Abdominoplasty, or tummy tuck, is a major surgical procedure intended to dramatically reduce the appearance of a protruding abdomen.
How is the surgery performed?
Typically, an incision is made from hipbone to hipbone, just above the pubic area. A second incision is made to free the navel from surrounding tissue. With partial abdominoplasty, the incision is much shorter and the navel may not be moved, although it may be pulled into an unnatural shape as the skin is tightened and stitched.
Next, the skin is separated from the abdominal wall all the way up to your ribs. The surgeon will lift a large skin flap to reveal the vertical muscles in your abdomen. These muscles are tightened by pulling them close together and stitching them into their new position. This provides a firmer abdominal wall and narrows the waistline.
The skin flap is then stretched down and the extra skin is removed. A new hole is cut for your navel, which is then stitched in place. Finally, the incisions will be stitched, dressings will be applied, and a temporary tube may be inserted to drain excess fluid from the surgical site.
In partial abdominoplasty, the skin is separated only between the incision line and the navel. This skin flap is stretched down, the excess is removed, and the flap is stitched back into place.
Will the surgery result in permanent scarring?
Abdominoplasty does produce a permanent scar, which, depending on the extent of the original problem and the surgery required to correct it, can extend from hip to hip. Your scars may actually appear to worsen during the first three to six months as they heal, but this is normal. Expect it to take nine months to a year before your scars flatten out and lighten in color. While they'll never disappear completely, abdominal scars will not show under most clothing, even under bathing suits.
How long does the procedure take?
A complete abdominoplasty usually takes two to five hours, depending on the extent of work required. Partial abdominoplasty may take one to two hours.
How long is the recovery time?
If you start out in top physical condition with strong abdominal muscles, recovery from abdominoplasty will be much faster than those who do not exercise on a regular basis. Some people return to work after two weeks, while others take three or four weeks to rest and recuperate.
Exercise will help you heal better. Even people who have never exercised before should begin an exercise program to reduce swelling, lower the chance of blood clots, and tone muscles. Vigorous exercise, however, should be avoided until you can do it comfortably.
Will I need anesthesia?
Your doctor may select general anesthesia, so you'll sleep through the operation.
Other surgeons use local anesthesia combined with a sedative to make you drowsy. You'll be awake but relaxed, and your abdominal region will be insensitive to pain. (However, you may feel some tugging or occasional discomfort.)
Am I a good candidate for abdominoplasty?
The best abdominoplasty candidates are men or women who are in relatively good shape but are bothered by a large fat deposit or loose abdominal skin that won't respond to diet or exercise. The surgery is particularly helpful to women who, through multiple pregnancies, have stretched their abdominal muscles and skin beyond the point where they can return to normal. Loss of skin elasticity in older patients, which frequently occurs with slight obesity, also can be improved.
Patients who intend to lose a lot of weight should postpone surgery. Also, women who plan future pregnancies should wait, as vertical muscles in the abdomen that are tightened during surgery can separate again during pregnancy. If you have scarring from previous abdominal surgery, your doctor may recommend against abdominoplasty or may caution you that scars could be unusually prominent.
Your surgeon will evaluate your health, determine the extent of fat deposits in your abdominal region, and carefully assess your skin tone during your initial consult. Be sure to tell your surgeon if you smoke and if you're taking any medications, vitamins or other drugs.
Your surgeon will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking and taking or avoiding certain vitamins and medications.
If you smoke, plan to quit at least one to two weeks before your surgery and not to resume for at least two weeks after your surgery. Avoid overexposure to the sun before surgery, especially to your abdomen, and do not go on a stringent diet, as both can inhibit your ability to heal. If you develop a cold or infection of any kind, your surgery will probably be postponed.
Whether your surgery is done on an outpatient or inpatient basis, you should arrange for someone to drive you home after your surgery and assist you for a day or two after you leave the medical center, if needed.
For the first few days, your abdomen will probably be swollen, and you're likely to feel some pain and discomfort, which can be controlled by medication. Depending on the extent of the surgery, you may be released within a few hours, or you may have to remain hospitalized for two to three days.
Your doctor will give you instructions for showering and changing your dressings. Although you may not be able to stand straight at first, you should start walking as soon as possible.
Surface stitches will be removed in five to seven days, and deeper sutures (with ends that protrude through the skin) will come out in two to three weeks. The dressing on your incision may be replaced by a support garment.
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