All you should know about Abdominoplasty (tummy tuck) surgery
What is Abdominoplasty (tummy tuck)?
Abdominoplasty, or tummy tuck, is a cosmetic surgery to improve the shape of the tummy area (abdomen).
It can involve removing excess loose skin, fat and stretch marks and tightening the abdominal muscles. It is sometimes combined with liposuction to help shape the abdomen. The results can be long lasting, particularly if you keep to a healthy weight after your surgery.
It is popular following pregnancy, massive weight loss or whenever a flabby abdomen with weak muscles impairs body contour.
It’s not a quick fix for losing weight as the procedure is usually only recommended for people with a healthy body mass index (BMI).
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When to consider an Abdominoplasty
. If you’ve got flab, stretch marks or excess skin in your abdomen that does not improve with diet or exercise.
. If the shape of your abdomen has been affected by pregnancy or massive weight loss.
. If you feel that your protruding abdomen is unattractive.
. If your self-confidence is marred by your stomach contour.
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Preparing for an Abdominoplasty
How should I prepare for an Abdominoplasty procedure?
Your surgeon will provide thorough pre-operative instructions, answer any questions you may have, take a detailed medical history and perform a physical exam to determine your fitness for surgery.
In advance of your procedure, your surgeon will ask you to:
. Stop smoking well before undergoing surgery to better promote healing.
. Avoid taking aspirin, certain anti-inflammatory medications and some herbal medications that can cause increased bleeding.
. Regardless of the type of surgery to be performed, hydration is very important before and after surgery for safe recovery.
. If he or she recommends weight benchmarks or lifestyle changes, do your best to achieve them to ensure the best results and minimize the chance of complications.
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Prepare your home for your recovery before surgery:
. If you have children, arrange for them to be cared for.
. If you will not have someone to prepare every meal, have easy-to-reheat meals on hand or cook your own and freeze them for heating up later. Choose healthful meals and snacks.
. Place all of your food and toiletries within easy reach, preferably at hip level, so that you do not have to reach, bend over or climb up to get them.
. Purchase several bags of frozen peas, usually three “sets” of what you will require for icing your surgical area.
. Have an area set up on your nightstand for your medications, with a medication organizer (with day and time dose compartments) and a written backup schedule/check list.
. Place several bottles of water and plain, low-sodium crackers on your nightstand.
. Place Wet-naps, Kleenex and a roll of paper towels within reach.
. Place a digital thermometer near the bed so that you will be reminded to take your temperature.
. Make sure your remote controls have fresh batteries or are fully charged.
. Have plenty of reading materialand movies ready in advance so that you will have something to do when you are not sleeping.
. Have your cellphone, charger cord and a power supply nearby as well. You can use your cellphone in an emergency and also to call or text your caretaker.
. Set up your bed with plenty of pillows, including body pillows. If you have a recliner, you may wish to sleep there instead.
Whether your surgery is performed on an inpatient or outpatient basis and whether you stay overnight at a recovery center is based on many variables, including your medical issues, the amount of surgery you will undergo, the length of time your surgery takes, other procedures that may be performed at the same time, and the availability of your caregiver at home. Your board-certified plastic surgeon is your best guide. If you go home the same day, be sure to arrange for someone to drive you home after surgery and to stay with you for at least the first night following surgery.
What can I expect on the day of Abdominoplasty surgery?
Your Abdominoplasty surgery may be performed in a hospital, free-standing ambulatory facility or an office-based surgical suite. Your surgeon will give you an estimate of how long your surgery will last based on the details of your surgery.
. You will receive medications to keep you comfortable during the surgical procedure. Local anesthesia combined with sedation may be an option or you will receive general anesthesia. An anesthesiologist or nurse anesthetist will be present to administer sedatives or general anesthesia and assist in monitoring.
. For your safety during the surgery, various monitors will be used to check your heart, blood pressure, pulse and the amount of oxygen circulating in your blood.
. Your plastic surgeon will follow the surgical plan discussed with you before surgery. Once the surgery has begun, he or she may decide to combine various techniques or change a technique to ensure the best result. It is important that you feel comfortable and trust your doctor to make these decisions.
. The surgical dressings used will depend on the procedures you undergo. Surgical drains may also be placed.
