Who is a Candidate for Abdominoplasty Surgery?

The best candidate for an abdominoplasty surgery is a person with a large fat deposit or loose abdominal skin that does not respond to exercise and diet. Patients should otherwise be in relatively good shape, physically healthy and psychologically stable. It's also important that patients have realistic expectations of what the procedure can offer. Tummy Tuck Surgery can be particularly effective when performed on patients following pregnancy or significant weight loss or on patients with weakened abdominal muscles, or older patients with decreased skin elasticity.

Patients anticipating future pregnancy or weight loss may want to wait until afterward for their tummy tuck surgery.

Before Abdominoplasty Surgery

At the initial visit, be specific about your wishes and expectations. If your surgeon fully understands your expectations, he will be able to determine whether your goals are realistic.

Your physician will evaluate your overall weight, your skin and muscle tone, and the distribution of fat deposits to determine if you qualify for an abdominoplasty and where incisions will be made and what results can be achieved. Your age, your skin type, thickness and texture, as well as your diet and level of regular exercise will all be important factors that will affect the final result.

Quick guide to pre-op Preparation

• Do not take aspirin or anti-inflammatory medications (your doctor can provide you with a list of OTC medications to avoid)
• If you smoke, quit smoking for at least 2 weeks pre-op (and anticipate no smoking for the recovery, smoking greatly increases your risk of complications)
• Obtain a copy of your doctor's protocol
• Make arrangements to have someone drive you to and from the operation
• Arrange for someone to care for you the first 24-48 hours after surgery
• Follow your physician's directions carefully regarding medications, eating & drinking, etc.

Abdominoplasty or Tummy Tuck Surgery

The exact nature of and amount of time needed for tummy tuck surgery will depend upon several factors, including the specific individual, the amount of work they require, and the surgeon's technique. In general, however, tummy tuck surgery typically takes between two and five hours to complete. A mini- or partial-abdominoplasty takes significantly less time, as little as two hours. Local anesthesia or general anesthesia is most commonly used.

For a complete or traditional tummy tuck, an incision is made from hipbone to hipbone just above the pubic area. A second incision is usually made around the navel and it may be connected to the lower incision to resemble an upside down 'T'. After the incisions are made, the surgeon will then separate the skin from the abdominal wall. The vertical muscles of the abdominal wall are usually tightened and excess skin and fat are removed. A new opening will be cut for the navel to be reinserted, and then the incisions are stitched closed. Dressings are typically applied over the incisions and drains may be temporarily placed at the incision sites to collect any excess fluid. Partial- or mini-abdominoplasty procedures follow the same general technique but with a much shorter incision and often without the second incision around the navel.

Recovery Time & Results

Recovery from liposuction can be uncomfortable, but most people are back to work within 10 days. During the first few weeks most people experience varying degrees of pain, burning, swelling and temporary numbness. Pain medications can alleviate discomfort (usually taken for 2 days - 2 weeks) and a body-compression garment will minimize swelling. You will need to refrain from any exercise other than walking for about a week after the procedure. Slowly work your way back to your old exercise routine.

Consider a massage therapist for lymphatic drainage massage to relieve swelling and possible itching (discuss this with your doctor).

Although the new shape of your body usually begins to emerge in the first few weeks, some swelling may remain for several months. Major weight gain or loss after liposuction can produce skin surface irregularities. The final result may not be clear until 6 months after surgery.

Many people assume that because liposuction permanently removes fat cells, it's impossible to regain weight in the treated areas. This is only partially true. Adults have a fixed number of fat cells, and liposuction removes some of these cells permanently. The remaining fat cells can grow bigger, especially if you do not exercise and maintain a healthy diet. This means problem spots can return. However, weight gain after liposuction will usually be distributed to other parts of your body instead of settling back into the old problem areas.

Results

In the vast majority of cases, a patient’s appearance is greatly improved after undergoing an abdominoplasty surgery. The stomach is flatter and toned, and the contour of the waste is narrower. The abdomen is also genuinely firmer. Many patients report that they feel much more comfortable with their bodies after completing the process of recovering from surgery. Their clothing fits better and overall they feel more confident about their appearance.

It may not be possible, for example, to achieve an absolutely flat abdomen in every patient; some roundness or softness may remain. In addition, although tummy tuck surgery may remove stretch marks on the lower abdomen, it may not remove all stretch marks. Most patients are satisfied with their tummy tuck results, but it is always a good idea for patients to discuss their personal cosmetic goals with their surgeon.

Quick Guide for a faster Recovery

• Drink adequate amounts of liquids to prevent dehydration
• Avoid alcoholic beverages for 48 hours before and after surgery
• Wear compression garments as suggested to prevent slow healing and excessive drainage
• Do NOT apply ice-packs or a heating pad to skin overlying the liposuctioned areas
• Do NOT apply hydrogen peroxide or plastic Band-Aids to incision sites
• Do NOT soak in a bath, Jacuzzi, swimming pool, or the ocean for at least 7 days after surgery in order to minimize the risk of infection
• Reduce your risk of fainting at home by: standing up slowly after urinating, remove compression garments slowly, have assistance for your first shower, sit down if you feel dizzy or light-headed

Why is an Abdominoplasty performed?

Excess skin on the tummy, droopy skin and lax abdominal muscles can occur after dramatic weight loss, multiple pregnancies or twin or triplet pregnancies.  In some cases the problem does not respond to further dieting or exercise and the only way to resolve the problem is surgical excision of the excess skin.

What is involved in the operation?

The operation involves a general anesthetic and a hospital stay of 2 to 4 days.  The best results are obtained in patients who are the correct weight for their height and you may be asked to lose weight before surgery is considered. You will be required to sign a consent form giving permission for the operation. This requires that you are aware of the risks and complications involved in the procedure.

Are there any complications?

There are general risks associated with a general anesthetic such as chest infection and DVTs (clots in the veins of the legs).  You will be encouraged to get up and walk around as soon as possible to reduce these risks.  This will feel uncomfortable and tight at first and you will be given painkillers to help with this.

Complications specific to this operation include infection and problems with wound healing.  This most commonly affects the most central part of the wound and it may require regular dressing for a few weeks.  Problems with the wound are more common in smokers, diabetics and overweight patients.  If you are smoker you are strongly advised to stop smoking before the operation.  Some people experience problems with red, raised and lumpy scars but most scars will become very pale and thin. Collections of blood (hematomas) and collections of fluid (seromas) can occur and may require drainage with a needle or more rarely a return to the operating theatre.  Numbness may occur and can occasionally be permanent.  In some cases minor adjustments under local anesthetic are required at a later date.

What happens after the operation?

When you come round from the anesthetic you will be bandaged and have drainage tubes in place.  The drains can usually be removed a day or so after the operation but occasionally will be left for a little longer if fluid continues to leak.  You may have dissolvable stitches but any permanent stitches that are used, especially around the navel, may need to be removed approximately 10 days after the surgery.

When can normal activities be resumed?

You can usually return to work after 2 to 4 weeks depending on your job but you should avoid any strenuous activity for up to 6 weeks after the operation.