Abdominoplasty

Reduces excess skin and fat from the arms.

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Abdominoplasty

Procedure

Abdominoplasty, also called tummy tuck surgery, surgically removes the excess skin and fat that lies between the umbilicus and the overhanging skin (or to a cesarean scar) from the abdominal area. Depending on the needs of the patient, the muscles of the abdominal wall are tightened. The incision is a half-moon shape (length is dependent on the mass of skin and fat to be removed).

Length

Approximately two to four hours.

Anesthesia

Most commonly patients are placed under general anesthesia. This procedure can also be performed with a regional nerve block obtained with local anesthetic agents.

Inpatient/Outpatient

Either is possible and depends on the patient’s health and the doctor’s preference.

Possible Side Effects

Temporary discomfort, low back pain, post-operative swelling, soreness or tenderness in the surrounding areas, numbness of abdominal skin and bruising are possible side effects.

Risks

Infection, bleeding under the skin flap or at the incision site, pulmonary embolism (a blood clot that travels to the lung), scarring (keloids), delayed healing, or the need for a second reversionary operation are potential risks, enlargement of the scar.

Recovery

The patient may return to work within two to four weeks. Upon re-evaluation by the physician, the patient may return to activity that is more strenuous after approximately four to six weeks. Scars should fade and flatten anywhere from three months to one year after surgery. Patients are asked to wear a body girdle for at least four weeks.

Results

The result will last many years, unless the patient gains weight or becomes pregnant.

Ideal candidates for abdominoplasty include men and women who want to remove excess abdominal skin and fat. These cosmetic concerns may be caused by the following factors:

- Weight fluctuations

- Pregnancy

- Aging

- Genetics

Ideal candidates should also be in good general health and within 25 pounds of their target weight. Women who are planning on getting pregnant should postpone tummy tuck surgery until they’ve finished having children, as pregnancy may reverse the effects of tummy tuck surgery.

Tummy tuck surgery is not a weight loss procedure and should not be performed on people who are significantly overweight. While the surgery does remove localized fat from the abdomen, it is a body contouring procedure. This means that your shape will be slimmer, and your clothes will probably fit you better, but the surgery will not result in significant weight loss.

There are two main types of abdominoplasty: partial abdominoplasty (“mini-tummy tuck”) and complete abdominoplasty. Some patients initially want to undergo a mini-tummy tuck simply to avoid having a longer scar. This may not be possible based on your degree of abdominal sagging and fat deposits.

True candidates for partial abdominoplasty are those rare individuals who only require surgery of the area below the navel. The procedure is not offered simply as a less-invasive alternative to complete abdominoplasty. Most patients are best treated with the complete abdominoplasty. Dr. Sajjadi will help you determine which procedure would best suit your needs.

Tummy tuck surgery can remove localized fat from the abdomen and excise drooping skin. It can also repair abdominal muscles that have separated due to pregnancy or other factors. It restores a more youthful and fit appearance to the abdomen.

Abdominoplasty typically begins with liposuction to reduce localized fat deposits. Then, a hip-to-hip incision is made across the lower abdomen, passing above the pubic area. This incision allows the abdominal apron to be pulled up, so the surgeon can access deeper tissues. Once the abdominal apron is lifted the surgeon can tighten separated abdominal muscles with stitches. Excess skin is excised, and fat deposits are removed, and then the incision is sutured back together. The belly button is brought out through a new opening in its original position, resulting in a scar around it.

The overall recovery process from tummy tuck surgery usually lasts six to eight weeks. For the first week you will experience moderate discomfort and a feeling of tightness in your abdomen. You will be required to wear a post-surgical compression garment for the first four weeks. This helps control swelling and fluid retention in the weeks following your surgery. It also helps your abdomen take on its newly sculpted shape.

Most patients return to work and regular daily activities within three to four weeks. Exercise and vigorous physical activity will need to be avoided for eight weeks to allow the repaired muscles to heal.

Well, the answer depends on several factors and to what level of recovery you are thinking about. If you don’t need the muscles repaired, it is likely that your recovery is going to be easier and quicker. Most patients having a full tummy tuck (with muscle repair) find that they are generally able to drive a car within a week, depending on their pain level (remember you don’t want to drive when on narcotic pain medicine). Many patients can work remotely from home, and find that they are able to log on to their computers, answer emails, or even have a conference call after only a few days, although they won’t feel like going in to work for maybe 2-3 weeks post surgery. Light exercise (e.g. walking or gently peddling on a stationary bike) can start by this time as well. By 6-8 weeks, most patients would consider themselves fully or nearly fully recovered, although it is worth remembering that the nerves will continue to heal, the scar will continue to fade, and the swelling will continue to go down for several months.

The results of tummy tuck surgery are very long lasting. Patients who maintain a healthy lifestyle can expect their results to last for many years. Becoming pregnant or gaining a significant amount of weight can negatively affect your results. For these reasons it’s recommended that people seeking abdominoplasty are close to their ideal weight and are not planning a future pregnancy.

Historically tummy tucks were one of the more painful operations that plastic surgeons performed, especially when repair of the muscles was required. Over the past several years, the development of some new ways of controlling pain has helped this situation a lot. First came the development of pain pumps – these are devices that push a local anesthetic through a small tube and into the area of surgery. These were very helpful and many surgeons still use them, but it requires a tube coming out of the skin. More recently there has been the development of a long lasting local anesthetic which can give significant pain control for up to 3 days, and it doesn’t require a tube. Good pain control clearly makes the recovery more pleasant. It also means that less narcotic pain medicine is required; therefore, there is less chance of a reaction to the medication. In addition, it may make the surgery even safer by allowing patients to move around more easily and to be more active.

Historically the answer to that question was “yes”; however, new techniques have eliminated the need for drains in many cases. We now can use special stitches – known as progressive tension sutures – to seal the tissue together so that there is no need for a drain. The progressive tension technique has another advantage as well; it often allows us to remove a bit more skin than we could otherwise. Although I currently can’t prove it, I also suspect that the sutures help make the scar from the tummy tuck better because they reduce the tension on the skin during healing. Patients love it when they don’t have to have drains.

There is not just one type of tummy tuck – abdominal contouring can include a variety of approaches depending on one’s individual situation. It is often helpful to think of a tummy tuck in terms of where the problem is. Is there too much loose skin, is there too much fat, or have the muscles been stretched or separated by pregnancy? If your skin is relatively tight then you may be a good candidate for a reduced scar approach, such as liposuction (tiny scars), an endoscopic abdominoplasty (1-2 inch scar), or a mini-abdominoplasty (a scar about the length of a C-section). On the other hand, if there is a lot of loose skin that you will need tightened, that will require a longer scar. If there is too much fat, then liposuction can be combined with the removal of skin – a very common situation. If the muscles are separated, then some sort of tummy tuck with muscle repair is needed, however the incision can be short or long depending on the skin.

Typical results include a flat abdomen with removal of any skin rolls. The results of a tummy tuck are very long lasting, as long as there aren’t huge fluctuations in weight due to dieting or pregnancy.

That depends on where the stretch marks are located, but the answer is usually “yes”. A full tummy tuck removes most of the skin in the lower abdomen, and any stretch marks in this zone will be removed along with 

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