. After surgery, you will be taken into a recovery area, where you will continue to be closely monitored.
. Before leaving for home, you (or someone looking after you) should feel comfortable emptying and resetting your drains.
. You may go home on the day of surgery or spend one or two nights in an aftercare center with a nurse, unless you and your plastic surgeon have made other plans for your immediate post-operative recovery. * Under no circumstances will you be permitted to go home alone or stay home without another adult present. Follow your doctor’s recommendation in relation to this decision.
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What are the Advantages and Disadvantages of Abdominoplasty?
. Tummy-tuck surgery will restore a flat tummy that is rigid and well set.
. It helps to trim the waist to one’s desired size.
. You will have a more youthful-looking body, which will show better in clothes and swimwear.
. The surgery eliminates unwanted skin lesions and the skin imperfections that exists on the stomach.
. It can be used along with the other clinical methods like liposuction to multiply the benefits on the body.
. Stretch marks can be found in both men and women. They appear as a result of the skin either growing or reducing in size. These marks are visible on particularly those who undergo weight loss programs and pregnant women. Stretch marks can be reduced or eliminated by the Abdominoplasty procedure and it helps in the process of increasing the skin quality of the people.
. It improves the psychological well-being of the patients who are dissatisfied by their current body shape.
. No risks can be associated with the combination of Abdominoplasty procedure and the other clinical procedures.
. The removal of the skin that is in excess does not cause the infections that occur in the folds of skin (that otherwise occur due to improper hygiene and sweating).
. You will have a permanent scar (located in the bikini area) that usually does not go fade, but this can easily be covered up by clothes, or even bathing suits.
. Another pregnancy may influence surgery results, so it is best to wait until you’ve finished having children before undergoing this procedure.
. This is an age-dependent outcome, hence it is important for you to understand all the possible outcomes and complications of the procedure before making a decision.
. Weight gain following abdominoplasty may negatively affect your surgery results.
Risks and Side effects
What are the Risks and Side effects of Abdominoplasty?
Fortunately, significant complications associated with Abdominoplastys are infrequent and the satisfaction rate is high. The overall complication rate is small if the operation is done by an experienced plastic surgeon operating in an accredited facility.
. There will be swelling which will obscure the actual result until the treated area is healed. This swelling can be controlled by bandages and compression garments.
. Standing and walking can be difficult in the first week after the surgery.
. The patient is likely to feel some pain and discomfort in the first couple of days after the surgery which can be dealt with by pain medication. Bruising is also a common complication.
. There may be fluid accumulation in the operated which can be drained by small pipes attached to the abdomen.
. Incision scars run from one end of the hip to the other. They heal over time but there is a risk of them not fading completely. Anti-scarring medication can help in this.
. Slight irritation around the incision sites where the ducts were inserted.
. Loose skin or ripple. The skin is usually pulled and pulled back after a few months. But in some people the skin may remain a little loose.
. Numbness or other changes in skin sensation
. Allergic reactions
. Damage to underlying structures
. Adverse reaction to anesthesia
. Hematoma or seroma (an accumulation of blood or fluid under the skin that may require removal).
. Poor wound healing
. Skin loss
. Skin discoloration
. Fatty tissue found deep in the skin might die (fat necrosis)
. Nerve damage
. Suture rupture
You can help minimize certain risks by following the advice and instructions of your board-certified plastic surgeon, both before and after your tummy-tuck surgery.
Who are the best candidates for an Abdominoplasty (tummy tuck)?
There comes a time when you realize that efforts at dieting and exercise are yielding lower numbers on your bathroom scale but not changing the appearance of your sagging and protruding abdomen. The following are some common reasons why you may want to consider a Abdominoplasty:
. Aging, heredity, pregnancy, prior surgery or weight fluctuations have left you with extra skin on your abdomen, abdominal muscle weakness, or both.
. You do not smoke. Smoking slows down the healing process and increases the risk of serious complications during and after surgery. If you smoke, you must quit at least six weeks before surgery.
. Your weight is stable. Slender individuals with extra fat and loose skin in the lower tummy are the best candidates; if you are generally obese, this procedure is not appropriate for you.
. If you have a significant amount of intra-abdominal fat surrounding your internal organs, you may need to slim down before considering a Abdominoplasty.
