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Abdominoplasty, also known as a “tummy-tuck,” is an elective cosmetic surgical procedure. It is major invasive surgery, which removes excess skin and fat from the middle and lower abdomen. It also tightens the muscles of the abdominal wall.
The procedure can dramatically reduce the appearance of a protruding abdomen. However, it also produces a permanent large scar, which can extend from hip to hip, depending upon the extent of the procedure. If you are considering abdominoplasty, this article will give you a basic understanding of when it can help, whom it can help, how it is performed, and results you can expect.
A common misconception amongst patients considering cosmetic surgery of the abdominal area is that the choice exists to have either a tummy tuck or liposuction and that either of these two procedures will produce similar results. In most cases, a patient is a far better candidate for either a tummy tuck or liposuction and the procedures are not interchangeable.
The decision as to which plastic surgery procedure is best must be made in conjunction with a qualified plastic surgeon but the following is a general guideline:
Typically, patients whose abdominal area has loose excess skin, or significant stretch marks will need a tummy tuck and will not benefit from liposuction alone. This is because liposuction is a procedure that only removes fat. Skin is essentially unaffected. Therefore if there is substantial loose skin or stretch marks to start with, liposuction will not remove any of the extra skin or any of the stretch mark-bearing skin. Furthermore, liposuction in these circumstances can actually worsen the problem by removing the “foundation” on which the skin rests, i.e. the underlying fat thereby leaving even looser skin than the patient started with.
Liposuction to the abdominal area is more appropriate in cases of younger patients with firm, taut abdominal skin whose main problem is extra fat. In these cases, skin reliably shrinks over the liposuctioned area and a great cosmetic result can be obtained. Remember that this is only a guideline. The ultimate decision as to which procedure(s) is best for you should be made during a consultation with a qualified surgeon at Centre for Surgery.
IS THIS PROCEDURE RIGHT FOR ME?
The best candidates for abdominoplasty are emotionally stable men and women who are in relatively good shape, close to their ideal body weight, and who have good overall skin elasticity, but are bothered by a large fat deposit or loose abdominal skin that won’t respond to diet or exercise.
The surgery is particularly helpful to women who have lost elasticity in the muscles and skin of the abdomen due to multiple pregnancies. Loss of skin elasticity in older patients because of weight loss can also be improved. Abdominoplasty is not a “one size fits all” procedure; it is unique for each patient. Much depends upon the joint decisions made by the patient and his or her surgeon.
Patients who plan to lose a lot of weight should postpone surgery until after they have achieved their desired weight. Young women who plan future pregnancies should also wait, since vertical muscles in the abdomen, which are tightened during surgery, can separate during pregnancy.
If you have heavy scarring from previous abdominal surgeries, your doctor may advise against an abdominoplasty because of the possibility of unusually prominent scars.
To be considered a good candidate for a tummy tuck procedure, you should:
- Be physically healthy
- Be at a stable weight
- Be a non-smoker
- Have realistic expectations as to what the procedure can do for your appearance
Who is an ideal patient for tummy tuck?
All patients should be in good health and have realistic expectations about what can be achieved with tummy tuck surgery.
We do not treat patients below the age of 18 years of age.
Healing is better if patients refrain from or quit smoking.
The tummy tuck procedure is performed purely for cosmetic purposes, to help improve one’s image and self-esteem.
The tummy tuck consultation
The consultation begins by having an opportunity to discuss your ideas, concerns and expectations about the tummy tuck procedure with your surgeon, and ask any relevant questions you may have.
Your tummy tuck surgeon will:
- Take a focused history and examine you
- Explain the tummy tuck procedure
- Take your needs and preferences into account when deciding on the most appropriate treatment option for you
A tummy tuck surgeon can be either from a plastic surgery or general surgery background. Both specialities are fully trained to perform tummy tuck.
TYPES OF ABDOMINOPLASTIES
There are two different types of abdominoplasties: the “mini-abdominoplasty,” and the more invasive type, “abdominoplasty.” Both these surgeries may involve liposuction. In both surgeries skin and fat are cut away from the abdomen.
In a mini-abdominoplasty an incision is made just above the pubic area; fat and excess skin is removed from the middle and lower abdomen. The navel is pulled lower to compensate for the stretching and removing of skin. Minimal or no abdominal tightening will be required. Recovery time is usually very quick.
A full abdominoplasty requires a much larger incision. Skin is separated from the abdominal wall, all the way up to the ribs. Muscles are sewn together to tighten them, and a significant amount of skin is removed, requiring the patient to be bent over for 10 to 14 days. Usually within 2 to 3 weeks the patient is able to resume normal activity, except for lifting. There should be no lifting or pushing, putting strain on the stomach muscles, for up to 2 months.
If you have diastasis caused by pregnancy, you may be a candidate for tummy tuck surgery. To be considered an ideal candidate for a tummy tuck procedure, you should:
- Be physically healthy
- Be at a stable weight
- Be a non-smoker
- Have realistic expectations for what the procedure can do to improve your appearance
It should be noted that tummy tuck surgery for diastasis repair is not a procedure for the removal of excessive amounts of intra-abdominal fat. It is only done to reconnect the separated sides of the abdomen in order to create a tighter abdominal area. The best way to determine if you’re a candidate for tummy tuck to repair your diastasis is to schedule a consultation with a surgeon at Centre for Surgery.
