An abdominalplasty other wise known as a Tummy Tuck, will flatten a protruding belly by tightening the muscles of the abdominal wall. It also removes the skin and excess fat making the abdomen flat and tight. This is a very satisfying surgery. Everyone wants a flat, youthful abdomen. There are variations of a tummy tuck depending on the degree of excess skin, fat and protrusion of the belly. The procedure is done in the office surgery suit either under general anesthesia or local anesthesia depending on exactly what was needed.
This surgical procedure can be performed in two ways: a full tummy tuck (complete tummy tuck) or a mini-tummy tuck (partial tummy tuck). This, of course, depends on your condition. Even if you are committed to a good diet and regular exercise, the excess fat that can accumulate in the abdominal area may just sit there and drive you crazy. The type of patients who most commonly undergo tummy tuck surgery are women left with a protruding belly after having multiple pregnancies.
Complete Abdominoplasty (Full Tummy Tuck):
- An incision is made from hip to hip just about the pubic area.
- Another incision is made to free the navel from the surrounding skin
- The skin is detached from the abdomin wall to reveal the muscle and tissue to be tightened. Then the muscle fascia wall is tightened with sutures
- Liposuction is often used to refine the transition zones of the abdominal sculpture
A dressing or sometimes a compression garment are applied and any excess fluid from the site is drained.
Partial Abdominoplasty (Mini Tummy Tuck)
- A smaller incision is made
- The skin and fat of the lower abdomen are detached in more limited fashion. The skin is streched down and excess skin removed
- Liposuctions is often used to contour the transition zone
- The flap is stiched back into place
- If the storage of excess fat is predominantly in your lower abdomen, a mini-tummy tuck may work out best with improving the appearance of loose, stretched-out skin. This technique is often done on an outpatient basis allowing for a quicker recovery period than with a full tummy tuck. Because a small, horizontal incision is made just above the pubic region, the discreetly-placed scar can be covered with clothing. To lose your pouch in the lower abdomen, the excess skin is cut and removed while the remainder is stitched back together for a firmer look and feel.
As compared to a fully tummy tuck, this minimal technique allows the navel to remain intact. A mini-tummy tuck can take about one to two hours, while complete abdominoplasty may take about two to five hours.
For both the mini and full techniques, you may receive general anesthesia or local anesthesia with a sedative. Dr. Hochstein commonly performs liposuction in conjunction with your tummy tuck technique in order to remove extra fat; this will help to contribute to a smoother abdominal profile. For more information about your options with abdominoplasty, please call our office to make an appointment for an initial consultation.
Partial Abdominoplasty (Mini Tummy Tuck)
- People close to their ideal body weight (within 30%)
- Is in good health and relatively good shape, but still has a large fat deposit or loose abdonminal skin that is diet and excercise resistant
- Weight has been stable for about 6 months or more
- Has good skin tone and elasticity
- Need to be in an emotionally stable state of mind
- Understands the risk that come along with surgury
- Helpful to women who have experienced pregnancy and they are having a hard time returning to normal shape through exercise and diet
- Men & women who have lost a great deal of weight but seem to still pocess a great deal of excess skin
General Facts Regarding Abdominoplasty ("Tummy Tuck”) Surgery
These informational materials presented to you is to aid you in making the decision regarding possible Tummy Tuck (Abdominoplasty) Surgery. This online information is not meant to be a substitute for personal interest or attention. Each patient’s procedure always receives individual thought, planning and care.
Please read this information carefully and review it several times at your leisure. Please discuss any questions or comments relating to this information with Dr. DiGeronimo prior to making any FINAL DECISION TO ASSURE COMPLETE UNDERSTANDING OF ALL THE INFORMATION INVOLVED.
Abdominoplasty or “Tummy Tuck” is a surgical procedure to remove excess skin and fatty tissue from the middle and lower portions of the abdomen as well as tighten the underlying musculature. It can tighten stretched/wrinkled skin and result in a firmer, flatter abdominal appearance and a narrower waistline.
Abdominoplasty is not a substitute for weight reduction and is not meant as a treatment for obesity. The ideal candidate for Abdominoplasty is relatively normal in weight with weak abdominal muscles and excess skin and fat of the lower abdomen. Frequently, diet and exercise alone cannot correct certain conditions, particularly when underlying muscles as well as skin are stretched, as often occurs after multiple pregnancies. Loss of skin elasticity which frequently occurs with slight obesity in older patients, or extreme fluctuations in weight can result in loose, stretched hanging skin and fat in the lower abdomen. These conditions can usually be markedly improved with this procedure. Abdominal wall hernias can sometimes be a complicating factor which will also be corrected during the surgery.