. You are physically healthy. You must be in relatively good physical shape to tolerate this procedure.
. You are finished having children. The muscles that are repaired during an abdominoplasty can separate again during future pregnancy.
. Internal or external scars from any previous abdominal surgery may also affect your candidacy.
If you are in good general health, have a positive attitude and realistic expectations, you are most likely a good candidate for this procedure.
Who should avoid undergoing Abdominoplasty?
. Pregnant women cannot undergo this procedure. However, pregnancy happens to be a major cause for women to undergo this procedure. Excess skin that becomes impossible to lose can be removed through abdominoplasty.
. Heart patients and individuals with circulatory disorders must refrain from undergoing this procedure unless cleared by their cardiologists.
. Individuals who have had major surgeries like kidney transplant, in the area in the past must be extremely careful as they have an increased risk of complications.
. Small, uncomplicated hernia repairs can be performed with an Abdominoplasty surgery.
. Smoking: Non-smokers are preferable, or smokers who quit at least six weeks before surgery.
. Amount of intra-abdominal fat surrounding your internal organs: You may need to slim down before considering a Abdominoplasty.
. Intention of having more children: Muscles repaired during an abdominoplasty can separate again during future pregnancy.
Important things to know about Abdominoplasty
. Women who are planning a pregnancy, people who can achieve results with exercise and people planning weight loss regimes should not undergo a Abdominoplasty surgery.
. Patients should adequately relax after this surgery and should take all the precautions that the doctor asks for. Patients generally need to give themselves 4 weeks to recover from a Abdominoplasty. They also need to take an approval from the doctor, before flying back to their country after this surgical procedure is performed.
. There are certain risks that are associated with this surgery like infection, scarring, persistent pain, possibility of revisional surgery, bruising, numbness, recurrent loosening of skin, fluid accumulation, blood clots, general allergy to blood anesthetics, fat necrosis (fatty tissue in the skin might die), and deep vein thrombosis, cardiac and pulmonary complications.
. The surgeon asks patients to sign consent forms to ensure awareness of the patient about how the procedure will take place and also about the associated risks. Therefore, one must be thoroughly informed about the surgery and must clarify any doubts that they might have.
. Certain Abdominoplasty procedures require the use of surgical drains. These help in the discharge of fluids during the recovery time. These are generally removed after 1-2 weeks. During this time, the patients should be very careful while taking a shower.
. A Abdominoplasty can take place in a hospital, an accredited office-based surgical facility, or a licensed ambulatory surgical centre.
. The patient should get a prior medical examination done and should inform the doctor of any health conditions or associated risk factors that he may have.
. Smoking, consumption of blood thinning and other herbal medicines should be stopped at least one week prior to the surgery.
. If the surgery is taking place on an outpatient basis, then one must arrange somebody to drive them at the place of rest and stay with them for the first night after the surgery.
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What are the different types of Abdominoplasty?
A personal consultation with your board-certified aesthetic plastic surgeon will determine the best option for you. Here are some different kinds of Abdominoplasty:
. Full Abdominoplasty
In addition to the incision across the lower abdomen, a traditional Abdominoplasty involves an incision around the navel. Excess skin is removed, muscles are tightened and liposuction may be used to contour the abdomen. This surgery removes skin from above the navel down to the pubic area that has been compromised by pregnancies, genetic laxity or obesity.
. Mini Abdominoplasty
If you only need a small amount of skin or fat removed, you can have a mini Abdominoplasty.
A single incision is made in the pubic area, which will be placed as low as possible and can range from a few inches to the entire span of your abdomen. Through this incision, your surgeon will remove excess skin, tighten slack muscles and possibly use liposuction to further refine the area. The ideal candidate for a mini-Abdominoplasty has laxity and protrusion below the navel. A mini-Abdominoplasty is usually recommended for those who have always been in fairly good shape but cannot achieve their aesthetic goals with diet and exercise.
. Extended or High Lateral Tension Abdominoplasty
If you have excess skin in the love handles or hips, your incision can be made longer to address this problem. The high lateral tension Abdominoplasty was one of the first procedures developed to address skin excess after significant weight loss or pregnancy. The technique uses a layer in the deeper tissue to support and maintain the repair. This procedure includes a Abdominoplasty in the front of the abdomen and transfers the lift over the hip to the side of the thigh to improve contour in this area, suspending and improving the hip and thigh. You can simulate the effect by grabbing the skin on the sides of your waist and pulling up as if you’re putting on a pair of pants.
