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.
What Are The Steps Of A Tummy Tuck Procedure?
A tummy tuck procedure includes the following steps:
Step 1 – Anesthesia
Medications are administered for your comfort during the surgical procedures. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.
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. Once the abdominal skin is lifted, the underlying weakened abdominal muscles are repaired.
A second incision around the navel may be 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, skin adhesives, tapes or clips close the skin incisions.
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. Get more information about tummy tuck results.
Yes-Abdominoplasty needs to be performed with the patient asleep.
Typical surgery time is around 2.5 to 3 hours.
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.
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.
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. Final scar appearance can take 9 months to 1 year.
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.
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 issues 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. The final result including fading of the tummy tuck scars can take up to 1 year.
Yes – I frequently perform multiple procedures on tummy tuck patients. Almost 100% of the time, I perform liposuction of the abdomen, sides and love handles. 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).
A full abdominoplasty with liposuction of the flanks and abdomen costs around $11,500-$12,500 at Dr. Medalie’s outpatient surgery location. All procedures are less expensive when combined with other procedures such as vaginoplasty or breast augmentation.
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 them a medical history form to be filled out and sent back. Typically the patient will come into 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. My patient care manager has information about hotels in the area as well as financing. You may contact her at valerie@clevelandplasticsurgery.com.
Please call Dr. Medalie at 216-393-9924. You can also e-mail his patient care manager, Valerie, at valerie@clevelandplasticsurgery.com.
