Tummy Tuck (Abdominoplasty)
A tummy tuck, also known as an abdominoplasty is a very common and safe procedure. This procedure addresses a very common issue both men and women struggle with on a daily basis. Sometimes no matter how much you exercise and eat right we all have those trouble areas that will not go away. It causes us to be self-conscious and avoid activities where we feel insecure about our bodies. There is no technology out there that is going to “remove your fat” as the science is not there! To achieve the overall effect of a smoother tighter stomach abdominoplasty is the only option.
What Is a Tummy Tuck?
Clinically known as abdominoplasty, the goal of a tummy tuck is to tighten the contour of a sagging abdomen. The procedure removes excess fat and skin, and restores weakened or separated muscles, resulting in a flatter, tighter, more contoured abdomen. A tummy tuck usually can change contours that won’t respond to exercise due to sagging skin and weakened muscles.
What Causes Sagging Skin on the Abdomen?
Our skin and underlying support tissues are remarkably resilient, but there are limits. When our skin is overstretched for a long period of time, it sometimes cannot rebound down to its former degree of tautness. That’s what happens with the localized stretch-weight gain of pregnancy. It also happens if a person gains and then loses a large amount of weight. The general slackening that comes with aging also plays a role, as we all develop a little abdominal pooch as we get older. Hormones play a large role in how and where we lay down fat. As we get older, we tend to have higher amounts of subcutaneous fat.
Who Is a Good Candidate for a Tummy Tuck?
The question of if this is the right procedure for you or not is the difference between sagging skin or pockets of fat. If your skin is still very elastic and has good turgor and tone, but you have a thick area of subcutaneous or accumulated pockets of fat around your abdomen, liposuction and/or BodyTite might be a better procedure. Understand that liposuction cannot be used to remove or reduce the fat that is intra-abdominal (around organs) or below the muscle. But if you have loose, inelastic skin, with some pockets of fat, a tummy tuck is the better option (probably combined with light liposuction particularly of the hip and flank region to remove the fat depots).
For women who have had children, it’s usually not just a problem with stretched, saggy skin. Pregnancy is especially hard on the abdominal muscles because of the way the pregnant uterus puts pressure on the abdomen from the inside and the focused weight gain is in such a small area. This can actually separate the abdominal muscles along the midline known as a rectus diastasis. These can be brought back together in the center of the abdomen during this surgery, narrowing the waist, and Drs. Carlotti routinely run a double corset stitch and routinely get inches of reduction. The average patient will go down 4 pant sizes.
One caveat with a tummy tuck, however, is that you should be sure you do not want to have any additional children. The effects of pregnancy could negate the results of your tummy tuck. Also, people who plan on losing significant amounts of additional weight should delay their tummy tuck because the additional weight loss, particularly if it occurs quickly, might create more loose skin. Ultimately, it’s important to remember that abdominoplasty is a body-contouring procedure, not a weight-loss procedure. Intra-abdominal fullness requires a dedication to weight loss.
Because women have babies, the vast majority of abdominoplasties are done on women but Drs. Carlotti do a fair number of older and young men. The older males may be wanting to remove untoned skin but our older and younger benefit from a tightening of the muscles especially when they have lost a fair amount of weight. Post-bariatric patients, men and women, tend to lose weight quite quickly after gastric bypass, gastric sleeves, or lap bands and nearly all opt for an extended full abdominoplasty, Type IV, with the tightening of their abdominal muscles.
How Is a Tummy Tuck Performed?
When you’re in your consultation with Dr. Carlotti (Dr. Michelle Carlotti or Dr. Albert Carlotti), you will discuss your goals and expectations for your tummy tuck. At that point, you’ll discuss whether you will benefit most from a full tummy tuck or a mini tuck or some level in between. The option that is right for you depends on the amount of loose, sagging skin and where it is located.
In a full tummy tuck aka Type IV abdominoplasty, an incision from hip bone to hip bone is made as well as above the belly button with a hexagonal removal of the excess to the sides to get rid of the ‘muffin top’ tendency. The goal is to have a low incision that matures into a well-healed scar that looks like a resting skin tension line that can easily be covered by undergarments or bathing suit. Once the skin is separated from the underlying muscle, the abdominal muscles are pulled together with a corset stitch to make the abdomen firmer and to narrow the waist. Next, the skin is pulled downward, excess skin is trimmed away, and the navel/umbilicus is brought back thru the flap in a natural position (transpositioned).
In a “mini tummy tuck”, a lower pooch is removed. The length of the incision on the bikini line here is dependent on how much loose skin is present. Type II’s address abdomens that primarily have issues isolated to below the belly button and III’s move the belly button, address the entire abdominal wall, but might not have enough skin to do a ‘full’.
