Overview of Abdominoplasty
Abdominoplasty is also known as tummy tuck. Because of its effectiveness at creating a tight, flat abdomen, it is one of the most common procedures performed in plastic surgery. In a tummy tuck, the surgeon makes an incision just above the pubic bone (similar to but slightly longer than a C-section incision) and removes excess abdominal skin and fat.
Today’s society places strong emphasis on a slender, youthful appearance of the abdomen. This is especially true in the the summer months, where fashion trends often focus on the midriff area.
The good news is that when the correct operation is chosen for the patient, the level of satisfaction is extremely high. A properly performed abdominoplasty can remove the redundant skin. The not so good news is that the operation leaves a long scar just above the pubic bone that often extends across the lower abdomen. If preformed properly, however, this procedure results in a scar that it is easily hidden by underwear.
Abdominoplasty procedures can be divided into 4 types: mini; standard; extended; and the most aggressive, a complete, circumferential body lift. The most appropriate procedure for you is determined during your consultation with your Dr, based on your goals and assessment of your skin excess, skin quality, fat excess, fat distribution, and body type.
In the least involved of these four types, the mini-abdominoplasty, the surgeon makes an incision within the pelvic bones that is relatively short, although slightly longer than a C-section incision. It usually is not necessary to reposition the umbilicus. The best candidate for this procedure typically has redundant skin and an abdominal “pooch” located below the umbilicus.
Standard Abdominoplasty (Standard Tummy Tuck)
The standard abdominoplasty is the most common abdominoplasty. It does an excellent job in eliminating the “abdominal pooch” below the umbilicus. The process results in a much flatter stomach. This flattens the stomach and narrows the waistline.
A standard abdominoplasty will not, however, effectively treat fat deposits in the flank area. This can be addressed with either liposuction or by performing an extended abdominoplasty. If there is only a small or moderate amount of flank fat, liposuction is the best course. If you have a significant amount of flank fat, an extended abdominoplasty would most likely be the best choice.
Extended Abdominoplasty (Extended Tummy Tuck)
The extended abdominoplasty gives hope to the patient who is not a candidate for a standard abdominoplasty. The incision for the extended abdominoplasty goes to the back of the hip area. To keep the incision low so that even low-rise clothing can be worn without scar exposure.
Circumferential Abdominoplasty (Body Lift)
The circumferential body lift is a very aggressive procedure reserved for those patients with a significant amount of redundant skin posteriorly. Another indication for this procedure is the patient with flabby hips and droopy buttocks. The hips and buttocks can be markedly elevated to give a sleeker, more youthful appearance. It must be mentioned, however, that this more aggressive operation will leave a circumferential scar and is more complicated. This will be discussed during your consultation.
Benefits of Abdominoplasty
The benefits of a properly performed abdominoplasty are abundant. The most impressive of these is the removal of the loose flabby abdominal skin that most patients thought would never go away. Another significant benefit is that the skin removed is usually the skin that contains stretch marks. In addition to the removal of excess skin, fat, and stretch marks, the underlying muscles are tightened.
This markedly flattens the stomach and enhances the contour. Overall, this procedure dramatically flattens the abdomen creating a sleeker, more attractive figure.
Are you a good candidate for Tummy Tuck?
The most significant determinant of a good candidate for abdominoplasty is the amount of loose skin that is below the belly button. Often, this loose skin is caused by significant weight loss. In both cases, the abdominal skin has been stretched beyond its ability to shrink.
If you can easily grab and pinch a large amount of loose skin, it is likely that an abdominoplasty would provide a highly noticeable improvement for you. If, on the other hand, the skin feels very thick and is not particularly loose, it is likely that an abdominoplasty is not for you. In fact, liposuction may be more appropriate. A visual evaluation is necessary to decide which procedure is right for the individual.
Possible complications associated with Abdominoplasty
Outlined below are the most common and significant complications associated with the procedure.
- Large scar. It is important to realize that all abdominoplasty procedures leave long scars. The total length of a scar depends on the amount of redundant fat and skin within the flank area. This is discussed further with a doctor prior to the operation.
- Blood clot. Blood clot formation after abdominoplasty is more common than with other cosmetic surgery procedures. This can be minimized if the patient wears compressive stockings and walks around immediately after the operation.
- Infection and wound healing problems.
- Fluid or blood collection within the wound.
- Asymmetry and/or contour irregularities.
Recovery time after Abdominoplasty
You will be encouraged to walk around the very next day. Returning to work can be somewhat variable depending on your job. If your job is sedentary you will be able to return to work in 10 to 14 days. If your job is labor intensive it may take up to 6 weeks to return. Expect to have bruising and swelling.
You may resume light exercise that does not require abdominal activity at approximately the 4th week. Abdominal activity, however, should not be attempted prior to 8 weeks and should only be done when there is absolutely no pain. The majority of the bruising and swelling will have subsided by 3 weeks but complete resolution will take at least 6 months to occur.
Typically, scars heal in a very methodical manner. For the first 6 to 8 weeks the scar becomes red as the body heals. After that stage, however, the scar becomes much less red and thinner. By one year, the scar is usually very light and easily hidden by underwear.