Tummy-tuck surgery or abdominoplasty, can flatten your abdomen by removing loose, excess fat and skin and tightening muscles in the abdominal wall. It can also remove some if not all of the stretch marks in your lower abdomen. It is popular following pregnancy, massive weight loss or whenever a flabby abdomen with weak muscles impairs body contour. Most patients report improved self-esteem as a result of this procedure.
When to consider a Tummy Tuck
- 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.
Are you a Good Candidate for a 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 tummy tuck:
- Aging, heredity, pregnancy, prior surgery or weight fluctuations have left you with extra skin on your abdomen, abdominal muscle weakness, or both.
- 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 tummy tuck.
- 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.
How is a Tummy Tuck Performed?
In this surgical procedure, the surgeon will remove your loose abdominal skin and tighten up your abdominal muscles with sutures.
- The 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 tummy tuck 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-tummy tuck, the 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, the 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, the 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. The surgeon cuts a hole through the redraped skin and sutures it around your navel.
- The surgeon will use sutures 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.
In addition to the incision across the lower abdomen, a traditional tummy tuck 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.
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, the surgeon will remove excess skin and tighten slack muscles. The ideal candidate for a mini-tummy tuck has laxity and protrusion below the navel. A mini-tummy tuck 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 tummy tuck 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 tummy tuck 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.
What will my Tummy Tuck 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. The 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-tummy tuck, 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-tummy tuck 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.
During your consultation, you will have the opportunity to discuss your cosmetic goals. The surgeon will evaluate you as a candidate for tummy-tuck surgery and clarify what approach is best for you.
You should come to the consultation prepared to discuss your complete medical history and answer the following questions:
- Do you have any medical conditions or drug allergies? Are you being treated for any medical conditions?
- Have you had any previous surgeries?
- What are your current medications and vitamin and herbal supplements?
- What is your current use of alcohol, tobacco and recreational drugs?
- What is your history with any noninvasive cosmetic procedures?
- What outcome do you expect from the surgery? What is your chief motivation in undergoing an abdominoplasty?
The surgeon will also:
- Ask you to look in a mirror and point out exactly what you would like to see improved.
- Take photos for your medical record.
- Evaluate your health status, including preexisting health conditions or risk factors.
- Evaluate the elasticity of your skin.
- Discuss your ideal weight, realistic weight and current weight.
- Discuss your plans related to future pregnancies.
- Explain the type of procedure or combination of procedures
- Explain outcomes that you can anticipate.
- Explain options for anesthesia.
- Explain what you can expect to experience after surgery.
- Show before-and-after photos of cases similar to yours and answer any questions
- Explain associated risks and complications.
On the Day of Tummy Tuck Surgery
The 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. Epidural anesthesia combined with sedation may be an option or you will receive general anesthesia. An anesthesiologist 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.
- The plastic surgeon will follow the surgical plan discussed with you before surgery. Once the surgery has begun, the surgeon may decide to combine various techniques or change a technique to ensure the best result.
- 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.
- You will spend one night in the private hospital.
Aftercare, Follow-up Checks and Recovery
The doctor will explain how long it will be before you can return to your normal level of activity and work following tummy tuck. After surgery, you will receive detailed instructions about your postsurgical care, including information about:
- Drains, if they have been placed
- Normal symptoms you will experience
- Any potential signs of complications
Immediately after Tummy Tuck
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.
- Immediately following an abdominoplasty, expect your abdomen to feel very sore or tender. Any pain you feel can be controlled with pain medications.
- Most tummy tuck patients require several days of bed rest.
- 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.
- The surgeon prefer to use absorbable sutures which need not have to be removed.
- The surgeon will provide you with detailed instructions for about your drains, bandages, and showering during recovery.
- Common side effects experienced by abdominoplasty patients include redness, bruising, and swelling. These effects usually subside in one to six weeks as your body adjusts to the new contours and the incisions heal. Please note that total physiological healing takes 6 months with tummy tuck operation. It is expected to become normal only at the end of the 6 months.
Recovery Process after a Tummy tuck
Recovery from a tummy tuck 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 seven days after surgery or while you are taking pain medication.
- 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 the 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 have your follow-up with your surgeon while you are staying in Turkey. During this visit, the doctor can remove the drains. Swelling should subside within five weeks.
- You should inform us 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-tummy tuck, and for those who are combining a tummy tuck 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.
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.
The aim of this article is to give you a general information about the surgical intervention in question. You need to make more research about possible complications and risks of this selected procedure in order to make an informed decision. Please note that complications occur more frequently with patients who are obese, smoke, and have a history or lung or other chronic underlying medical conditions.
Smokers are recognized to have a significantly higher risk of post operative wound healing problems with a subsequently higher potential of infection as well as operative and post operative bleeding. Patients should discontinue smoking for two weeks before and two weeks after surgery. Although it helps to stop smoking before and after surgery, this does not completely eliminate the increased risks resulting from long term smoking. Smoking also has a long term adverse effect on the skin and ageing process.