Abdominalplasty (Tummy Tuck)

Once stretched by pregnancy or weight gain, the abdomen often fails to return to its original shape. Stretched beyond the capacity to return to normal, these tissues will also fail to respond to exercise or diet programs. In these cases, abdominoplasty can provide a long-lasting solution. Abdominoplasty, commonly called a tummy tuck, is a frequently performed procedure used to tighten overly stretched abdominal muscles and skin for a smoother, flatter appearance.

If you’re considering abdominoplasty, the following information will provide you with a good introduction to the procedure.

Common Questions

What are some of the most common benefits of a tummy tuck?
The tummy tuck, or abdominoplasty, can dramatically tighten the abdominal muscles, as well as the sagging, excess skin and accumulated fatty tissue. Not only will the abdomen be firmer and flatter, but the waist will be smaller as well.

The amount of improvement depends upon the extent of surgery and the patient’s skin tone, body build, and healing process. Most people are happy with the results, and report a better body image after the surgery.

What will happen at the initial consultation?

During the consultation, you and your surgeon will discuss the changes that you would like to make in your appearance. He/she will explain the different options available to you, the procedure itself, the risks and limitations, and the type of anesthesia that will be used. Your surgeon will also evaluate your health, determine the extent of fat deposits in your abdominal region, and carefully assess your skin tone.

Be sure to ask all the questions you have about the surgery, and ask to see photos of the doctor’s recent patients, before and after surgery. Also ask for, and follow up on, patient references. Learning everything you can about your options, risks and benefits is the key to making an informed decision.

How is the tummy tuck done?
There are several different tummy tuck techniques. The most common procedure is performed under general anesthesia. In the full tummy tuck, an incision is made across the lower abdomen, just above the pubic area. Another incision is made around the belly button to free the surrounding skin, and the all of the skin is separated from the abdominal wall. Then the surgeon pulls the loose muscles from the left and the right sides and sutures them together. This tightens the muscles to create a stronger abdominal wall and a smaller waist. Excess skin is removed, and a new opening is made for the belly button at the right position. The incisions are closed with sutures (stitches) and/or staples, and gauze is placed over the incision area.

If your only problem area is below the belly button, you may benefit from a less complex procedure called a partial abdominoplasty or partial tummy tuck, which can often be performed on an outpatient basis, under local anesthetic, such as that used by dentists. Or, your surgeon may recommend either a partial or complete abdominoplasty done in conjunction with liposuction to remove fat deposits from the hips, for a better body contour. Sometimes liposuction alone offers the best results.

How long does the tummy tuck take?
The tummy tuck generally takes about 2-5 hours, depending on the extent of the repair. A partial abdominoplasty takes about 1 or 2 hours.

How much pain is there?
For the first few days, your abdomen will probably be swollen and you’re likely to feel some pain and discomfort which can be controlled by medication. Depending on the extent of the surgery and the technique used, you may be released within a few hours or you may have to remain hospitalized for two to three days.

What can I expect after a tummy tuck?
Bed rest for two to three days is recommended. While in bed, your legs should be bent at the hips in order to reduce the strain on the abdominal area. You will be provided with a firm abdominal binder to offer support to the tightened areas.

Your doctor will give you instructions for showering and changing your dressings. And though you may not be able to stand straight at first, you should start walking as soon as possible.
Surface stitches will be removed in five to seven days, and deeper sutures, with ends that protrude through the skin, will come out in two to three weeks.

What is the recovery period like?
It may take you several weeks to feel completely back to normal. If you are in top physical condition, recovery will be much faster. Some people return to work after two weeks, while others take four weeks to recuperate.

After about three days, you may begin light activities. At this point, the gauze may be replaced by a new abdominal supporter.
Even if you’ve never exercised before, you should begin a light exercise program to reduce swelling, lower the chance of blood clots, and improve muscle tone. However, vigorous exercise, especially lifting, should wait until you can do it comfortably and your surgeon gives you permission.

Your scars may appear to worsen during the first few months, but this is normal. It may take up to a year before your scars flatten out and lighten in color. While they’ll never disappear completely, these scars will be placed so that they’ll be covered by your clothes, including most bathing suits.

What is the long-term outcome like for most people?
As long as you keep your weight relatively constant, eat a healthy diet, exercise regularly, and follow your surgeon’s instructions about how to resume physical activity, the long-term results from a tummy tuck are generally excellent.

Alternatives:
Strenuous exercise and weight loss alone will reduce the bulk of the abdominal wall and tighten the muscle tone; however, the stretched skin may not be able to contract without surgery. Ultrasonic liposuction has been touted as causing contraction of excess skin, but most often will not be effective enough to achieve results in patients who consider abdominoplasty.

Risks:
All surgery has some potential risks, including the risks of bleeding, reaction to the anesthetic, and infection. Scars are to be expected, but they will become lighter and flatter with time.
Smoking may increase the risk of complications and delay healing. This could result in larger scars, and a second surgery. You can reduce your risk of complications by closely following your surgeon’s instructions before and after the surgery, especially with regard to when and how to resume physical activity.

Costs:
The national average of 1999 surgeon fees for the tummy tuck was $4,215 (Source: The American Society of Aesthetic Plastic Surgery). Regional averages: New England states: $4,995; middle Atlantic states: $3,926; north central states: $4,175; south central states: $3,681; and mountain/Pacific states: $4,247. These fees do not include anesthesia, operating room facility, hospital stay and other related expenses.

In most cases, health insurance policies do not cover the cost of abdominoplasty, but you should check your policy to be sure. Ask your surgeon to determine if your needs are medically indicated, in which case the costs may be covered by your medical insurance.

Be sure to:

* Tell your doctor about any allergies you have (to foods, drugs, environmental elements).
* Tell your doctor about all medications, herbal supplements or natural supplements you are taking (both prescription and non-prescription).
* Be sure to tell your doctor if you smoke. Smoking can lead to complications and poor healing.
* Carefully follow any instructions your surgeon gives you regarding eating and drinking.
* Avoid aspirin and aspirin-containing medicines for two weeks prior to surgery.
* Arrange for someone to drive you home after surgery and help you for a few days afterward, if needed.

The information on this web site is only intended as an introduction to this procedure and should not be used to determine whether you will have the procedure performed nor as a guarantee of the result. The best method of determining your options is to consult qualified surgeons who are able to answer specific questions related to your situation.