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During the Procedure
How is an Abdominoplasty procedure performed?
In this surgical procedure, your surgeon will remove your loose abdominal skin and tighten up your abdominal muscles with sutures.
. Your surgeon will mark your abdomen to indicate the location of the incisions, the center of your torso and the location of the repositioned navel.
. A solution of lidocaine (a local anesthetic) and epinephrine (a vasoconstrictor that controls bleeding by constricting blood vessels) will be injected.
. The primary Abdominoplasty incision will be above the pubic mound, from one hipbone to the other. In a full abdominoplasty, another incision is made around your navel. In a mini-Abdominoplasty, your surgeon will use a shorter incision.
. The surgeon will loosen the skin from your abdominal wall to your ribcage and then place sutures in the fascia of your abdominal muscles to pull them into a tighter position. This is the muscle repair portion of the surgery.
. After your abdominal muscles have been sutured, your surgeon will remove excess fat by liposuction or other methods. Your abdominal skin is then stretched down over your incision line and the excess skin is removed.
. Next, your surgeon will mark the placement of your navel. Although the skin around your navel has been moved, the navel almost always stays in the same place. Your surgeon cuts a hole through the redraped skin and sutures it around your navel.
. Your surgeon will use tissue glue, sutures, staples or Steri-Strips to close the incisions.
. In a full abdominoplasty, the surgeon will often insert one or more drains to prevent fluid buildup, which can cause pressure on the incision. The drain is a clear plastic tube placed through a very short incision below the main incision, which leads out of the body to a small oval-shaped bulb. Each time you empty a bulb and before you close it again, you will be asked to squeeze it to help drain the wound.
The goal of your aesthetic plastic surgeon and staff is to help you achieve the best results and to make your surgical experience as easy and comfortable as possible.
Depending on what exactly you’re having done, the operation can take between two and four hours, but this may vary between surgeons.
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Aftercare and Recovery
Your doctor will discuss how long it will be before you can return to your normal level of activity and work following liposuction. After surgery, you and your caregiver will receive detailed instructions about your post-surgical care, including information about:
. Drains, if they have been placed
. Normal symptoms you will experience
. Any potential signs of complications
Immediately after your Abdominoplasty
You may expect the following immediately after the procedure:
. As the anesthesia wears off, you may feel dizzy, disoriented, and nauseated. These sensations should pass within a few hours, although some types of oral pain medications may cause these symptoms to recur.
. If you return home the same day, you will need someone to drive you. Depending on the extent of the procedure, you may be required to spend a night or two in the hospital recovering from surgery.
. Immediately following an abdominoplasty, expect your abdomen to feel very sore or tender. Any pain you feel can be controlled with pain medications.
. Most Abdominoplasty patients require several days of bed rest, even if they return home the same day as their surgery.
. Your incision site will be covered with a dressing to keep the area clean and protected. You will also be wearing a wide elastic compression garment to reduce swelling and provide support to the skin as it tightens. You will wear this garment for several weeks.
. Depending on the extent of your abdominoplasty, you may have tubes in your incision to drain away fluid. You will be asked to empty the drains a few times a day and keep track of how much fluid comes out. Drains are usually removed from three to fourteen days after your surgery, depending on how much fluid is coming out.
. If you have traditional sutures, these will typically be removed within the first week or two (absorbable sutures will not have to be removed).
. Your surgeon should provide you with detailed instructions for managing your drains, changing your bandages, and showering during recovery. You will also be told whether you can put any ointment on your incisions to reduce discomfort.
. Common side effects experienced by abdominoplasty patients include redness, bruising, and swelling. These effects usually subside in one to three weeks as your body adjusts to the new contours and the incisions heal.
Recovery time frame after an Abdominoplasty
Recovery from an Abdominoplasty procedure occurs over a period of six months or more. In the first couple of days, managing pain and avoiding complications is your top priority. The first week will be the worst, and you will still feel like you are recovering for about two to three weeks. After a few weeks, regaining mobility and fitness becomes important. After several months, you can start evaluating the aesthetic outcome of your surgery. It is important to remember that the time it takes to recover varies greatly among individuals.
