin and by tightening muscles of the abdominal wall. This major surgery, which we perform on an outpatient basis, can dramatically reduce the appearance of a protruding abdomen. The procedure does leave a permanent scar, but it generally can be hidden even under a bathing suit.
The best candidates for a tummy tuck are women or men 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. Patients who intend to lose a lot of weight should postpone the surgery, as should women who are planning future pregnancies, since abdominal muscles tightened during surgery can separate again during pregnancy. Abdominoplasty patients should expect to be off work for two to four weeks. Insurance generally does not cover this procedure with the exception of a hernia repair if present.
“ Many of my patients are surprised to learn that I believe surgical intervention should be a last resort to abdominal shaping. The optimal treatment for many cases is a dedicated commitment to a good diet and exercise. Then, interventions such as abdominoplasty and liposuction can be applied to abdominal fat deposits that do not respond to diet and exercise. My ultimate goal is to be a partner in your long-term success. Your commitment to caring for yourself is just as important as any support I am able to offer to you. ”
--Dr. Mark Chariker, MD, FACS
Planning Your Surgery
In your initial consultation, we will determine the extent of fat deposits in your abdominal region, carefully assess your skin tone, and give you a frank recommendation of the procedure he will choose for you and a realistic outcome. If your fat deposits are limited to the area below the navel, you may require a less complex procedure called a partial abdominoplasty or mini-tummy tuck. On the other hand, we may recommend a partial or full abdominoplasty along with liposuction to remove fat deposits from the hips to give you better body contour.
In / Outpatient, Anesthesia, Length of Procedure
We usually performs tummy tucks in our nationally accredited outpatient surgical center. You will receive general anesthesia, which means you will sleep through the surgery. The surgery will last anywhere from two to five hours depending on the extent of the procedure. For example, a partial abdominoplasty, may take an hour or two.
During and After
In a full abdominoplasty, we make a long incision from hipbone to hipbone, just above the pubic area, and a second incision to free the navel from surrounding tissue. He then 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. He pulls these muscles close together and sutures them into their new position, providing a firmer abdominal wall and narrower waistline. He stretches the skin flap back down, removes the extra skin, and cuts a new hole for the navel, which he sutures in place. Finally, he sutures and then dresses the incisions. In a partial abdominoplasty, the skin is separated only between the incision line and the navel. The skin flap is stretched down, the excess is removed, and the flap is stitched back into place.
For the first few days after surgery, your abdomen will probably be swollen and you're likely to feel some pain and discomfort; therefore, we will prescribe pain medication for you. Although you may not be able to stand up straight, you should start walking as soon as possible. The doctor will remove surface sutures–which protrude through the skin–in seven to ten days; deeper sutures will dissolve within three months. Most tummy tuck patients are able to go back to work in two to four weeks.
Side Effects and Risks
Typical side effects from a tummy tuck procedure include temporary pain, swelling, soreness, numbness of abdominal skin, and bruising, which should dissipate in a week or two. In addition, patients may feel tired for several weeks or months.
Post-operative complications such as infection, blood clots, and bleeding under the skin flap are rare, but can occur. Poor healing, which results in conspicuous scars or even skin loss, may require a second surgery. Smoking may increase the risk of complications and delay healing; patients are urged to quit smoking several weeks before surgery.
It may take you weeks or months to feel like yourself 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 to four weeks to rest and recuperate.
Exercise will help you heal better. To reduce swelling, lower the chance of blood clots, and further tone muscles, all patients should engage in physical activity. Vigorous exercise, however, should be avoided until you can do it comfortably. It will take time for your scars to flatten out and fade. They may actually appear to worsen during the first three to six months as they heal, but this is normal. Expect the healing process to take nine months to a year before your scars flatten out and lighten in color.
Duration of Results
In most cases, the results of abdominoplasty are long lasting if patients follow a balanced diet and exercise regularly.