What is a Beverly Hills Tummy Tuck (Abdominoplasty)?
Changes in weight such as in pregnancy or after massive weight loss, can contribute to a protruding abdominal wall contour and excess skin that is difficult to reduce with diet and exercise alone.
In addition, the natural aging process can contribute to loose and excess skin of the abdominal wall.
An abdominoplasty (“tummy tuck”) is a procedure designed to remove excess skin from the abdominal area, while also tightening the abdominal wall musculature and repairing any rectus diastasis that may exist (separation of rectus muscles in the midline).
It is frequently combined with liposuction of the abdomen and flanks in order to reduce and contour the waistline.
What is a Tummy Tuck +360 Liposuction?
A tummy tuck with +360 liposuction is a standard tummy tuck plus additional liposuction of the upper back, flanks, waist, and abdomen.
This is more than a standard tummy tuck which typically does a smaller amount of liposuction of just the flanks and abdomen.
A tummy tuck +360 liposuction is designed to more thoroughly reduce and contour the entire trunk area, as opposed to just the abdomen and waistline.
What Are Additional Types of Tummy Tucks?
A mini tummy tuck is usually reserved for patients with very little excess skin that mainly involves only the lower abdomen. It is frequently combined with a C-section scar revision.
In this procedure, a limited incision is made in the lower abdomen and excess skin below the belly button is removed. It can be combined with suture tightening of the lower abdominal rectus muscles and liposuction of the abdomen and flanks.
It does not reposition the belly button and it does not treat loose or excess skin around or above the belly button.
Extended Tummy Tuck
If there is a large amount of excess skin that extends past the hipbones, then an extended tummy tuck is frequently required.
This means that the incision goes past the hipbones and around towards the lower back.
Although it is longer than a traditional incision, it is still in a very low position that can be hidden underneath underwear and bikinis.
This extended incision is necessary to fully remove all of the extra skin.
Without this extension, it will be hard to achieve a smooth hourglass contour and there will be an unsightly step-off between the flat contour of the abdomen and the extra tissue present on the sides of the abdomen.
In patients with a history of massive weight loss, a single lower abdominal incision is not always sufficient to remove all of the extra skin.
In these situations, an additional vertical midline incision is created to remove additional skin (fleur-de-lis abdominoplasty).
This is not performed very commonly, and it is typically reserved for patients that have lost more than 100 pounds.
Even in this situation, it is not always necessary.
Dr. Rovelo evaluates each patient on a case by case basis to assess what will work best for each individual patient.
Circumferential Tummy Tuck (Lower Body Lift)
For patients that have lost large amounts of weight, the excess skin frequently involves the lower back, outer thighs, and gluteus.
For these patients, a full +360 incision may be required to optimally contour the entire abdomen and trunk.
At the time of your consultation, Dr. Rovelo will discuss if this is an option for you.
Benefits of a Tummy Tuck
A tummy tuck procedure is an excellent way to create a sleek and trim abdominal shape and contour.
Diet and exercise alone may reduce your overall size, but they will never address excess skin.
This excess skin will then detract and camouflage all of your other efforts at weight loss and strength training.
Similarly, if you have a rectus diastasis, exercise alone will not repair it. Both of these situations require a surgical treatment to adequately address the problem.
As a result, a tummy tuck is usually a high satisfaction procedure that allows patients to achieve the flat and trim abdominal contour that they have thus far been unable to achieve on their own.
A tummy tuck plus liposuction also provides the ability to have a beautiful hourglass shape that also may not be possible with diet and exercise alone.
Tummy Tuck as Part of a Mommy Makeover
A tummy tuck is usually a major part of a mommy makeover.
Although there is no strict definition of what constitutes a mommy makeover, it usually consists of an abdominal contouring procedure (tummy tuck, liposuction), a breast rejuvenation (breast lift +/- breast augmentation) and sometimes a labiaplasty.
Usually these procedures can be combined into one surgery.
However, it is important to know that this will result in a longer surgery and a more intense recovery period.
Sometimes, if one area needs an extensive amount of work, Dr. Rovelo may advise you to break up the procedures into additional surgeries.
