Tummy Tucks (Abdominoplasty Surgery) Information

Is close to their ideal body weight (within 30%)
Wants to remove specific areas of loose skin or fat that is diet- and exercise-resistant
Weight has been stable for 6 months or more
Has good skin tone and elasticity
Has realistic expectations
Is emotionally stable
Understands the risks of surgery

If you do not meet all of these criteria, but meet some of them, you may still be a good candidate for a tummy tuck. The procedure is most suited to those who are close to their ideal body weight, but if you have a lot of fat in a isolated area, you may still be a good candidate.

If you intend to lose a lot of weight, wait until after your weight loss to schedule surgery. If you plan on future pregnancies, you should wait until you are done having children to have surgery as pregnancy will stretch the abdomen again.

initial consultation

At your initial consultation, your surgeon will evaluate your health, determine the extent of fat deposits in your abdomen, and assess your skin tone. Be specific about what you would like done. If your surgeon fully understands your expectations, she'll be able to determine whether your goals are realistic.

If your fat deposits are limited to the area below the navel, you may require a less complex procedure called a partial abdominoplasty, also know as a mini-tummy tuck, which can often be performed on an outpatient basis. You may, on the other hand, benefit more from partial or complete abdominoplasty done in conjunction with liposuction to remove fat deposits from the hips, for a better body contour. Liposuction alone may create the best result.

You are at increased risk for complications if you have diabetes, poor circulation, heart, lung or liver disease, smoke, have a family history of blood clots, take certain medications, etc. You'll want to discuss your medical history thoroughly with your physician before you choose to undergo surgery.

pre-op preparation

Before Surgery:
[ ] 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 24-72 hours after surgery (consider hiring a nurse for the first 24 hours, this is can be very tiring and emotional for loved ones)
[ ] Fill prescriptions (especially pain medications) before surgery
[ ] Purchase any homeopathic medicines (i.e. Bromelain and Arnica Gel, for swelling and bruising) Be sure to discuss this with your doctor
[ ] Prepare and freeze meals for 2 weeks
Consider: Protein shakes, soup, pudding, applesauce, yogurt, oatmeal, cottage cheese, juice (purchase flexible straws for easier drinking)
Talk to your doctor about low-sodium foods to reduce swelling
[ ] Set up home recovery area: lots of pillows, books, magazines, journal, stationery, lotion, baby wipes, tv, videos, remote control
[ ] Black out windows so you can rest during the day
[ ] Whistle, bell, walkie-talkies or intercom system for requesting help
[ ] Telephone with speaker phone near your bed
[ ] Prepare Icepacks (can also use packs of frozen veggies) to reduce post-op swelling
Purchase large clips to hold packs in place
[ ] Mouthwash (you won't be able to brush your teeth for the first day or two)
[ ] Moisturizers, scar reducing/minimizing creams (such as Mederma) and petroleum jelly for incisions
[ ] Laxatives (pain medications are often binding
[ ] Eye Drops (after any surgery, eyes can be dry)
[ ] Consider hand-held shower head and bathroom chair
[ ] Telephone with speaker phone near your bed
[ ] On the day of surgery, wear loose clothing which will be easy to get off and on after operation (a shirt that buttons in front)
[ ] Follow your physician's directions carefully regarding medications, eating & drinking, etc.

Insurance Coverage
Insurance generally does not cover elective surgery. However, it may cover a portion of the abdominoplasty if there is excessive spreading of the anterior muscles ora hernia is present. Check with your insurance company, and be sure to obtain proper pre-authorization for your surgery.

Questions to ask your insurance:

Does my policy cover the costs of the surgery, the implant, the anesthesia, and/or other related hospital costs?
Will there be an increase in my insurance premium?
Will future coverage be affected?

basic procedures/techniques

Anesthesia: General or local with sedative
Location: Hospital, surgical center (overnight stay,possibly 2 nights)
Surgery time: 1-3 hours

The Procedure
An abdominoplasty is a major surgical procedure that will remove excess skin and fat from the lower abdomen and tighten the abdominal muscles.

An incision is made across the lower abdomen from hipbone to hipbone. A second incision is made around the belly button. The skin and fat are separated from the abdominal wall. Excess skin and fat are then excised. The abdominal muscles are tightened by shortening them and suturing them together. A small incision creates a new opening for the belly button. It is brought out through the opening sutured to the new skin. Stretch marks and scars may be removed during surgery.

Drains may be placed in the skin and removed a few days later. The drains reduce swelling by collecting excess blood and fluid. All incisions are closed.

recovery

Pain Level: Moderate to severe discomfort. 1-2 weeks of pain medication
Swelling: 2-6 weeks
Bruising: No bruising
Numbness: 6 months or more
Bandages: Changed in 2-5 days (sutures removed first 7-10 days)
Work: Return to desk job after 1 week, other jobs 10-14 days
Exercise: Wait 4-8 weeks
Final result: After scars heal, approximately 6 months-1 year

For the first few days after surgery, the abdomen will probably be swollen and some pain and discomfort may occur which can be controlled by medication. Depending on the extent of the surgery, you may be released within a few hours or remain hospitalized for two to three days.

The incisions will be covered with surgical tape for 2 weeks to insure proper healing.

For faster recovery:

Walk around every hour or so and flex your feet to prevent blood clots in the calf veins
Keep your hips gently flexed for the first week to prevent tension on the sutures
Do not shower until the drains have been removed (sponge baths until drains removed)
Do not bathe for the first 2 weeks (showers permitted after drains removed
Be careful of surgical tape when showering
Limit any activity that causes discomfort

risks/complications

List of possible complications:
Anesthesia reaction
Belly button death
Bleeding
Hematoma (risk is 3-4%)
Infection (risk is less than 1 %)
Keloid (heavy scar)
Puckered skin
Reactions to medications
Seroma
Skin irregularities
Skin necrosis or skin death (more likely with smokers)
Slow healing
Suture Rupture
Swelling
Visible scar

Serious complications after an abdominoplasty are uncommon. However, there are risks with any surgery and specific complications associated with this procedure.

Complications such as infection and blood clots are rare, but can occur. Infection can be treated with drainage and antibiotics, but will prolong your recovery. You can minimize the risk of blood clots by moving around as soon after the surgery as possible (immobility allows blood to pool and create a clot which can travel to the lungs, heart or brain causing a pulmonary embolism, heart attack or stroke).

If wound problems develop, it may delay healing for several weeks or even months. Areas of skin may die and slough off (this complication is more common among smokers). This will result in delayed healing and may require a skin graft. Although rare, it is possible for fat to liquefy and drain through the incision. Additional surgery may also be necessary.

One of the more common problems after an abdominoplasty is collection of fluid under the skin after the drains have been removed. Your surgeon can aspirate the fluid with a needle. The drainage stops within a month and will not affect the final results.

scars

Surgical scars are permanent. There will be a long scar extending from hip to hip. However, the incisions are usually placed below the swimsuit line so they will not normally be in view . Your scars may actually worsen during the first three to six months as it heals, but this is normal. It normally takes 9 months to a year before scars flatten out and lighten in color.

Information provided is for general education about cosmetic surgery. This information is subject to change. Board Certified Database.com does not guarantee that it is accurate or complete, and is not responsible for any actions resulting from the use of this information. General information provided in this fashion should not be construed as specific medical advice or recommendation, and is not a substitute for a consultation and physical examination by a physician. Only discussion of your individual needs with a qualified physician will determine the best method of treatment for you.
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