Abdominoplasty

What Is a Tummy Tuck?

Many of us strive to achieve a flat and well-toned abdomen through exercise, dieting and weight control. Sometimes these methods cannot help us achieve our goals, so when this happens, a cosmetic surgery procedure named tummy tuck or abdominoplasty is used to make the abdomen more firm. It involves removing excess skin and fat from the middle and lower abdomen in order to tighten the muscle and fascia of the abdominal wall. In most cases, this procedure restores weakened or separated muscle creating an abdominal profile that is smoother and firmer.

People with otherwise normal body weight and proportion can develop an abdomen that protrudes, is loose and sagging. The most common causes of this include heredity, pregnancy, aging, significant fluctuations in weight or prior surgery. Tummy tucks should in no way be seen as a substitute for weight loss or an appropriate exercise program! Also, the procedure is not recommended for individuals who are planning on substantial weight loss or women who may be considering future pregnancies, as the positive outcome of the surgery can be greatly diminished by significant fluctuations in a patient’s weight.

Tummy Tuck Categories

Abdominoplasty operations vary in scope and can last anywhere from 1 hour to 5 hours, depending on the extent of the surgery. Common procedures include:

• complete abdominoplasty
• partial abdominoplasty
• extended abdominoplasty
• high lateral tension abdominoplasty
• floating abdominoplasty (FAB technique)
• circumferential abdominoplasty

Complete Abdominoplasty

During a complete tummy tuck, an incision is made from hip to hip, just above the area, and another incision is made to free the navel from the surrounding skin. Next, the skin is detached from the abdominal wall, revealing the muscle and fascia. The surgeon then proceeds to tighten the muscle fascia wall with sutures and will use liposuction to refine the transition zones, if needed. Excess fluid is then drained from the site and a dressing or sometimes a compression garment is applied.

Partial Abdominoplasty

Also named mini abdominoplasty or mini-tuck, the procedure can be completed between 1 to 2 hours. A smaller incision is needed and the skin and fat of the lower abdomen will be detached in a more limited fashion from the muscle fascia. Sometimes the belly button stalk is divided from the muscle below and the surgeon slides the belly button lower on the abdominal wall. After the procedure is completed, the flap is stitched back into place. Liposuction is often used to contour the transition zone to avoid any possible irregularities and the surgeon may also tighten a portion of the abdominal muscle fascia.

Extended Abdominoplasty

This procedure is basically a complete abdominoplasty plus a lateral thigh lift. Apart from doing all of the contouring of a complete tummy tuck, the procedure also allows further improvement of the waist and smoothing the contour of the upper lateral thigh.

High Lateral Tension Abdominoplasty

An advanced technique, the high lateral tension tummy tuck takes a little more than 4.5 hours to perform. What makes it different from others is the fact that in addition to vertical-line tightening, muscles are also tightened horizontally, resulting in a dramatically flat abdomen and a significantly better-defined waistline.

Floating Abdominoplasty

This technique is also known as an extended mini-tuck, allowing tightening and shaping through a smaller incision that is not placed around the belly button. Excess skin is removed and the belly button is temporarily detached, floating above the muscles during this process. Muscles are tightened and reshaped from the sternum to the pubic area, the skin is tightened and the belly button reattached, or moved down 1-2 centimeters if desired.

Circumferential Abdominoplasty

This procedure involves an extended tummy tuck plus a buttock lift, with a resulting scar running all the way around the body. Also called a body lift or belt lipectomy, this procedure is most appropriate for patients who have undergone massive weight loss.

Tummy Tuck Procedure Steps

A tummy tuck procedure includes the following steps:

• anesthesia administration (IV or general anesthesia)
• a horizontally-oriented incision is made between the pubic hairline and belly button
• lifting of the abdominal skin
• repairing underlying abdominal muscles
• a second incision around the navel to remove excess skin in the upper abdomen (if the case)
• pulling down the upper abdominal skin
• trimming excess skin and suturing the remaining together
• creating a new opening for the belly button
• popping the belly button through to the surface and suturing it into position
• closing the incisions using sutures, skin adhesives, tapes or clips

Risks and Safety

All surgical procedures have some degree of risk, but fortunately, significant complications associated with tummy tucks are infrequent and the satisfaction rate is high. Some of the potential complications include:

• anesthesia risks
• bleeding
• infection
• fluid accumulation
• skin loss
• poor wound healing
• unfavorable scarring
• persistent pain
• suboptimal aesthetic result
• possibility of revisional surgery

These risks and others will be discussed prior to your consent. Your surgeon will ask you to sign consent forms to ensure that you fully understand the procedure and the potential risks involved.

Preparing for Consultation and Surgery

During your tummy tuck consultation, you should be prepared to discuss your surgical goals with your doctor. Inform him or her about your medical conditions, drug allergies and medical treatments, your current medications, vitamins, alcohol, tobacco and drug use if the case. Also, the surgeon will ask you about any previous surgeries that you might have had in the past.

After you have been provided with thorough preoperative instructions, in advance of your procedure, your surgeon will ask you to:

• avoid taking aspirin, certain anti-inflammatory medications and some herbal medications that can cause increased bleeding
• stop smoking well before undergoing surgery to better promote healing (you should stop smoking at least 6 weeks before surgery)
• keep hydrated at all times before and after surgery for safe recovery

Your surgeon will also evaluate your general health status and any pre-existing health conditions or risk factors. He or she will take before and after surgery photographs, discuss your options and recommend a course of treatment in order to achieve your desired appearance.

Am I a Candidate for a Tummy Tuck?

Although dieting and exercising regularly are helping you lower numbers on your scale, they might not change the appearance of your protruding or sagging abdomen. The 3 basic factors that influence whether you are or not a candidate for tummy tuck are:

• a good general health
• a positive attitude
• realistic expectations

Other common reasons why you may want to consider a tummy tuck:

• you have been left with extra skin on your abdomen, abdominal weakness or both due to aging, heredity, prior surgery, pregnancy or weight fluctuations
• you are finished having children – the muscles that are repaired during a tummy tuck can separate again during future pregnancy
• your weight is stable – slender people with extra fat and loose skin in the lower tummy are the best candidates
• you are a non-smoker – smoking increases the risk of serious complications during and after surgery and slows down the healing process

Internal or external scars from any previous abdominal surgery may also affect your tummy tuck candidacy. Also, if you have a significant amount of intra-abdominal fat surrounding your internal organs, you may need to slim down before surgery. If you are generally obese, abdominoplasty is not the right procedure for you.