To better understand your options, book an appointment with Dr. Rovelo today.
Who is a Candidate for a Tummy Tuck in Beverly Hills?
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.
For patients with elevated BMIs, an abdominoplasty can still be combined with +360 liposuction, but this is usually a more extensive and time-consuming procedure.
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.
For a minimal amount of excess skin, a mini-tummy tuck may be a more suitable option.
Dr. Rovelo will discuss with you if a tummy tuck is right for you, or a mini-tummy tuck may be more suitable.
Your Tummy Tuck Consultation
At the time of your consultation, Dr. Rovelo will obtain a very thorough medical history including any history of previous pregnancy and/or weight loss.
Dr. Rovelo will then do a physical exam and assess how much excess skin and tissue is present.
She will also assess the strength and functionality of your abdominal wall muscles.
Once all of the above has been assessed, Dr. Rovelo will discuss the best surgical option for you.
This will include whether or not you are an appropriate candidate for surgery, as well as the amount of liposuction that needs to be performed, and the length of the incision.
Dr. Rovelo will review all of the details of the recovery process and what you can expect as a final outcome.
By booking an appointment with Dr. Rovelo today, you will then have the chance to have all of your questions answered.
How is a Beverly Hills Tummy Tuck Procedure Performed?
Liposuction is frequently performed at the same time as an abdominoplasty.
This results in the removal of unwanted areas of excess fat. In a standard abdominoplasty, liposuction is performed of the abdomen and flanks.
In a tummy tuck +360 liposuction, liposuction is performed of the abdomen, flanks, waistline, and upper back.
The goal is to create an hourglass shape of the waistline (for women), and more of a straight waistline (for men).
After liposuction is complete, the abdominoplasty portion of the procedure begins.
An abdominoplasty incision is hidden in the bikini line, and runs from one hipbone to the other hipbone.
Through this incision, skin and fat of the abdominal wall is elevated off of the underlying rectus muscles.
The rectus muscles are visualized and tightened in the midline with a series of sutures designed to flatten and contour the abdominal wall.
This part of the surgery also corrects any rectus diastasis that may exist.
The previously elevated flap of skin and fat is pulled down tightly over the muscles and the excess skin and fat are excised.
Typically this involves all of the skin and fat from the level of the belly button down to the pubic bone.
One this tissue has been removed, the incision is closed with a series of absorbable sutures.
The umbilicus (“belly button”) has been preserved throughout this whole procedure via its direct connection to the abdominal wall.
However, in order to remove the extra skin, the skin attachments of the belly button have to be released.
Once the extra skin is removed and the incision is closed, a new incision is made through the skin and the belly button is brought out through this new incision and sutured into place.
At the completion of the procedure, the abdomen is much flatter and more contoured. The umbilicus appears in a position similar to where it was at the beginning of the procedure.
The incision is covered with a dressing and an abdominal garment or binder is applied.
Sometimes, an abdominoplasty can be performed without drains, although some patients may require them.
Dr. Rovelo will discuss with you whether or not you are a good candidate for a drainless abdominoplasty.
What Can You Expect After a Tummy Tuck Surgery in Beverly Hills?
An abdominoplasty or a tummy tuck is performed in either an outpatient surgery center or hospital, under general anesthesia.
The length of surgery depends on the amount of liposuction required and the extent of skin that needs to be removed. It can range anywhere from 3-6 hours.
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.
Follow ups will continue on a weekly basis for the first 2-3 weeks.
Visits will then be spaced out to three weeks, six weeks, three months, six months, and then a year.
You are encouraged to call the office at any time during the recovery process if you are experiencing difficulties or have questions.
For the first week, patients will need to sleep in a reclined “beach chair” position, and they will be unable to stand up completely straight.
After a week, they will be able to stand and sit in any position that is comfortable.
Pain medication is provided and usually required for the first 3-5 days.
After two to three weeks, light activity and return to desk work can be initiated.
Patients may return to full strength activities and exercises after 6 weeks.
During the first 6-12 weeks, patients will need to wear an abdominal compression garment all of the time, except when showering.