It is important to realize that if significant amounts of stretch marks are present, abdominoplasty may not remove all of them. Only the stretch marks on the excess or hanging skin will be removed. This may even leave in place the majority of stretch marks, however, there will be a flatter and firmer lower abdomen.
An ideal candidate is also free of any complicating pre-existing medical conditions including heart disease, hypertension, diabetes, skin/connective tissue disorders, etc.
This surgical procedure always results in a transverse scar completely across the lower abdomen, just above the pubic area. The exact location of the incision will depend upon several factors which include the “bikini” line (French cut or high waisted vs the traditional cut), as well as each person’s individual requirements. This will be decided on an individual basis. There will also be a scar around the belly button (umbilicus) as this is made free from the surrounding skin to allow removal of the excess and loose skin. After the skin and fat are separated from the abdominal wall, from the transverse incision across the lower abdomen to the lower portion of the rib cage, the underlying abdominal wall and muscles are tightened with sutures (stitches). The elevated skin is lowered and the excess removed. The belly button (umbilicus) is then reinstated. The incisions are closed with sutures and a dressing as well as an abdominal binder — loosely fitted – is applied. The dressings and abdominal binder will generally remain in place for approximately ten days, after which time the external sutures will be removed. However, the patient will continue to wear an abdominal binder for three to six weeks following the surgery. After that time, light abdominal support is recommended for two to three months.
In selected cases, a less extensive procedure with skin and fat being separated from the abdominal wall, from the lower transverse incision across the lower abdomen just above the pubic area to the level of the belly button (umbilicus), or just above, may be performed. In this case, an incision around the belly button (umbilicus) may not be necessary and tightening of the abdominal wall and muscles may or may not be done depending upon the individual requirements of the patient.
Although every effort will be made to minimize the scarring, abdominoplasty scars are permanent.Generally, within three to six months (of up to one year) the scars will flatten and lighten in color.
The surgery may be performed in a hospital or in an outpatient surgical facility. It is usually performed under general anesthesia. The anesthesia is administered
by a D.O./M.D. Anesthesiologist or by a nurse anesthetist (CRNA) under the supervision of a D.O./M.D. Anesthesiologist.
The patient generally remains in the hospital or recovery facility for two to three days following the surgery. The patient must remain in bed with his/her head, shoulders and back elevated and hips bent (two or three pillows under the knees) in order to keep tension off the abdominal area.
In certain instances, “drains” are placed in the incision areas. Generally, they do not create additional discomfort and are easily tolerated by the patient. The “drains” are generally removed on the second or third day following the surgery.
After the surgery you will experience swelling, soreness and pain in the upper and lower abdominal region. This may be relieved with the prescribed pain medication.
The exact degree of improvement is unpredictable and cannot be determined with certainty prior to the surgery. Patients must also understand that no plastic surgical procedure can be expected to produce a perfect result or achieve complete correction of a particular problem. Significant improvement is the goal. Complications and poor healing can occur with any procedure leading to cosmetic deformity, medical complications and less improvement than anticipated or desired. For these reasons no guarantee of precise appearance or result of surgery can be given.
As with any surgical procedure, there are potential risks and complications or problems. These include, but are not limited to, potential complications or problems from the surgery itself and reactions to anesthesia and medications used before, during and after the surgery. Other complications include, bleeding, infection, blood clots, and emboli (blood clots or even fat that may dislodge and travel in the blood stream to distant sites which may be fatal). More specific complications associated with this surgery include poor, uneven or delayed healing which may result in more conspicuous scars. Skin loss or “slough” resulting in delayed healing and conspicuous scars is also an infrequent but potential complication.
Certain medical conditions and prescribed medications may also increase the possibility of complications associated with abdominoplasty (tummy tuck) surgery. These medical conditions include, but are not limited to, diabetes, high blood pressure, circulation or heart abnormalities, lung or pulmonary abnormalities and certain blood and blood cell disorders. Smoking also increases the risks and complications associated with this surgery and patients must stop smoking at least two weeks prior to the surgery to lessen these risks.
These and other complications/deformities may require additional procedures to attempt correction. These procedures would, of course, involve additional surgery, risk and expense.
