Q. What is an abdominoplasty or “tummy tuck”?
A. Many women and men have a tendency to accumulate fat in the lower tummy. Multiple pregnancies, C-sections, hysterectomies, and weight gains and losses take a tremendous toll on a person’s figure, especially in the lower stomach area. Repeatedly stretched and scarred, many woman’s bellies are loose, pouchy, and out-out-of-shape. An abdominoplasty or “tummy tuck” is a procedure designed not only to remove excess skin and fat, but also to tighten the muscles of the belly which have loosened and stretched over time. It is occasionally combined with liposuction and can have a dramatic effect on the contour of the mid- and lower-tummy, hips, and buttocks area
Q. What results can I expect from this procedure?
A. Most women drop 2 to 3 clothing sizes after a tummy tuck and assume a trimmer, more fit figure and a flatter, smoother abdomen. Some also experience a tremendous emotional boost and go on to lose even more weight. Their self-esteem is lifted to the point where they become motivated to look even better. Many say they feel younger because they see themselves in a better light—they have a new outlook to go with their new figure.
Q. Do I need to lose weight before surgery?
A. This operation is not a substitute for a good weight reduction or fitness program. It is designed for those who have gone that route with minimal or no results. It is not essential to lose weight before this operation. This operation frequently removes excess fat and skin which can not be removed with either exercise or diet. I do recommend, however, thatyou maintain a balanced, nutritional diet and a regular exercise program both before and after this procedure.
Q. How much weight will I lose after this procedure?
A. Weight loss averages between 5 and 8 pounds of fat and skin. However, it can be as high as 12 to 16 pounds and as low as 2 pounds, depending on your shape before surgery.
Q. Will insurance cover this surgery?
A. Sometimes there is an opening or weakness between the muscles of the belly called a hernia. In addition, some patients experience frequent bouts of dermatitis or skin irritation under an apron of skin and fat that hangs down over the pubic region. These are serious medical conditions which can be improved by an abdominoplasty. Coverage by your insurance company will, of course, depend upon your particular plan, but if the above-mentioned medical conditions are present, insurance companies may sometimes pay for at least a portion of the procedure.
Q. Can this operation be combined with other types of plastic surgery?
A. Yes, I have combined this procedure with liposuction, breast augmentation, breast reduction routinely. Other procedures have been included if possible. Combination surgery depends on the general health and age of the patient and must be determined on an individual basis.
Q. Is a tummy tuck painful?
A. This depends upon the patient’s individual tolerance for pain, but most report discomfort, not pain, for the first two days after surgery. This discomfort is readily relieved with pain medication. Usually by day 5 or 6 after surgery, no pain medication is needed.
Q. Will I have a scar?
A. Unfortunately, to make an omelet, we must first break a few eggs, so the answer is yes. However, I try very hard to place the incision where the scar will be inconspicuous. In a standard tummy tuck, the incision is placed just inside the pubic hairline, and the scar is easily hidden by a bikini panty or swimsuit.
Q. What should I do to prepare for this surgery?
A. You must avoid aspirin for 4 weeks before and two weeks after the procedure. You need to avoid garlic, vitamin E, alcohol, Chinese food (and MSG), Indian food (and curry powder), and the medications in the “Drugs to Avoid” handout.
You must not smoke or be around other people’s cigarette smoke for 2 weeks before and after this procedure. I also recommend doing daily situps (10 to 20 per day) for 3 to 4 weeks before this surgery. You should also apply manual pressure to your belly and take 5 deep breaths at least 4 to 5 times a day for 3 to 4 weeks prior to having the procedure. I will demonstrate these exercises to you before your surgery. These exercises slowly adjust your body to the conditions you will experience after the surgery, and they help you recover much faster.
Q. Am I asleep during the procedure?
A. Yes. Tummy tucks are performed with intravenous sedation, also called “twilight anesthesia,” in most cases. Occasionally general anesthesia is necessary, but this depends on certain medical conditions and the anesthesia provider.
Q. How long will I be in the surgery center after the procedure?
A. You will be in the Renaissance Center for approximately 8 hours, between the operating room and the recovery room. Once you have met the critieria for recovery, you will be discharged to the “Spa,” where you will stay overnight in our very comfortable care facility. We provide a nurse to help with your needs during the night, and you can go home the next morning.
Q. Is there a smaller operation that might achieve the same results?
A. Yes. There are a significant number of patients for whom a full tummy tuck is too much and liposuction is too little to correct the problem. These patients generally have a tight, flat upper belly but a pouchy, loose section below the navel. For these patients, a procedure called a mini-abdominoplasty was designed. It differs from a full tummy tuck in that it requires a smaller incision and a shorter recovery period. It is also less expensive and does not require repositioning the navel. It is done as an outpatient procedure using twilight anesthesia. A private consultation can determine if you are a candidate for this procedure.
Q. Must I wear a special garment after surgery?
A. Yes. This is a compression garment which helps to reduce swelling and gives support to your belly. It also makes for a faster, smoother recovery period and is usually worn for 2 to 3 weeks after the procedure. it will not interfere with bowel or bladder function. It will be removed during your first postop visit.
Q. When can I urinate, move my bowels, and cough afterwards?
A. For several hours after this procedure, most of my patients have a urinary catheter in place because it allows urination without the patient having to get up during the night of surgery to go to the bathroom. This catheter is inserted while you are asleep and is painlessly removed the next day. This operation does not interfere in any way with bowel movements. Excessive ingestion of narcotics after surgery, however, can cause constipation. If for any reason you must cough during the first few days after this procedure, I recommend that a pillow be held over the belly to relieve pressure on the muscles.
Q. When are the stitches taken out?
A. I use absorbable sutures, so it is not necessary to remove them. They all absorb into the body over time. All surgical dressings are removed at the first postop visit.
Q. When can I go back to work?
A. Most patients can return to work 10 days after surgery at least on a part-time basis. By 3 weeks after surgery, a full work load can usually be resumed. But it is advisable to arrange for help with small children, errands, housework, or any activity that requires lifting during the recovery period.
Q. Will I be able to do sit-ups normally after the surgery?
A. I ask my patients to walk slightly hunched over for 2 to 3 days after surgery to prevent tension on the incision. Then they may gradually straighten up as the belly skin becomes adjusted to the new body contour. But sit-ups and all forms of exercise such as aerobics and weight-training must wait until healing is complete (3 to 4 weeks). At that time, and after receiving an okay from me, your normal exercise routine can be resumed.
Q. What are the possible complications of having a tummy tuck?
A. As with any surgery, certain complications can arise. Modern anesthesia and surgical advances, however, have made the tummy tuck a safe and effective procedure. In addition, I give all my patients antibiotics before and during surgery to help prevent infection. I may advise vitamin C three weeks afterward to help with healing. I use a meticulous surgical procedure that places as little tension on the skin as possible so that healing can take place most often without a problem, and scarring is minimal.
Despite all these precautions, there is still an occasional patient who develops a complication. The most common complications include bleeding, infection, vein clots, skin slough, and wide scars. Each of these complications can be corrected. For the vast majority of patients, this operation goes smoothly and produces excellent results.