Lymphatic massages are also highly encouraged.
Lymphatic massages are designed to be done after body contouring procedures and are very helpful in decreasing swelling and ensuring a smooth and tight contour as soon as possible after surgery.
Our office will be able to assist you in finding a massage therapist in your area.
When Will I See my Results from a Tummy Tuck?
You will notice an immediate improvement right after surgery, particularly if you had a large amount of extra skin and/or fat. You will, however, be very swollen.
Swelling will peak within the first week and then start to decrease.
Over the next 2-3 weeks, the shape and the contour of the abdomen will start to emerge.
By 6 weeks, swelling will be approximately 85-90% resolved. By 3 months, swelling will be mostly resolved.
The scar will continue to mature and fade over the next 6-12 months.
If there are no major fluctuations in weight, the results of a tummy tuck can last a very long time.
Although all skin will continue to relax with age, it will never return to its pre-surgical condition.
What are the Risks of a Tummy Tuck Surgery?
All surgery is associated with risks.
Risks associated with an abdominoplasty include bleeding, infection, fluid collections (seromas), wound healing problems, scarring, contour irregularities, 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 as soon as possible.
In an effort to minimize post-operative complications, including blood clots, 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.
Is a Tummy Tuck Surgery Covered by Insurance?
In some instances, a portion of a tummy tuck may be covered by insurance.
If patients have a history of massive weight loss resulting in a large amount of excess skin that is causing problems such as rashes and infections, insurance may cover a procedure called a panniculectomy.
A panniculectomy is removal of the excess skin and fat of the lower abdomen.
It does not remove extra skin around or above the belly button, it does not include any muscle repair, and it does not include liposuction.
A panniculectomy alone is a medical procedure and it is not designed to aesthetically recontour the abdomen.
If a patient is approved for a panniculectomy, they may choose to add on the additional cosmetic procedures of a tummy tuck including the muscle repair, liposuction, and transposition of the belly button.
This will require payment of separate cosmetic fees that are in addition to whatever co-insurance fees are associated with the panniculectomy.
Contact Dr. Rovelo to better understand your options.
What is the Cost for a Tummy Tuck in Los Angeles?
Dr Rovelo doesn’t believe in a “one-size-fits-all approach,” and evaluates and customizes a treatment plan that is right for you.
Costs will range depending on how much liposuction will need to be performed, as well as on how much skin will need to be removed.
With years of experience, Millicent Rovelo MD is considered one of the best tummy tuck surgeons in Beverly Hills, California.
Why Choose Dr. Rovelo for a Tummy Tuck?
Dr. Rovelo is a body contouring expert who has performed many tummy tucks in a variety of patients.
She uses this experience to design a surgical plan unique to each patient.
She is dedicated to performing her surgeries meticulously and with attention to detail.
This includes risk reduction techniques to reduce the chances of intra-operative or post-operative complications.
In addition to her technical skills, Dr. Rovelo also has an eye for beauty.
Dr. Rovelo takes great pride in creating a beautiful, attractive, feminine shape.
Her goal is to help her patients feel comfortable, sexy, and confident in their bodies.
Dr. Rovelo works very closely with her patients from the beginning to the end of their surgical journey.
She listens to them and guides them through their journey with knowledge, compassion, and expertise.
Frequently Asked Questions (FAQs)
What is the difference between a tummy tuck and liposuction?
Liposuction uses several tiny incisions through which thin instruments are inserted. These instruments remove fat through suction techniques. With liposuction alone, no skin is removed. In patients with good skin quality and minimal skin excess, this can be a sufficient technique to contour the abdomen. If the skin quality is poor or there is excess skin, liposuction alone is not a great option. It can even make the excess skin worse.
A tummy tuck involves a formal incision that usually involves the length of the lower abdomen. Through this incision, extra skin is removed. A tummy tuck is frequently combined with liposuction. This allows for removal of excess fat as well as excess skin.
What is an alternative to a Tummy Tuck?