Preparing for Tummy Tuck Surgery
You prepare for this surgery as you would any surgery. You’ll need to stop taking aspirin, anti-inflammatory medications, and certain supplements. You’ll need to stop smoking a minimum of a couple of weeks before and after your surgery. We’ll discuss what you need to do to prepare physically.
But you also need to prepare for your recovery ahead of time. During your preoperative visit, you will receive a comprehensive book and counseling session to make this as easy as possible on you. We all at Austin Cosmetic Surgery understand we have done this hundreds, if not thousands, of times and some folks get overwhelmed as this is your first. You will receive all of your prescriptions so you are prepared ahead of time and day of surgery will be seamless. You’ll need to get your bed and other recovery areas ready. Because a tummy tuck addresses skin, support tissue, and muscle in the abdomen, we will advise you when you can advance activity and lifting. That means you’ll need to enlist help with children and other household chores. By day 5, Dr. Michelle Carlotti is a stickler about walking and asks that you are walking a minimum of 1 mile a day and by day 10 you will be walking 2+ miles a day.
Recovery After Tummy Tuck Surgery
Since abdominoplasty involves incisions in the abdomen and movement of muscle fiber, recovery is not a cakewalk. There will be more tightness than true pain, but the amount varies by the individual. You’ll be encouraged to walk soon after your surgery and should taking short walks three or four times a day for just a few minutes each time. You’ll have to walk a little hunched over and the skin of your abdomen may feel tight. If you have drains, they will be removed anywhere from four days to two weeks after your surgery. You’ll wear a compression garment to help your skin adapt to its new slimmer contour. Most patients can return to work 10 days to two weeks after their surgery, but this is an individual thing — it may take longer. You’ll have residual soreness that will come and go, and it may last for weeks. Any strenuous exercise or lifting will have to wait for at least six weeks.
What Are the Risks of Abdominoplasty?
This is major surgery, so the risks are the same as with any other surgery: excessive bleeding, poor incision healing, infection, keloid scar formation, and the like. This is a safe procedure and complications are rare.
Will I Have a Noticeable Scar After Tummy Tuck Surgery?
You will have an extensive scar from a full tummy tuck. We will place the incision so that it is covered by a bathing suit bottom or your underwear. Still, there will be a scar. You may have a second incision around the belly button. We will go into scar management mode approximately 3-4 weeks postop to optimize the healing process and onboard any scar management modalities that might be indicated.
As your incisions heal, they will darken initially as the body creates new collagen fibers to fill and close the wounds. This will make your scars darker, thicker, and somewhat more prominent for anywhere from 3-6 months. This can be ultimately depressing, but patience is a good thing here because they will lighten. Once the body has formed enough collagen at the wound site, some of it will break down as the blood supply decreases. Now the scar will become lighter, thinner, and flatter. It takes one to two years for scars to fully mature and vigilance and patience pays off. Sun protection is critical!
What Happens If I Have Another Child After I Have a Tummy Tuck?
Another pregnancy will negate the changes made by your surgery. After all, you will stretching the same area all over again. Plus, pregnancy will place real stress on your incisions, possibly distorting the scars. A tummy tuck isn’t something to have if you’re even remotely considering having more children.
Is a Tummy Tuck an Alternative to Weight-Loss Surgery?
Some people think a tummy tuck is an alternative to bariatric surgery. But this is not at all the case. At Austin Cosmetic Surgery, we only perform this surgery on patients who are within 10-15 percent of their ideal weight, preferably at their ideal weight. When a potential patient comes in who has not lost all of her baby weight yet, we advise her to come back when she has lost all of the weight. This is again because significant weight loss will set up more sagging skin, which is what this surgery is trying to correct. This is a body-contouring procedure, not a weight-loss procedure.
Can a Tummy Tuck Be Combined with Other Procedures?
A tummy tuck is an involved surgery and recovery, so you may want to think twice before looking to combine it with other procedures. Still, should you want to address the effects pregnancy and breastfeeding had on your breasts, you could combine a tummy tuck with either a breast augmentation, breast lift or a breast lift with augmentation. When a tummy tuck, breast rejuvenation, and/or liposuction are combined into a single surgery session, we call it a Mommy Makeover.
Schedule a Consultation
If you are interested in Tummy Tuck surgery and would like to find out if you are a candidate for the procedure, contact our office today at 512.688.8000. Our helpful staff can answer your questions and schedule a complimentary consultation with one of our board-certified plastic surgeons.