Abdominoplasty or tummy tuck surgery is one of the most rewarding procedures with results that are often immediate and dramatic. Pregnancy and weight loss can cause the skin of the abdominal wall to become loose and sometimes leave permanent stretch marks behind. The abdominal wall muscles can become lax and cause the abdominal wall to be more prominent especially with flexing. This condition is often unresponsive to exercise and skin creams.
Abdominoplasty is a body contouring option that removes the excess wrinkled skin and fatty tissue from the abdomen and tightens abdominal muscles. The best candidate for this surgery has relatively normal weight, weak muscles and excess skin. Patients who are considerably overweight are less ideal candidates for the operation and may be advised to lose weight prior to surgery or to have liposuction performed before a tummy tuck. Age and skin tone have a lot to do with the level of improvement you may expect. The incision is made low on the abdomen, near the pubic region, so that any scarring is hidden by most underwear and bathing suits. For individuals with loose abdominal muscles and minimal skin excess, a “mini abdominoplasty” may be all that is needed. Many patients find this procedure highly beneficial because it results in a shorter scar.
PLANNING FOR YOUR SURGERY
Communication is vital in reaching your goals. You will have the opportunity to discuss your goals and the results you’d like to achieve. Dr. Wright will work with you to reach an understanding about what you can expect from this procedure and what long-term benefits you will experience. Every patient is different, and he will choose the surgical technique and treatment plan that is right for you.
During your initial consultation:
- Provide a complete medical history. Include information about any previous surgical procedures; past and present medical conditions; and all medications or herbal supplements you are taking.
- Expect an examination of your abdomen, including the quality of your abdominal skin; the location of any existing scars; the amount and location of any excess fat; and the status of the underlying muscles.
- Be prepared to discuss possible risks and complications of the procedure.
The operation is carried out under general anesthesia and will be performed in our state-of-the-art surgical suite. A full abdominoplasty takes between two to four hours depending on the extent of work involved and whether or not it is combined with some degree of liposuction. After the incision is made, the abdominal skin above the umbilicus is lifted. The umbilicus is cut free from this skin and left on its attachment. This is later brought out through a new incision. The abdominal muscles are tightened by pulling them close together and stitching them into their new position. This provides a firmer abdominal wall and narrows the waistline. Excess skin and fat are removed and the incision is closed. An abdominal binder or compression garment is placed to support the abdomen and help to decrease swelling during your recovery.
In a partial abdominoplasty, or “mini tummy tuck,” the skin is separated only between the incision line and the belly button. This skin flap is stretched down, the excess skin is removed, and the flap is stitched back into place. A partial abdominoplasty may take an hour or two.
Although there will be some soreness and discomfort, Dr. Wright will prescribe medications that will help make you feel more comfortable. Drain tubes are left in place for approximately one to two weeks after surgery. Showering is permitted with the drain tubes. During your recovery, you will remain somewhat flexed at the waist and the knees to feel comfortable and to minimize tension on your incision, but you will start walking as soon as possible. The abdomen feels “tight” for several weeks after surgery. Numbness is common in certain areas and may be permanent for some.
Heavy lifting, aerobic activity, and vigorous exercise should be avoided for six to eight weeks. Lifting should be limited to fifteen to twenty pounds during the first six weeks. Some people return to work after two weeks, while others take three or four weeks to rest and recuperate. Exercise will help you heal better. Even people who have never exercised before should begin an exercise program to reduce swelling, lower the chance of blood clots, and tone muscles. Vigorous exercise, however, should be avoided until you can do it comfortably. Resuming activities will be discussed with you on an individual basis. The scar begins to fade two to three months later and may take one to two years to reach its final appearance. Swelling will resolve within six weeks by 75 percent, and the remainder will be gone after six months.
WHAT ARE THE RISKS?
There are risks in any surgical procedure. Post-operative complications such as infection and blood clots are rare, but can occur. Infection can be treated with drainage and antibiotics. You will remain on antibiotics as long as you still have the drain. You can minimize the risk of blood clots by moving around as soon after the surgery as possible. Poor healing, which results in conspicuous scars, may necessitate a scar revision. Smokers should be advised to stop smoking, as smoking may increase the risk of complications and delay healing. You can reduce your risk of complications by closely following your instructions before and after the surgery, especially with regard to when and how you should resume physical activity.
- Have someone drive you home after surgery and help you at home for 1-2 days.
- Get plenty of rest.
- Follow balanced diet.
- Decreased activity may promote constipation, so you may want to add more raw fruit to your diet, and be sure to increase fluid intake.
- Take pain medication as prescribed. Do not take aspirin or any products containing aspirin until approved by your physician.
- Do not drink alcohol when taking pain medications.
- If you are taking vitamins with iron, resume these as tolerated.
- Do not smoke, as smoking delays healing and increases the risk of complications.
- You may shower 48 hours after removal of all drainage tubes.
- Avoid exposing scars to sun for at least 12 months.
- Always use a strong sunblock, if sun exposure is unavoidable (SPF 30 or greater).
- Keep steri-strips on (when applicable).
- Keep incisions clean and inspect daily for signs of infection.
- No tub soaking while sutures or drains are in place.
- Wear you compression garment 24/7 for 6 weeks post op.
- Place daily soft dressing over incisions and around drain sites to wick away moisture and to prevent irritation by garment along the incision line
- Sleep with head slightly elevated and pillows under your knees to decrease tension on your incision.
WHEN TO CALL
- If you have increased swelling or bruising.
- If swelling and redness persist after a few days.
- If you have increased redness along the incision.
- If you have severe or increased pain not relieved by medication.
- If you have any side effects to medications; such as, rash, nausea, headache, vomiting.
- If you have an oral temperature over 100.4 degrees.
- If you have any yellowish or greenish drainage from the incisions or notice a foul odor.
- If you have bleeding from the incisions that is difficult to control with light pressure.