Diet and exercise sometimes do little to eliminate unwanted fat and loose skin in the abdominal area. If you are bothered by these appearance problems, abdominoplasty (tummy tuck) may be a good choice for you. Abdominoplasty is performed to rid a person of excess skin and to tighten the weak abdominal wall muscles. This is frequently present in women following childbirth.
The procedure can be done as an outpatient surgery and sometimes can be done as a mini-abdominoplasty, which works mainly on the lower portion of the abdomen (in combination with liposuction). Recovery period is anywhere from 14-21 days, depending on the extent of the procedure and the tightening of the abdominal wall musculature. Liposuction and body contouring can also be performed at the time of this surgery.
A tummy tuck procedure includes the following steps:
Step 1 – Anesthesia
Medications are administered for your comfort during the surgical procedures. Dr. Medalie prefers general anesthesia for this surgery in order to keep the abdominal muscles completely relaxed for the procedure. After the patient is asleep, Dr. Medalie always uses tumescent local infiltration to help constrict the blood vessels and minimize immediate post-op pain. At the end of the surgery a nerve block is used in the abdomen to further help with post- operative discomfort.
Step 2 – The incision
A full tummy tuck requires a horizontally-oriented incision in the area between the pubic hairline and belly button.
The shape and length of the incision will be determined by the amount of excess skin (but typically the incision travels at least from hip bone to hip bone). Once the abdominal skin is lifted, the underlying weakened abdominal muscles are repaired with a triple layer of sutures.
A second incision around the navel is usually necessary to remove excess skin in the upper abdomen.
The upper abdominal skin is pulled down like a window shade. The excess skin is trimmed and the remaining skin is sutured together. A new opening for the belly button is created. The belly button is popped through to the surface and sutured into position.
Step 3 – Closing the incisions
Sutures that dissolve are used in both the deep and superficial layers of the incision. Skin adhesives and steri-strips close the skin incisions. An outer layer of adhesive foam is applied and then an abdominal binder is used to compress the tissue and control swelling and bruising.
Step 4 – See the results
Your tummy tuck will result in a flatter, firmer abdominal contour that is more proportionate with your body type and weight. Final results are not evident for up to 4-6 months, but within a few weeks you will notice a much slimmer abdomen.
*Plastic surgery results can vary from patient to patient and are not guaranteed.
» View Frequently Asked Questions about Tummy Tuck Surgery
Do I need general anesthesia?
Yes-Abdominoplasty needs to be performed with the patient asleep.
How long does it take?
Typical surgery time is around 2.5 hours.
What is the chance of infection?
I typically give my patients antibiotics on the day of surgery. Post operative infections are rare and are typically related to the dissolving sutures which can sometimes irritate the skin. Please be aware that smoking is the number one reason for post-operative infections and healing problems. I thus require my patients to STOP SMOKING at least 3 months prior to a tummy tuck procedure.
Are there bleeding risks?
During the surgery local anesthetic is injected into the tissue using a tumescent technique-this blocks the sensation and also constricts blood vessels. As a result, there is very little bleeding during the surgery. I have NEVER had a patient have a severe bleeding complication post-op, but it is not impossible and a return trip to the OR may be necessary. No one has ever needed a blood transfusion for this procedure.
What is the recovery?
This is a big operation and requires a fairly long recovery. Pain that may require narcotic pain medicine typically lasts 1-2 weeks. After that, ibuprofen (Motrin and Advil) is sufficient. I recommend that patients take at least 2 weeks off from work (and probably more if you can), but if you have a desk job, 2-3 weeks may be sufficient. The post-op care involves drain care for the first 7-14 days and then scar massage after that. Most of the swelling and all of the buried stitches have disappeared by 3-4 months
When can I resume my normal activity?
I recommend that patients refrain from exercise for at least 3 weeks after surgery. Even after 3 weeks, the incisions may be sensitive and patients need to use caution. Full activity including abdominal crunches can not resume until the patient is 3 months out from surgery.
When will I be completely healed?
Some of the deep sutures under the skin can take up to three months to completely dissolve. For this reason, some patients may report sensitivity issue such as itching for up to three months post-op. Abdominal wall sensation may always be a little numb.Typically my patients have resumed full activity by 3 months.
Can other procedures be performed at the same time as abdominoplasty?
Yes – I frequently perform multiple procedures on tummy tuck patients. Frequently I perform liposuction. Sometimes I also perform breast procedures such as breast augmentation or breast lift. Many of my patients ask for vaginoplasty or labiplasty as an adjunct to the tummy tuck (please see the mommy makeover section)
What does it cost?
A full abdominoplasty with liposuction of the flanks and abdomen costs around $9000 at Dr. Medalie’s outpatient surgery location. All procedures are less expensive when combined with other procedures such as vaginoplasty or breast augmentation.
What if I am from out of town?
I frequently perform abdominoplasty and body contouring surgery on patients who live out of town and are unable to easily to see me in consultation prior to the procedure. I have several requirements for these patients: I must see pictures of them prior to scheduling surgery. They need to contact my office and have my patient care manager email or fax them a history and physical form to be filled out and sent back. Typically the patient will come in to town 1 day prior to the procedure, and I will see them the day of surgery. I will perform a phone consultation about 3 weeks prior to surgery. I will then perform the operation and see them back in my clinic in several days to check the surgical site and answer any questions. This means that the patient will spend around 4-7 days in the Cleveland area. Patients who live far away, but can drive to Cleveland (2-6 hrs.), can go home the next day and drive back to see me for their first post-operative appointment. I will then follow the progress of the patient via e-mailed pictures on a weekly basis. My patient care manager has information about hotels in the area as well as financing. You may contact her at firstname.lastname@example.org.
Where can I get more information?
» Read a more detailed description of abdominoplasty and see more of Dr. Medalie’s abdominoplasty before and after photos