What is Abdominoplasty?
The aging process, as well as pregnancy and massive weight loss, can contribute to a lax abdominal wall that is difficult to reduce with diet and exercise alone. An abdominoplasty (“tummy tuck”) is a procedure designed to remove excess skin and fat from the abdominal area, while also tightening the abdominal wall musculature. An abdominoplasty procedure is an excellent way to create a sleek and trim abdominal shape and contour.
Who is a candidate for Abdominoplasty?
You may want to consider an abdominoplasty if you have:
- Excess skin and fat of the abdominal wall and are otherwise at a healthy weight
- Laxity and protrusion of your rectus muscles (six pack muscles) either from genetics, age, or pregnancy
The ideal abdominoplasty patient is in the normal-slightly overweight range. An abdominoplasty cannot reduce excess intra-abdominal fat and will be ineffective in improving the abdominal contour in this situation. Women who are considering having more children should wait until childbearing is complete.
How is Abdominoplasty Performed?
Liposuction is frequently performed at the same time as an abdominoplasty, and the procedure starts with liposuction of the flanks. The goal is to create an hourglass shape to the waistline (for women), and more of a straight waistline (for men). After liposuction is complete, the abdominoplasty portion of the procedure commences.
An abdominoplasty incision is hidden in the bikini line, and runs from one hipbone to the other hipbone. A flap consisting of the skin and fat of the abdominal wall is elevated off of the underlying muscles. The rectus muscles are visualized and tightened in the midline with a series of sutures designed to flatten and contour the abdominal wall. The previously elevated flap of skin and fat is pulled down tightly over the muscles and the excess skin and fat are excised. The umbilicus (“belly button”) is contained within this flap of excess tissue, therefore, in order to preserve the umbilicus, it is relocated. At the completion of the procedure, the abdomen is much flatter and the umbilicus appears in a position similar to where it was at the beginning of the procedure. Most of the time, an abdominoplasty can be performed without drains, although some patients may require them. Dr. Rovelo will discuss with you whether you are a good candidate for a drainless abdominoplasty.
All surgery is associated with risks. Risks associated with abdominoplasty include bleeding, infection, fluid collections (seromas), wound healing problems, scarring, and need for revisional procedures. Of all the plastic surgery procedures, an abdominoplasty has the highest incidence of blood clots that can travel to the lungs (pulmonary embolism). Despite this, the overall risk of blood clots is still very low. However, all measures to prevent blood clots are undertaken in the OR, and post-operatively, patients are encouraged to ambulate. In addition, patients are encouraged to spend one night in an aftercare facility. It is important to talk with Dr. Rovelo about the risks of your surgery and how the risks can be minimized to provide the best possible outcome.
An abdominoplasty is performed in an outpatient surgery setting, under general anesthesia. Surgery takes about 3 hours to perform. Patients are encouraged to spend the night at an aftercare facility to assist with pain control, ambulation, and monitoring. Patients are seen the following day, and then again at one week. For the first 1-2 weeks, patients will need to sleep in a reclined “beach chair” position, and they will be unable to stand up completely straight. After two weeks, light activity and return to work can be initiated. Patients may return to full strength activities and exercises after 6 weeks. During the first 2 weeks, patients will need to wear an abdominal compression garment all of the time, except when showering. After 2 weeks, compression garments may be removed at night, although full-time is preferable. Garments may be discontinued after 6 weeks.