"Tummy Tuck" or Abdominoplasty
is a surgery which removes excess skin and fat from the abdomen, and tightens the abdominal muscles. Abdominoplasty can significantly improve the contour of the abdomen, flattening the protruding belly which is commonly associated with aging, obesity and pregnancy.
The best candidates are those men and women who are in relatively good shape, but have excess fat or loose skin and muscles of the mid/lower abdomen. Patients who are somewhat overweight may still be good candidates for abdominoplasty, but patients who plan to lose a large amount of weight should attempt weight loss prior to surgery.
Abdominoplasty may be particularly useful for patients who have lost abdominal tone after pregnancy, and for patients who have already lost large amounts of weight after dieting or obesity surgery, but are left with loose skin and muscles.
Abdominoplasty is often performed under general anesthesia, though in some cases the surgeon may use a local anesthetic combined with sedation. The surgery usually lasts several hours, and an overnight stay is usually required. Depending on the patient and the extent of the surgery, a longer hospital stay may be necessary.
In performing abdominoplasty, an incision is made in the lower abdomen just above the pubic area. The length of the incision depends on the amount of tissue which will need to be removed, and may vary from a smaller "Bikini line" incision to a much longer incision which extends from hip to hip.
Another incision is typically made around the umbilicus ("belly button"), freeing it from the surrounding skin. The surgeon then elevates the skin of the abdomen, and tightens the abdominal muscles. Excess skin and fat are removed, and the remaining skin stretched downward to flatten the abdomen and close the surgical site.
The umbilicus is properly positioned prior to closure. Temporary drainage tubes are often placed to remove excess fluid which may develop after surgery, and these are removed within a few days. Pain and discomfort following the surgery are controlled with medication.
An elastic "abdominal binder" or support garment may be used for several days to a few weeks following the surgery, and this helps to control swelling and discomfort. Most stitches are removed within one week after surgery, and within two to three weeks most patients can return to work.
Some bruising, swelling and discomfort may persist for longer periods of time, depending on the exact nature of the surgery and the patient. The scar from the incision(s) will typically fade over time, becoming more flat and pale. This process may take six months to a year or more. While such scars never disappear, most can be covered with a bathing suit.
"Mini-abdominoplasty" may be used in patients with modest abdominal laxity and/or excess skin. This procedure involves a smaller incision above the pubic area only, and can often be performed as an outpatient.
In some cases, fat removal though the use of liposuction will not correct a body contour problem. Such patients frequently have extra skin as well as fat tissue. Small amounts of extra skin are typically not a problem but for patients with a moderate or excessive amount of extra skin, it must be surgically removed to improve the appearance of this area. These procedures are also effective for patients who were once very overweight but have lost some of the fat tissue but not the skin overlying it. Procedures that remove both fat and skin are types of body lifting procedures. Almost any location can be treated by body lifting but typically these procedures are performed on the trunk, abdomen, legs or arms.
Patients undergoing these procedures may require a general anesthetic and in some cases an overnight stay in the hospital. Because of the varied nature of such operations, an individualized consultation must be obtained to determine if this procedure is right for you.