Tummy Tuck
Abdminoplasty
An abdominoplasty is a cosmetic procedure that is designed to improve the overall appearance of the abdomen. It accomplishes this by removing excess skin and fat. It can also further tighten and flatten the abdomen by repairing any separation of the paired rectus muscles that may have occurred due to pregnancy or weight gain. Pregnancy can produce a profound stretching of the abdominal skin. If the skin becomes stretched beyond its elastic limits, micro-tears in the skin (“stretch marks”) can be produced. The resulting skin redundancies and stretch marks cannot be corrected by diet and exercise alone.
Pregnancy can produce a profound stretching of the abdominal skin. If the skin becomes stretched beyond its elastic limits, micro-tears in the skin (“stretch marks”) can be produced. The resulting skin redundancies and stretch marks cannot be corrected by diet and exercise alone.
Pregnancy (and weight gain) can also stimulate the production of additional fat cells in the lower abdominal tissues in women. These fat cells are hormonal and diet-resistant, and once added to the fat cell population, they are added for good. They can be shrunk in size by way of diet and exercise, but they will never go away on their own.
Finally, the intra-abdominal protrusion can stretch the paired rectus muscles apart, leading to a weakness of the entire vertical midline of the abdominal wall. This can give the appearance of residual bulging of the abdomen long after the pregnancy has been completed. This weakness in the abdominal wall (the equivalent of a hernia) can only be corrected by mechanically plicating the muscles back together.
Many women feel guilty that they cannot correct these problem areas just by working hard enough via diet and exercise. It is important for them (and their husbands) to realize that these are mechanical problems that can only be corrected with the mechanical solutions of direct excision and repair. Simply put, surgery can do things that diet and exercise alone cannot.
But this is not to say that surgery is a substitute for adequate diet and exercise. It is not. Surgery can indeed do things that diet and exercise cannot do. But diet and exercise can also do things that surgery cannot. When both are used in conjunction with one another, a woman can once again re-establish (and often improve) the abdominal contour that she once had prior to pregnancy or weight gain.
-
This incorporates a limited lower abdominal incision (often just an extension of an existing C-section scar) and limited removal of lower abdominal skin and fat. Similarly, a limited amount of muscle tightening can be performed at the same time.
-
An extended incision is made in the lower abdomen, and all of the tissues from the pubic region to the rib margin are elevated and transposed inferiorly. A significant amount of excess skin and fat is removed with this procedure, and the entire length of the rectus separation can be repaired with this exposure.
Types of Tummy Tucks
Best Candidates
Women who have returned to a healthy body weight after pregnancy but still have stretched-out skin, residual diet-resistant fat, and separation of the abdominal muscles are good candidates for a tummy tuck. Similarly, women who have successfully lost excess body weight through the combined effects of diet optimization (gradually eating fewer calories and gradually eating better quality calories) and exercise, but still have redundancies of excess skin and diet-resistant fat are also excellent candidates for the procedure.
Tummy Tuck Timing
Those women who are firmly committed to the healthy reduction of body weight (and Body Fat) should actually focus on diet modification and a sound exercise program first. In the ideal world, the procedure can then be performed at any time after a healthy body weight has been achieved
In the real world, many women never get to this final healthy body weight on their own. They are diligently doing the hard work of eating better and exercising harder, and they are seeing the numbers fall on the scales. But every time they look in the mirror, they do not see how much more muscular definition they have in their arms and their legs and how better (and healthier) they are looking overall. The only thing that they see is the same redundant skin and fat, and the same lower bulge of the abdomen that they had to begin with. Frustration ensues as weight loss begins to plateau, and hope begins to be lost.
For these patients, Dr. Lober feels that the Abdominoplasty procedure be considered at any time after the patient has reached roughly 50% of their overall weight loss goal. In this way, the procedure itself can then be used as a psychological “carrot on a stick” to help these patients get themselves past the plateau phase of weight loss and ultimately on to their final body weight goal.
The Abdominoplasty procedure can produce dramatic improvements in a patient’s visual appearance, but it absolutely must be utilized in conjunction with diet modification and exercise in order to reach the ultimate goal of achieving not only healthier total body weight, but also a healthier overall body composition as well. .
Surgery & Recovery
The Tummy Tuck Procedure is performed under general anesthesia in our private Surgery Center. The procedure generally takes anywhere from one and a half to two and a half hours to perform. Absorbable sutures are utilized, and drains (usually two) are required for this procedure. These drains are typically removed within 7 to 10 days. Patients are encouraged to resume light activities the day after surgery. Some patients are able to drive within 3 to 5 days, but most will not feel comfortable driving until 7 to 10 days. Moderate exercise can be resumed by 14 days.