Childbirth is one of the most wonderful times in a woman’s life. Unfortunately, what pregnancy can do to a woman’s tummy is less than wonderful. Some women have no stretch marks and can regain a nice flat tummy. For many others, however, he result is loose, stretched out, hanging skin with a road map of stretch marks.
For such women, a tummy tuck (abdominoplasty) may be the ideal procedure for a woman to regain the abdominal contour enabling women to wear clothes comfortably and even begin wearing a bathing suit again.
Others who may be good candidates for this procedure, both men and women who have lost large amounts of weight, either through exercise, or after weight loss surgery such as lap band or gastric bypass surgery.
The results can give a person new found confidence and not only improve ones appearance, but also in some alleviate the back pain that occurs when abdominal muscles have loosened or a large amount of abdominal skin.
Abdominoplasty has a very high level of satisfaction and many patients find it life changing, improving self-image as well as feeling more comfortable.
Abdominoplasty is performed in Dr. Edelson’s outpatient surgical center under general anesthesia provided by a physician anesthesiologist. It typically takes 2-4 hours depending on the size of the individual or if additional procedures are done such as liposuction and incision is made as a gentle smile-like curve across the lower abdomen extending to the hips. The skin is elevated off the muscle up to the rib cage, leaving the umbilicus behind, attached to the muscle. The abdominal muscles are then tightened with permanent sutures by forming an “internal corset” up and down the mid line. The skin is then pulled down and excess skin and fat removed. The final incision is across the lower abdomen where it can be concealed in a bathing suit. A new opening for the umbilici us is then made. The umbilici is pulled through the opening a sutured in its new location, so there is a scar around it but it usually heals very nicely.
If a muscle tightening procedure is intended, this will be a source of post surgical discomfort for about a week. Many surgeons also use a drain under the skin for several days so that fluid or blood do not accumulate under the skin.
If your job includes desk work only, expect 10-14 days before returning to work and about 3-4 weeks before resuming exercise and sexual activity
Most of the skin will retain sensation, but there is a portion of abdominal skin that almost always stays numb. This is the area just above the scar in the midline. Patients are aware of the numbness but it usually is not bothersome.
Generally most Plastic Surgeons advise that you wait until you are sure you do not plan any more pregnancies, as this will likely stretch the skin again requiring the abdominoplasty to be redone.
I have performed Breast Augmentation, Mastopexy and Breast Reductions concurrently with abdominoplasty. Some people refer to this as the “Mommy Makeover”. This procedure can take over 6 hours. If I anticipate one portion of the procedure may be particularly lengthy (such as a patient with very large breasts or a larger tummy tuck, I may advise doing the procedures at different times for safety reasons.
In most people the scar will be red for a while and gradually fades over the course of time, usually about a year. However, hypertrophic, thick scars may occur especially in darker skinned individual or those with a history of keloids. The surgical skill and placement of the incision can also affect the quality of the scar.
A body lift (sometimes called a belt lipectomy) is really an extended abdominoplasty. The skin excision continues beyond the hips and goes entirely around the back. Candidates for this are usually patients who have lost huge amounts of weight through bariatric surgery.
In certain cases back pain can be improved. This is usually in the situation where stretched out abdominal muscles contribute to the back pain. Tightening those muscles as well as removing the heavy sagging skin of the abdomen can often improve back support and alleviate pain and has been substantiated in many studies. But even in this case your insurance is unlikely to pay for it.
You can have liposuction to other areas of the body at the time as a tummy tuck, most commonly on the hips, thighs, and buttocks. However performing liposuction of the abdomen at the same time can increase risks of wound healing problems because of the double trauma of skin tightening and liposuction at the same time.
You should consult a Board Certified Plastic Surgeon with experience in both procedures. It is tempting to opt for the liposuction because it is an easier operation to go through and is less costly. However if you really need a tummy tuck, liposuction alone will give you a disappointing result.
Very few insurance carriers will pay for a tummy tuck, even if the surgeon says you have back pain or a ventral hernia. Insurance companies in the past have had a lot of experience with people trying to get it covered for a variety of issues or symptoms so that now most companies have a blanket policy that they won’t pay for any abdominoplasty at all. To be sure, consult you own carrier to determine their policy.
A mini-tummy tuck involves surgery confined to the lower abdomen and removes much less skin. Candidates are usually thin with a modest amount of loose skin, often times just above a scar from a Cesarean section. The benefit are a shorter procedure, shorter scar and easier recovery and no scar around the umbilicus. Unfortunately it does not accomplish nearly as much as a standard tummy tuck. So if you need a full tummy tuck and elect to have a mini instead you might be disappointed that it didn’t accomplish as much as expected.