All of the above factors should be fully understood and discussed prior to making any final decision to undergo abdominoplasty (tummy tuck) surgery.
To Prepare for Surgery
1. Every patient must have a written medical clearance from his/her family physician with the following:
a) a history and physical and a letter stating that he/she is in good physical condition and able to undergo the surgery.
c) Electrocardiogram if you are forty years of age or older or have cardiac problems
2. Do not take any aspirin or medications that contain aspirin, Advil, Motrin, Ibuprofen or Vitamin E for two weeks prior to surgery and for two weeks following surgery. Tylenol or Extra Strength Tylenol may be taken as needed. Please refer to the list available from the office of aspirin related products to make sure you avoid them for at least two weeks prior to surgery.
3. Patients who smoke must refrain from doing so for at least two weeks prior to surgery and two weeks following surgery. Smoking will increase the risks and possible complications associates with surgery, healing and with anesthesia.
4. If you take any medications such as for your heart or high blood pressure pills, diabetes medication, birth control pills, etc., please be sure to discuss these with Dr. DiGeronimo. You will be given special instructions regarding the taking of these medications prior to the surgery. If you are going to a recovery facility following the surgery, bring all the medications with you on the day of surgery.
5. At least two weeks prior to surgery begin taking 1000 mg of Vitamin C, 50mg of Zinc, 200 mg of Bromelain and a multi-vitamin that contains No Vitamin E on a daily basis.
6. If you wear dentures, please discuss this with Dr. DiGeronimo.
7. On the night before surgery be certain to take all medications that you have been instructed to take.
8. On the night before surgery take a shower and wash your hair. This should be repeated on the morning of surgery.
9. DO NOT HAVE ANYTHING TO EAT OR DRINK INCLUDING WATER after midnight the night before the surgery unless otherwise instructed by Dr. DiGeronimo.
10. If you are not returning home following the surgery, bring with you an overnight bag in which you have changes of underwear, a fresh robe which opens all the way down the front or pajamas which open all the way down the front, slippers without heels, toiletries and ALL MEDICATIONS.
11. Please be sure to provide the office with the name of someone to contact if necessary. If you are not going to a recovery facility or are not staying overnight in the hospital, please make arrangements to have a responsible adult drive you to and from the surgery and spend at least the first night with you.
The Day of the Surgery
1. As previously stated, shower the morning of the surgery.
2. Brush your teeth (using a very small amount of water) and use a mouthwash on the morning of surgery.
3. Do not wear any makeup, hair spray, jewelry, pantyhose or stockings on the morning of surgery. Leave all valuables at home.
4. If you wear dentures please be certain to advise the anesthesiologist, the nurse and Dr. DiGeronimo that you have dentures in place.
5. Please be prompt. Please be sure you have followed all the instructions. Preparations will begin when you arrive.
6. When you arrive for surgery, you will change into a gown. An Intravenous line will then be started in your arm and you may be given some medications through the intravenous line.
7. Surgery time varies with each patient. Please inform your family and friends that you will be with us for several hours.
After the Surgery
1. After the surgery is completed dressings and an abdominal binder will be loosely applied. These will remain in place for approximately ten days after which time the external sutures (stitches) will be removed. However, you will continue to wear the abdominal binder for three to six weeks following the surgery. After that time, light abdominal support is recommended for two to three months.
2. You are to remain in bed for 24 to 48 hours with your head and shoulders elevated on two or three pillows and your hips bent by placing two or three pillows under your knees with bathroom privileges with assistance only.
3. DO NOT LAY FLAT OR SIT IN AN ERECT POSITION UNTIL INSTRUCTED TO DO SO BY DR. DIGERONIMO. This helps to keep tension off the abdominal area.
4. Discomfort or pain in the upper and lower abdominal region may be expected. This may be relieved with the prescribed pain medication.
5. Take all prescribed medications.
6. Remain as quiet as possible for the first 48 hours following the surgery.
7. You may have moderate amounts of liquids and soft foods as desired and tolerated the first night following the surgery. The following day you may resume a normal diet. No alcohol for period of seven days following the surgery.
8. No bathing or showering until instructed by Dr. DiGeronimo.
9. No lifting, bending, squatting, stretching, sunbathing, overheating, excessive walking or any form of exercise until instructed by Dr. DiGeronimo.
10. If you experience excessive swelling, bleeding, pain or fever, contact the office immediately.