A protruding abdomen can be a cause of distress for both men and women alike. It can be the result of weak abdominal muscles, loss of elasticity due to aging, or stretching of skin after a dramatic weight loss or pregnancy. Abdominoplasty or “Tummy Tuck” is a surgical procedure designed to flatten a protruding abdomen by removing excess skin and fat tissue from the abdomen while tightening the abdominal muscles. The result is a smoother and more contoured look. The best candidates for the surgery are patients who feel are at their ideal weight but have fat deposits or loose abdominal skin that will not respond to diet and exercise. Furthermore, many patients combine their tummy tuck with other cosmetic procedures such as liposuction, breast augmentation, or breast reduction.

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PRIOR TO SURGERY

A complete medical history and a careful examination with blood tests will be done in the initial preoperative visit to determine the general health of the patient. The surgeon will also evaluate the extent of surgery needed for ones desired look based on factors such as location of fat deposits and muscle and skin tone. If fat deposits and loose skin are located below the navel a partial abdominoplasty can be performed but for those with a severe laxity of abdominal tissue a full tuck would be required. Photographs may also be taken before and after surgery to evaluate the extent of improvement in addition to discussing the procedure, type of anesthesia to be used, and possible risks of surgery. Preoperative instructions generally include taking certain vitamins and elimination of certain drugs to minimize the possibility of excess bleeding. Furthermore, antibiotics or bathing with an antiseptic soap may be prescribed for the days prior to surgery in order to prevent infection.

THE OPERATION

Abdominoplasty can be performed in an office based surgical setting or in a hospital, usually under general anesthesia depending on the extent of surgery. The entire operation can take anywhere from two to five hours. The most common procedure used by surgeons for a full abdominoplasty involves a “u” shaped incision across the pubic area from one hip bone to the other. The navel is then removed with a second cut and the abdominal skin is lifted up to the breast. Weak abdominal muscles are sutured in order to tighten those that are stretched out. Next, the skin is lowered over the abdomen, excess fat and skin removed, and the navel is reconstructed. Before the incisions are sutured shut, drains may be inserted to prevent fluid buildup. Finally, elastic dressings are applied to the area. In a mini tummy tuck, a smaller incision is made and no cut is made around the navel. All tightening of abdominal muscles and excess skin and fat removal are done through this small incision. Sometimes, in a mini tummy tuck one can do a small volume of liposuction in the upper abdomen, but most surgeons do not recommend doing lipo and abdominoplasty at the same time. It is best to allow a month in between the procedures.

AFTER SURGERY

Patients can be released up to a few hours after the operation or they may stay in a hospital up to two days depending on the procedure. Discomfort from the procedure can be controlled with oral medication. Sutures and drains (if used) are removed approximately one week after surgery and bandages are later replaced with an abdominal support garment. The total recovery time depends on ones general health and physical condition and can range from two weeks or months. During this time heavy lifting or straining should be eliminated although light exercise can help recovery, reduce swelling, and lower the chances of blood clots. Abdominoplasty scars actually appear to worsen over the first few months as they heal but this a normal condition. However, over time they will begin flatten out and fade significantly.

RISKS

Each year thousands of abdominoplasties are successfully performed with positive results, but as with any surgery there are always risks. Complications such as blood clots, infections, and poor healing are very rare but must be discussed with the physician prior to surgery. Patients can minimize these risks by carefully following the physician’s directions.