Abdominoplasty, more commonly referred to as a Tummy Tuck is a procedure, which removes extra skin and fat from the abdomen and tightens the over stretched muscles. Excessive laxity of the abdominal skin and muscles is generally due to multiple pregnancies or significant weight loss in overweight people. While exercising is effective in toning muscles in mild cases, it is not capable of reversing sagging skin nor is it capable of tightening loose abdominal muscles. Rolls of abdominal skin, which may extend down into the pubic area are called Panniculus or Pannus. Removal of abdominal or pubic area pannus without tightening of the abdominal muscles is referred to as abdominal or pubic panniculectomy. When tightening of the muscles is also included the procedure becomes an Abdominoplasty.
A conventional Abdominoplasty tightens muscles in a vertical line. Our premiere Tummy Tuck specialist Dr. Ivan Thomas prefers the new method known as High Lateral Tension Abdominoplasty, which in addition to vertical-line tightening, muscles are also tightened horizontally. The final result with this technique is a dramatically flat abdomen with a significantly better-defined waistline.
Since a tummy tuck is a skin tailoring and trimming operation, an abdominal scar is to be expected. Incision is placed very low in the abdomen so the scar is less conspicuous. In some patients the hair bearing pubic area is stretched beyond its normal height. In these cases, pubic area excision or panniculectomy is performed which not only tightens and lifts the pubic area but also reduces the height of the hair-bearing region. After the skin is trimmed a new opening is made in the tightly pulled skin for the relocation of the umbilicus. In reality, the operation does not create a new belly button, it is the patient's own umbilicus which appears through a new opening. Prior to the final skin tightening, the loose and stretched abdominal muscles are sewn together in the vertical and horizontal plane. All suturing is done under the skin surface with absorbable sutures therefore; there is no need for stitch removal. Patients who have excessive amount of fat under the skin may also require liposuction and body sculpting of the abdomen.
The most dramatic effects in the waistline we've seen in patients in our Beverly Hills and Lancaster offices are for those who, in addition to abdominoplasty also undergo liposuctioning of the abdomen, flanks, hip rolls, and lower back.
Abdominoplasty is performed under general anesthesia and requires a recovery time of 10 to 15 days. Patients are advised to stay away from anti-inflammatory medication such as aspirin, Advil, Ibuprophen and Motrin, starting 2 weeks prior to surgery and continue avoiding such medications 10 days post-operatively. Abdominal exercises should be avoided for the period of 6 to 8 weeks. This is to avoid undue additional tension on the tightened muscles until healing is completed.
Patients who undergo Abdominoplasty not only look better but also feel better about their appearance. Once again shopping for outfits become enjoyable. Quite often patients are so motivated to maintain the newly contoured shape that changing their eating and exercising habits become part of their new lifestyles.
1. Are tummy tucks painful?
Every operation has a certain degree of pain and discomfort during the first few days however post surgical pain in general is easily controlled with prescription pain medication. For the past several years a new device called the "pain pump" has been available for Tummy Tuck patients. The pain pump consists of a balloon type container which is filled with local anesthetic medication. It is designed to slowly squeeze out the anesthesia medication through a catheter which is left under the abdominal skin. It takes approximate four to five days for the pump to empty its contents during which time the Tummy Tuck wound is kept numb. After 4-5 days the pain level has generally decreased to a level that just prescription medication or even Tylenol is all that is required. Since a Tummy Tuck is an operation which is performed above the abdominal muscles and no muscles are cut, the pain level in general is less than operations that cut through muscles and enter the abdominal cavity such as a C-Section or a hysterectomy.
2. Will weight gain after a tummy tuck affect the results?
When one gains weight, fat is deposited both inside the abdomen and out side under the tummy skin. Expansion of fat inside the abdomen will stretch the tightened abdominal muscles while expansion of fat under the skin will stretch the tightened skin. Minimal weight gain will not have a significant detrimental effect but excessive weight gain will effect the results of a Tummy Tuck. Most of our Beverly Hills and Lancaster patients after seeing the results of a Tummy Tuck on their body, become very motivated to change their life style by healthier dietary habits and more physical activity. It is not uncommon to see people loosing weight following a Tummy Tuck surgery by just lifestyle changes.
3. Can you explain what a partial abdominoplasty is?
Partial or mini abdominoplasty refers to a limited or minimal Tummy Tuck performed to excise loose skin which is below the level of the umbilicus. Since Tummy Tuck patients show evidence of stretching and bulging of the entire abdomen, the partial or mini Tummy Tuck operation has a very limited application. One hardly sees a patient whose abdomen above the umbilicus looks perfectly fine while only the part below the belly button is all stretched and loose.
4. Will future pregnancy affect the results of a tummy tuck?
Any increase in intraabdominal volume will result in stretching of the abdominal muscles and skin. Therefore pregnancy can effect the result of a Tummy Tuck.
5. Can stretch marks be removed with a tummy tuck?
If stretch marks are located mainly in the lower abdomen they will be removed as a part of the skin excess. Higher stretch marks especially above the umbilicus can not be removed with a Tummy Tuck. How much of the stretch marks can be removed is determined during the consultation and the exact amount can only be determined in surgery.
6. How long before I can return to my normal activities?
Tummy Tuck patients will require a recovery time of two weeks. After two weeks normal daily activities are allowed excluding heavy lifting. Walking is encouraged early on but physical activity and exercises involving the abdominal muscles should be avoided for 8 weeks.
7. What is the source of problems in the abdominal area?
Gradual growth of the uterus during pregnancy requires adequate expansion of the abdomen. Expansion towards the back is not possible because the spine occupies the back. Expansion toward the sides is not possible because the sides of the rib cage extend down towards the flanks and the sides of the pelvic bone extend up into the flanks leaving a very narrow stretch of skin and muscles in the flank area which effectively block the side ways expansion of the abdomen. The only unobstructed skin and muscles are in the front which can expand and stretch to allow the baby's growth. This is why the loose skin left behind after pregnancy is almost always in the front of the abdomen. We have to realize that pregnancy is not the only reason for stretching of the abdomen. Any expansion will cause a similar deformity. The best seen examples are in individuals who gain excessive weight followed by weight loss, either by gastric bypass surgery or weight loss by means of diet and exercising. Tumors or cysts can grow inside the abdomen with similar consequences.
8. What health issues can interfere with healing from a tummy tuck?
Smoking constricts arteries and limits blood flow to the healing wound. Diabetics and immune deficiency patients have a higher chance of poor healing and infection. Low protein levels with chronic kidney and liver disease will also interfere with normal wound healing.
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