In patients with relatively good skin quality who do not have a significant amount of skin excess, liposuction plus additional skin tightening devices can be used as an alternative to a tummy tuck. Dr. Rovelo frequently uses Renuvion® in combination with liposuction to improve skin tightness. Renuvion® is a minimally invasive procedure that uses radiofrequency technology to tighten the skin. This can be combined post-operatively with devices such as Morpheus Body® to provide additional skin tightening.
Will there be any scars after surgery?
All surgery will result in a scar. However, Dr. Rovelo takes post-operative scar management very seriously. Once the incision is fully healed, she will suggest additional scar treatment modalities to improve the appearance of the scars. These include silicone scar therapies, as well as lasers and microneedling treatments.
Most scars will fade over the course of a year. Any scars that have not healed well can always be revised, if needed.
How does one prepare for surgery?
Prior to having a tummy tuck, patients would ideally be at their goal weight. If there is still a large amount of excess fat, this can diminish the overall aesthetic results, as well as increase the risk of complications.
Further weight loss after a tummy tuck (greater than 10-15 pounds) may also diminish the results of the tummy tuck. Skin may appear looser and require additional excision.
Fad diets and juice cleanses prior to surgery should be avoided. Patients should eat a sensible diet with adequate amounts of protein and calories. They should avoid heavy foods and meals in the days prior to surgery to avoid problems with constipation.
Discuss with your doctor if you are taking any kind of vitamins or supplements, as many of these will increase your risk of bleeding post-operatively.
Make sure that you have people who can assist with your post-operative recovery, particularly if you have small children or other dependents that require care. You will not be able to do much physical activity for the first few weeks, and you will not be able to lift more than 5-10 pounds for several weeks, therefore additional help at home is essential.
Does a Tummy Tuck get rid of stretchmarks?
Sometimes! It depends where the stretch marks are located. If they are within the area of skin that is being removed, then yes. This is frequently the lower abdominal (below the belly button) area. Stretch marks that are above the belly button will persist, but they may sit in a lower position than they used to, and therefore they may be easier to conceal.
Can I have children after a Tummy Tuck?
Yes. Ideally, childbearing would be complete prior to having a tummy tuck, in order to preserve the results. However, sometimes life happens and patients may become pregnant after a tummy tuck. In this situation, there is no concern for the developing baby and they will be able to grow and develop normally. However, post-partum, there may be recurrence of the rectus diastasis and additional excess skin. In this situation, a revision tummy tuck may be required.
What are dog ears and how do I avoid them?
Dog ears are areas of residual excess skin at the ends of the incisions. This frequently happens when the incision is not made long enough to include all of the extra skin. When the dog ears are small, they can frequently be revised in the office under local anesthesia. If they are larger, then conversion to an extended abdominoplasty or circumferential abdominoplasty may be required for optimal abdominal contouring.
Is the belly button removed with a tummy tuck?
No. The belly button is attached via a stalk to the abdominal wall. During a classic tummy tuck, this stalk is left attached at its base, but the skin around the belly button is released. This allows for the skin to be manipulated and removed, independent of its attachments to the belly button. Once the excess skin is removed and redraped into its new position, an incision is made in the skin and the belly button stalk is pulled through into this new opening.
I’ve been told I have an umbilical hernia. Can this be repaired at the same time as a Tummy Tuck?
It depends on the size of the hernia. If it is very large, then repair with mesh may be required. In this circumstance, Dr. Rovelo recommends having the hernia repaired first and then proceeding with the tummy tuck 3-6 months later. This is because the blood supply to the belly button may be compromised during the course of the hernia repair, and doing a tummy tuck at the same time will further diminish the blood supply and result in loss of the belly button.
If the hernia is small, then it can frequently be repaired at the same time as the tummy tuck. However, there is still a slightly increased risk of diminished blood supply to the belly button.
Is a tummy tuck permanent?
Yes! Mostly. In the absence of major weight fluctuations, a tummy tuck result can be permanent. That being said, the skin will continue to undergo changes related to natural aging, but the excess skin will never recur to the degree that it was initially.
In patients with a history of massive weight loss, a significant amount of skin is usually removed at the time of surgery. However, the skin that remains is usually not great quality. As a result, there may be some residual skin looseness, but not necessarily skin excess.