Abdonminoplasty: The Tummy Tuck

     The Tummy Tuck operation is a commonly requested procedure which yields a very satisfying result to the patient.  The operation is a safe procedure when performed with skill and care.  The purpose of the operation is two-fold: first, to flatten the abdomen by tightening the muscles of the abdominal wall, and second, to remove excess skin, fat, and stretch marks. 

     The abdomen tends to take on a rounded appearance as we age, as our weight fluctuates, and after such events as childbirth.  The muscle and tissues of the abdomen are weakened, and the skin becomes stretched, so no amount of sit-ups or leg raises can remove this shape.  Strengthening the abdomen is very helpful, but this will not reposition stretched muscles and skin.  A Tummy Tuck can re-contour and reposition these tissues with the added benefit of removing any pre-existing scars from the lower abdomen.  During the Tummy Tuck operation, it is common for the patient to undergo additional procedures, such as liposuction, which the surgeon may recommend in the hip and flank area to help reshape the entire waistline.

How Long Does It Last?

     The Tummy Tuck procedure can last for many years.  If there are no large fluctuations in weight and no pregnancies after the tummy tuck, the changes will be relatively permanent.  Certainly some relaxation of the tissues can reoccur but not to the extent prior to surgery.

The Operation

     Abdominoplasty is performed as an outpatient procedure under light sleep sedation.  Local anesthesia is then used to numb the tissues of the abdomen.  The operation is performed by making an incision in the lower abdomen at a position just above the pubis.  The incision goes from hip to hip and is placed in the bikini line so that it is well hidden.  The skin and fat are dissected off of the abdominal muscles all the way up to the bottom of the rib cage.  The belly button is separated from the skin, and most frequently, all the skin and fat below the belly button are removed.  Sutures are placed on the muscles of the abdominal wall to tighten and flatten the abdomen significantly.  The skin above the belly button is drawn down to the pubis and sutured into position.  A new opening is created for the belly button and is then sutured into place.  The positioning of the belly button does not change after surgery.  Two drains are placed under the skin and exit just below the Tummy Tuck incision.  At the end of surgery, a compression garment and absorbent padding will be placed on the abdomen. 

After The Surgery

     The patient is able to walk immediately after surgery and is, in fact, encouraged to do so three to four times per day for several minutes each time.  The skin of the abdomen is quite tight, and we ask the patient to remain bent at the waist for the first four to five days after surgery.  Patients often note some back discomfort during this time.  The drains that have been placed will generally be removed 10 to 14 days after surgery or when the fluid levels have decreased.  The abdominal compression garment will remain in place after drain removal and will be worn for a total of four to six weeks.

     Some swelling and bruising is normal but is generally minimal.  The amount of pain associated with this procedure is quite variable.   Some patients note a minimum amount of discomfort, and for some it is more intense, but certainly there is some level of discomfort.  Scars from the procedure remain but fade significantly in time.

     Most patients will be off from work for two to three weeks after surgery.  During this time, patients must refrain from any lifting, straining, or over-activity.  Normal strenuous activity may be resumed in five to six weeks.