Tummy Tuck – Abdominoplasty
Many factors change the contour of your abdomen. Childbirth or significant weight gain can stretch abdominal tissues to an extent that is uncorrectable with exercise. Excess fat deposits may produce undesirable bulges or fullness, and loose skin following childbirth or weight loss may result in an unattractive abdomen.
Abdominoplasty is a procedure that improves the contour and appearance of the abdomen by tightening the underlying muscle framework, and removing excess fat and loose skin and many stretch marks.
Pregnancy causes enlargement of your uterus with significant stretching of the tissues of your abdomen. After delivery, you can exercise to recover the tone in the muscles themselves, but the fascial tissues, which interconnect the muscles, do not respond to this effort. Stretching or looseness of the lower abdominal tissues creates bulging, which you cannot correct with exercise.
As fat is lost beneath the skin of your abdomen, especially after significant weight loss, the tissues may become much looser and may actually hang downward. Skin also does not respond to any type of exercise; however, excess loose skin can be removed during an abdominoplasty.
Even in individuals who are not overweight, localized deposits of fat can occur in areas of the abdomen, producing an undesirable contour. If fat deposits are the only contour problem, they may be correctable with liposuction alone. However, if stretched musculature or loose skin is present, an abdominoplasty is necessary to achieve the best result.
Abdominoplasty can achieve the following: It reshapes the underlying framework of the abdomen to firm the abdominal wall, removes excess fat deposits that may be present, eliminates excess loose skin to produce a flatter, more youthful abdomen and removes some (and occasionally all) “stretch marks”.
During your consultation, Dr. Morris will ask you about the areas of your abdomen that concern you. He will specifically explain which components of an abdominoplasty will be necessary to achieve the best contour, and describe the type of changes you may hopefully achieve.
During the Surgery
Incisions for abdominoplasty are placed low on your abdomen to allow them to be concealed. The length of the incision depends on the degree of looseness in your skin and how much will need to be removed. Dr. Morris will discuss your unique situation with you.
The skin and fat are first lifted off the underlying musculature of the abdomen. If the fascia (the tissue that interconnects the muscles) is stretched, he will tighten it by placing multiple rows of sutures. In essence, the underlying framework of the abdomen is reshaped. The skin and fat are then pulled downward, and the excess is removed. Due to the amount of skin that generally must be removed, it is usually necessary to make an incision around the umbilicus (belly button).
Following abdominoplasty procedures, most patients have moderate discomfort the first 48-72 hours, decreasing rapidly thereafter. The degree of discomfort depends largely on the extent of surgery required to reshape your abdomen and your personal pain tolerance. We will prescribe medication to keep you as comfortable as possible. Your abdomen will feel tighter as the result of the procedure. The feeling of tightness will decrease over 1-3 weeks as swelling abates and the tissues become accustomed to their new position.
Because of the dramatic changes this procedure provides, the discomfort level is, for most patients, greater than most other procedures. For this reason Dr. Morris prefers that you stay in the hospital the first night for observation, and proper pain control. He will prescribe a pain pump which allows you to administer to yourself small doses of pain medication as you need it. This medication runs directly into your IV line, avoiding the need for shots or injections to control your discomfort.
Many patients only need minimal narcotic pain medicines due to the fact that Dr. Morris offers a couple of pain relief options following surgery. One is the ON-Q® PainBuster® Post-Op Pain Relief System. This system helps reduce postoperative discomfort via two very tiny tubes that are placed on the surface of your tightened muscles, delivering a constant supply of a local anesthetic solution. The system is in place 3-4 days and the tubes are painlessly removed by the patient at home. The use of this system has replaced pain control as the primary reason for the overnight stay with simply convenience and nursing assistance until you get acclimated to moving around on your own.
The other avoids the small tubes and reservoir – an injection of timed released local anesthetic is placed at the time of surgery – Exparel®. This is highly effective and produces excellent pain reduction for most patients for several days.
It is important to be up and about the day following your procedure. How much activity we recommend depends upon the specific procedure required to reshape your abdomen.
After the Surgery
All of your incisions will be carefully closed with sutures placed with the utmost care so that we maximize the chance for very fine-line scars. Usually, you’ll be able to shower or bathe a few days after surgery. To minimize fluid collection and swelling, and to improve your comfort in the treated areas, we’ll ask you to wear an elastic garment (which we provide) for two weeks or more after surgery.
The Stages of Recovery
For abdominoplasty procedures, the average….
|Hospitalization time:||1 night|
|Bruising and swelling resolve:||7-21 days|
|Return to work, social activity:||5-14 days|
|Aerobic or strenuous activity:||6 weeks|
We encourage you to be active, but to adhere to the limitations we prescribe. To assure the best result and to prevent damaging the reshaped areas, we will tailor your activity accordingly.
How much your abdomen can be reshaped depends on several factors. The quality of your tissues is very important, and is a factor over which we have little control. If you are significantly overweight, you will get a much better correction if you achieve a more ideal body weight before your abdominoplasty. There is a limit to the amount of fat and skin that can be safely removed during the procedure.
To reshape the underlying muscular framework and remove excess skin, incisions are necessary. Incisions are placed low on the abdomen, and their length depends on the amount of correction you require. In most cases, it is necessary to reshape your umbilicus (belly button). Dr. Morris will discuss the specifics of the incisions during your consultation.
Any incision will produce a scar. The quality of these scars depends on several factors – most importantly your own specific healing characteristics. You should think of scars as a worthwhile trade-off for the often dramatic improvement in the shape of your abdomen.
Abdominoplasty cannot change the underlying skeleton and is limited by how much the muscles can be tailored. Limitations are present. Risks associated with abdominoplasty are generally very small. We want to provide you the best information so that you’ll be well informed in making your decision. Dr. Morris will discuss any specific limitations during your consultation. This procedure can produce extremely dramatic results and has an exceptionally high ranking for procedures producing the greatest patient satisfaction.