Tummy Tuck
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Abdominoplasty/Tummy Tuck Overview

A tummy tuck, also known as abdominoplasty, is a cosmetic procedure performed to dramatically improve the appearance of the abdomen. Individuals may develop a protruding, unsightly abdomen for a number of reasons including pregnancy, weight fluctuations, or as a normal process in an otherwise healthy person. The abdominal deformity typically includes an excess of skin, some fat excess, stretch marks of the lower abdomen, and laxity of the fascia covering the abdominal wall muscles. In addition to having these anatomical changes, the ideal candidate for a tummy tuck also needs to be at or near their ideal weight, be in good overall health, and understand the risks of elective cosmetic surgery. A tummy tuck can help many patients improve their self image by restoring a more youthful appearance to the abdomen. The American Society of Plastic Surgeons estimates that roughly 116,000 patients underwent a tummy tuck in 2010.

 

Photos of an ideal candidate for abdominoplasty showing moderate skin excess, minimal fat excess, and musculofascial laxity

The Abdominoplasty Procedure

The basics fundamental of the tummy tuck procedure are as follows. Most are performed at an outpatient surgery center. Patients are marked by the plastic surgeon in the preoperative area. Next patients are taken to the operating room and general anesthesia is administered with patients going to sleep completely. The first part of the procedure involves the making of an incision at the bottom of the abdomen and around the belly button.

Abdominoplasty incision and scar locations

The abdominal skin is then disconnected from its deeper attachments to the fascia covering the abdominal muscles. Next, the loose fascia is tightened with permanent sutures that act like an internal girdle. This is typically referred to as fascial plication.

Before and after plication of the rectus fascia

Next, the abdominal skin and muscle is pulled tight, and the excess is carefully removed. The belly button is then sewn into place after an incision is made in the skin flap. Prior to the final closure suction drains are placed and sutured in place. The lower abdominal wound is then closed in layers with absorbable sutures. Although the scar can be long, it generally is well hidden by the patient’s undergarments and tends to fade with time. There will also be a circular scar near the base of the belly button. An abdominal compression binder is placed at the end of the procedure. The length of the procedure depends on a number of variables. Most experienced plastic surgeons will have operative times of two to three hours for an otherwise standard tummy tuck. Operative times will obviously be longer if any additional procedures, such as liposuction, are added. Of course not all patients are the same; some patients with more severe deformities will certainly require longer times for the best result. Patients with lesser deformities that do not involve the entire abdomen can sometimes be candidate for shorter procedures which are often called mini or modified tummy tucks.

Abdominoplasty Risks

Like most cosmetic surgical procedures, tummy tuck surgery tends to be safe when performed by an experienced board certified plastic surgeon. However, even under the best of circumstances there are still risks to the surgery. The following complications can occur during tummy tuck surgery:
• Anesthesia risks
• Bleeding
• Wound infection
• Delayed wound healing
• Unsightly scars
• Skin loss
• Prolonged numbness
• Fluid collections called seromas
• Fat necrosis
• Major wound separation
• Asymmetry
• Recurrent skin laxity
• Deep vein thrombosis and/or pulmonary embolus
• Nerve damage

Recovery After a Tummy Tuck

Although a tummy tuck is an elective cosmetic surgery, it still is a major surgery. After surgery, most patients will go home the same day as their procedure. Pain medicine is required for at least the first week after surgery. Patients are seen within one or two days of surgery to make sure there are no early problems. A second follow up appointment is scheduled for 7-10 days after surgery during which the drains are usually removed. Patients can typically expect to resume driving after two weeks or earlier as long as narcotic pain medications are no longer be used. The vast majority of patients will return to work within two to three weeks, unless their job is more physical in nature and requires heavy lifting. Heavy lifting greater than 20 lbs or any strenuous activity is prohibited for the first four weeks following surgery. Tummy tuck patients may start to resume normal activity after 4 weeks, but they are encouraged to start slow and to ease back into their normal exercise routines. Most patients can expect to feel roughly back to normal within in six to eight weeks of surgery. An abdominal compression garment is worn for the first 6-8 weeks to aid in the resolution of edema and to prevent seromas. It does take a minimum of one year to heal completely for any major surgery. During the first year following surgery patients can expect for the scars to fade and for most if not all of the numbness to resolve.  The surgical results after a tummy tuck tend to be quite long lasting. If patients avoid any drastic weight gain and do not become pregnant, they should expect to be satisfied for a number of years or even indefinitely.

Appearance of tummy tuck scars three months after surgery

 

Additional links

Abdominoplasty Photos

Abdominoplasty with Flank Liposuction Photos