Abdominoplasty, commonly referred to as a tummy tuck, is a surgical procedure that improves the contour of the abdomen by combining techniques that incorporate tightening the abdominal muscles, removing excess skin and thinning out areas where fatty-tissue is disproportionate.
Who is a good candidate?
Good candidates for abdominoplasty are healthy, non-smokers who feel that, despite dieting and exercise, their lower abdomen has skin overhang and fatty tissue that prevents an optimal overall aesthetic appearance. Many women are simply bothered by stretch marks that have occurred in their lower abdomen following pregnancy or weight gain, and this procedure is traditionally able to remove a substantial amount of this over-stretched skin to give a rejuvenated appearance to the entire lower torso. Patients who have lost substantial weight following bariatric surgery or other lifestyle modifications also typically see dramatic changes in the appearance of their abdomen following the procedure. Ideally, female patients have completed all anticipated pregnancies and patients who have undergone bariatric surgery have stable weight for at least six months prior to surgery.
What is the post-operative recovery?
Patients typically benefit by allowing a full two weeks to recover from the procedure. While the procedure is outpatient surgery, the muscle tightening portion of the procedure can provide a degree of soreness that takes a week or so before patients feel more able to fully integrate themselves back into activities of daily living. Not all patients require muscle tightening, but those that do should avoid lifting anything heavier than 5 pounds for 4-6 weeks to allow for the muscles to heal without stressing the internal stitches. Most patients are back at work by the second week following surgery although the procedure requires 5-6 weeks before patients feel as if they have fully recovered to the degree of their pre-surgical state.
How is the procedure performed?
Traditional tummy-tuck surgery is performed under general anesthesia in our accredited operating room. An incision is made low on the abdomen. This allows the skin excess to be removed and for muscle-tightening to be performed as necessary. In patients with minimal excess skin and only mild muscle laxity, a mini-tummy tuck allows for improvement in the abdominal appearance through a smaller incision kept largely over the pubic region. Other patients with more severe skin laxity may derive optimal improvement from an extended abdominoplasty that incorporates a midline incision to allow for side-to-side tightening and a more corset-type improvement in their waistline. The specific type of abdominal contouring procedure that you are a candidate for will be discussed during your initial consultation with Dr. Grotting and Cohn. Abdominoplasty is individually tailored to maximize overall contour improvement while respecting the need to minimize scarring and allow for a prompt and safe recovery.
What type of result can I expect?
Patients who undergo abdominoplasty typically see a dramatic result in the contour of their abdomen. The procedure incorporates several critical components that are individually assessed to provide the most optimal result for the patient. Specifically, the procedure incorporates removal of excess skin, tightening of the underlying abdominal muscles to create a flat, tight surface for the skin to be rewrapped upon, and liposuction to address skin thickness and provide optimal contour along love handle regions and wherever needed. The end result is a markedly more flat, contoured abdominal surface with a significant improvement in skin laxity and overall abdominal tone. Liposuction is incorporated as necessary to optimize overall contour and to accentuate the overall waistline. The resultant scar typically runs across the length of the lower abdomen below the level of waistline. Scar placement is low on the abdomen, as would be with a C-section or hysterectomy, but the scar extends slightly further and wider, usually to the hip bones or so. There is also a small scar around the belly-button to allow for re-positioning and inset of the belly-button. This scar is typically subtle and within the depth of the belly-button to allow for minimization of its appearance. Swelling is largely dissipated during the first several weeks following the procedure, but can persist for several months. Patients are able to appreciate the dramatic change in contour immediately following the procedure, although swelling may take several months to completely resolve and to allow for appreciation of the final result.
What are the potential risk and complications?
Risks include standard aspects seen with all surgery, like bleeding and infection. Fortunately, these are rarely seen. More frequently encountered complications include things like small areas of delayed healing that may require short-courses of antibiotic ointment to assist with healing or unfavorable scarring that may benefit from steroid injections during the early post-operative period.
Are there additional relevant considerations regarding this procedure?
- How do I know if I am a better candidate for liposuction or abdominoplasty? Both procedures are useful and common in abdominal contouring operations. Liposuction is a first-line procedure for patients without significant amount of stretch marks and for the patient with good abdominal muscle tone who doesn’t require re-tightening of the abdominal muscles. Incisions are smaller and recovery is quicker with liposuction procedures, but the ability to remove excess skin and tighten the abdominal wall is not a component of liposuction. More often than not, liposuction is used at some point during the abdominoplasty procedure to refine and improve the end result. Liposuction of love handles is common and liposuction can be safely performed with certain types of abdominoplasties to thin the thickness of the remaining abdominal skin. During your consultation with Drs. Grotting and Cohn, you will have an opportunity to discuss various surgical options and will review benefits and limitations of each specific procedure to help in achieving an ideal result that is tailored for your specific goals.
- Will insurance cover my abdominoplasty? Some insurance providers will cover panniculectomy procedures. This operation is different from an abdominoplasty in several important aspects. A panniculectomy is an operation that is aimed at addressing hygiene concerns at the level of the abdominal fold, where skin-on-skin contact can result in moisture build-up, infection and chronic skin conditions. Different insurance carriers have various criteria for determining if you are a candidate for this operation. Common criteria to be considered for an insurance-procedure candidate include photo-documentation of the degree of skin excess showing that it extends to the hair-bearing pubic region and failed conservative management using powders and non-surgical treatments as documented by your primary care doctor. We are happy to assist you in determining your candidacy for insurance coverage. Of note, a panniculectomy is an operation performed to address a medical issue, and while it does improve the appearance of the abdomen, the muscle tightening and comprehensive skin redraping and tightening performed with an abdominoplasty is not part of a panniculectomy procedure. Patients undergoing a panniculectomy may elect to have cosmetic abdominal work performed during the course of the operation, but these aspects are not typically covered by insurance. We are happy to discuss these aspects with you during your consultation and visit.