. The first few days after surgery, you should rest quietly. Remember, you must not take aspirin or certain anti-inflammatory medications. To prevent coughing and bleeding, do not smoke after your procedure. Do not drink alcohol for five days after surgery or while you are taking pain medication.
. Arrange for someone to help you get around the house and help with your medication for at least the first two days after surgery.
. Make sure you continue to have lots of help at home—this cannot be stressed enough. You’ll be tempted to try to help around the house, but you won’t feel like yourself for at least seven to ten days and you still shouldn’t do any heavy lifting (such as picking up your children or baskets of laundry) for four to six weeks. If you have small children, you must put someone else totally in charge of their care for at least two weeks.
. Follow your surgeon’s instructions carefully. The first two days are the most uncomfortable, so if you are instructed to take medications at certain times, stay on the schedule. Discomfort typically drops down to a “nagging” level by five to seven days.
. You will likely go back for follow-up with your surgeon within five days. During this visit, your doctor can remove the drains. Swelling should subside within five weeks.
. Call your surgeon immediately if you notice an increase in swelling, pain, redness, drainage, or bleeding in the surgical area, or if you develop fever, dizziness, nausea, or vomiting. Other red flags include shortness of breath, chest pains, and an unusual heartbeat.
. You should be up and walking the day after surgery, although slowly. It is important to walk to discourage swelling and to prevent blood clots in the legs. However, avoid strenuous exercise for four to six weeks, because it can trigger unnecessary fluid retention in the treated areas.
. Plan to take about two weeks off from work, depending on the physical demands of your job.
. Make an effort to ease back into your normal routine gradually rather than all at once.
. The recovery period is typically longest for patients undergoing a traditional abdominoplasty, rather than a mini-Abdominoplasty, and for those who are combining a Abdominoplasty with other surgical procedures.
. Wearing your compression garment as directed reduces the likelihood of loose or sagging skin after an abdominoplasty. The compression garment also helps to control swelling, resulting in a shorter recovery period.
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What is the post-operative diet for an Abdominoplasty procedure?
. No specific diet is necessary. A healthy, well-balanced diet with adequate protein and exercise will help you maintain the results you get from the Abdominoplasty.
. Drink plenty of fluids and maintain good nutrition with adequate protein.
. Following recovery it is a good idea to make sure your caloric intake is balanced with your activity level.
. One suggestion is to substitute greens for grains.
. Do not eat processed and packaged foods. The sodium will make you swell.
. Do not drink soda. It will cause gas and bloating.
What will my Abdominoplasty incisions and scars be like?
The incision for a full abdominoplasty usually runs from hipbone to hipbone, and may be in a V-cut or U-cut shape, so that the scar can be hidden in a bikini. Your surgeon will determine the shape and length of the incision based on your preferences and the amount of correction you need. You may also have an incision around the navel.
With a mini-Abdominoplasty, the surgeon can place the incision as low as possible; it can be hidden in the pubic bone area. The abdominal skin that is removed is below the navel, and there are no incisions around the navel. The length of the mini-Abdominoplasty incision will vary based on how much skin your surgeon removes.
With a high lateral tension abdominoplasty, scars are longer and often higher than scars in more traditional abdominoplasties and mini- tummy tucks. It is common not to excise the umbilical (navel) site, because not as much skin is removed centrally.
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How long will the results last?
Barring another pregnancy or significant weight gain, your results should be permanent, although plastic surgery will not prevent the effects of normal aging. Once the skin is tightened, it will get a little looser as you age, but not much. However, if you gain and then lose a large amount of weight after a Abdominoplasty, the abdominal skin could stretch out again, negatively impacting the overall contour. Likewise, if you become pregnant your abdomen will loosen again. For this reason, it is best to wait until after you finish having children to undergo a Abdominoplasty. If you’re planning to lose weight, do it before the surgery.
Is an Abdominoplasty painful?
Recovering from a Abdominoplasty can be painful and generally a pain management program is recommended by the doctor. This should be seriously followed. It can take up to 4 weeks to recover fully and 6 weeks to be able to start exercising again. Usually the patients are not able to walk for the first week. You must give yourself as much rest as prescribed by the doctor.
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