Abdominoplasty, or a tummy tuck, is one of the most common cosmetic surgery procedures performed. Often, factors such as multiple pregnancies and genetics can contribute to the development of loose skin, fat deposits, and stretch marks in the abdominal region. Even substantial weight loss can contribute to the development of loose skin in the abdomen. As these areas typically persist despite proper diet and exercise, they can make the abdomen appear disproportionate with the rest of the body.
How an Abdominoplasty Works
An abdominoplasty works by removing loose skin, fat deposits, and stretch marks from the abdominal region. In addition, vertical abdominal muscles that have been stretched and weakened over time are tightened, restoring the appearance of a firmer, flatter abdomen. Abdominoplasty procedures can be performed alone, but are often performed with liposuction to further improve body contours. An abdominoplasty should not be considered as a treatment for obesity, or a substitute for proper diet and exercise. Individuals considering an abdominoplasty should be healthy and relatively fit. Future pregnancies and substantial changes in weight following an abdominoplasty, as well as the presence of scars from prior surgeries may decrease the effectiveness and longevity of treatment.
The length of an abdominoplasty procedure can vary depending on the extent of tissue removal, or the necessity for an additional procedure such as liposuction. However, most abdominoplasty procedures last approximately two to five hours. Prior to the start of your abdominoplasty procedure, the treatment area will be cleansed and incision guidelines will be drawn. For complex procedures, which involve the removal of a large amount of tissue, or are performed in conjunction with another procedure, general anesthesia will likely be administered. Conversely, a local anesthetic and sedative may be administered for less complex procedures, which will help you stay comfortable and relaxed.
Abdominoplasty procedures typically require two incisions. The surgeon will make an incision just above the pubic area that spans from one hip bone to the other. The length of the incision and its shape will depend on the extent of treatment as well as the contours of your body. While the surgeon will attempt to place the incision so that it is hidden by a bathing suit or undergarments, it is important to realize that you will have a permanent scar. A second incision is usually made around the navel.
Exposure of Abdominal Wall
The skin and fat layers that lie above the abdominal wall are separated from the wall using a cautery device. The tissue is then lifted upward toward the rib cage to expose the abdominal muscles.
Tightening of Abdominal Muscles
In order to tighten the abdomen, the surgeon will suture the abdominal muscles, pulling them closer together, which creates a flatter, firmer abdominal wall and a slimmer waistline.
Replacing Skin and Naval Position
The surgeon will stretch the layer of skin and fat, that had been lifted away, back tightly over the abdominal wall. Although your navel remains intact and attached to the abdominal wall, it will become covered by the layer of skin when it is pulled back into place. Therefore, the surgeon will make an incision through the layers of skin and fat to create a new hole for your navel. The skin and fat that hangs beyond the original incision line will be removed.
In order to prevent fluid build up as you heal, drainage tubes will likely be placed in the abdomen, and will remain in place for approximately two to three weeks. The incisions will be sutured and dressings and bandages will be applied.
You will most likely have to wear a type of compression garment, which is similar to a girdle. This tight-fitting garment will help to reduce swelling by preventing fluid build up, as well as provide comfort and support as you heal. Depending on the extent of surgery, you may have to wear the compression garment up to several weeks. As with any major surgical procedure, you will likely experience pain, bruising, and swelling, most of which will subside in a few weeks. While you may not be able to stand fully upright, it is important that you begin to walk for short periods soon after your procedure to facilitate blood flow. Your stitches may dissolve with time. However non-dissolving stitches will be removed in approximately one week, whereas sutures may remain in place for up to two weeks.
Most patients are able to return to work in one to three weeks time. However, it may take six to eight weeks before you feel able to return to full normal activity including heavy lifting and strenuous exercise. Although you will have a permanent scar, it will slowly fade over time. It is important to realize that if you become pregnant or experience substantial weight gain or loss, the results from your procedure may be compromised. However, with proper diet and exercise, the results from an abdominoplasty can be maintained for several years.