There are many differences between a mini tummy tuck and a full tummy tuck. The main differences is that with a mini tummy tuck the area at and above the navel is not treated, so there is no scar or repositioning of the navel.
A full tummy tuck is a much more extensive procedure with a longer recovery period and downtime.
A large amount of weight loss and the resulting sagging skin is only one reason to consider a tummy tuck. Other causes of excess, loose and sagging skin include:
- Previous pregnancy
- Prior surgery
It is perfectly normal to want to have sagging skin or a protruding belly corrected. In addition to wanting to remove the loose skin around the midsection, patients may also want to consider a tummy tuck to:
- Correct a protruding stomach that is not consistent with the body’s proportions
- Improve tone in the abdominal and stomach muscles
- Eliminate skin problems in the skin fold under the abdomen
- Remove those areas of fat that simply won’t respond to exercise or dieting
- Correct prominent C-section scarring and stretch marks
- Repair diastasis recti
- Repair abdominal muscles that are overly stretched out
General anaesthetic is used to put you to sleep.
In a tummy tuck, an incision is made from hip to hip in the area between the public hairline and the belly button. The amount of excess skin will determine the length of the incision.
The skin will be undermined upwards, the muscles are tightened and the belly button is repositioned while excess skin is removed. This helps to dramatically improve the appearance and strength of the abdominal area. The surgeon may recommend having liposuction along with the tummy tuck to provide optimal results.
After the excess fat and skin are removed, the remaining skin from the upper abdomen is released and pulled down over the open area to close it. Skin is tightened, muscles are tightened, and the abdomen is flatter. Once the procedure is completed, the incision will be closed and dressings applied. You may be given an elastic bandage or compression garment to wear in order to minimise swelling to support the abdomen as it heals.
The medical team will call you the day after your surgery and at specified intervals during the weeks following your surgery. This is done so that the Surgeon can monitor the recovery process, and to ensure that you have the most pleasing aesthetic results.
The tummy tuck surgery will leave your abdomen bruised and swollen, which will diminish over a period of one to two weeks. Because patients retain some water following the procedure, there will be some temporary weight gain. This is normal, and will dissipate quickly.
Recovery from tummy tuck surgery requires rest and taking it easy. The first two days following the surgery are usually the most uncomfortable. After the first two days you’ll notice a dramatic improvement in how you feel. Because of the innovative surgical techniques used by the surgeon, your discomfort will be easily controlled with prescription medication only.
During your recovery you should avoid strenuous physical activity; this is especially important if your abdominal muscles have been repaired from diastasis recti. You may need to limit your physical activity from four to six weeks.
After your tummy tuck procedure, you will have a flatter, firmer abdominal contour that is proportionate with your individual body type and weight. The actual results will be hidden due to swelling at first, but you will begin to see your new slimmer profile within one to two weeks after surgery. Depending on the surgery, it may take anywhere from several weeks or months to see the final results.
During recovery it is critical that you refrain from smoking. Smoking deprives your body of oxygen, which increases the risk of wound breakdown and infection following the surgery.
The goal of a tummy tuck is to provide you with a tighter, smoother and more attractive abdomen. Your love handles will be smaller, and you will look more fit, youthful and healthier.
How Much Pain Will I Have?
Following a tummy tuck, patients describe a major feeling of tightness around the abdomen. The discomfort is described as an intense muscle ache similar to the feeling after an aggressive abdominal workout. It is generally the case that the most expertly performed tummy tucks will cause a certain amount of post operative discomfort. This is related to the extent of tightening that the surgeon has achieved. If a tummy tuck doesn’t hurt at all, the abdomen was likely not tightened adequately.
Bruising and swelling is always seen after a tummy tuck or liposuction. Additional liposuction to the upper abdominal area and love handles and bruising will also be performed
Can I go home the same day?
Patients are able to leave the hospital on the evening of their procedure. Although straining, heavy lifting and bending should be avoided, tummy tuck patients must start minimal walking and leg exercises the day of the surgery. Lying in bed for hours at a time is dangerous and must be avoided to minimise the risk of blood clots. When going to sleep, a couple of pillows under the knees and behind the head will act to ease the tension on the surgical incision and will help relieve discomfort.
When Can I Return To Work?
Patients with jobs that require significant physical activity including bending, lifting, or quick movement will need about four weeks off before being able to return to full duties comfortably. Those patients with jobs not demanding physical activity can return to work after two weeks.
When can I restart gym activities?
Light work outs involving exercises that do not strain the surgical incision or the abdominal muscles can begin at two or three weeks post-op. This includes brisk walking or stationary bike riding.
Heavier work outs including abdominal crunches, sit-ups and running should not be attempted for about one month.
Do I Need to Wear a compression garment?
Yes, tummy tuck patients should wear a special compression garment for four weeks after a tummy tuck.