Abdominoplasty
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What is a tummy tuck?
A tummy tuck, also called an abdominoplasty, is a procedure that removes excess loose skin and fat from the lower abdomen while also tightening the muscles of the abdominal wall. Tummy tucks are common following pregnancy and significant weight loss, but it may be an appropriate procedure for anyone who has excess skin and fat or muscle laxity. Pregnancy or weight gain can cause significant stretching of the abdominal skin and musculature. These changes can be difficult to improve, even with aggressive diet and exercise.
Typical appearance of stretch marks and lower abdominal laxity
Improving abdominal contour and reducing stretch marks and excess skin from the lower abdomen can significantly improve yourself-image and self-confidence.
Pictured above is a 46-year-old female patient of Dr. Forsberg who underwent abdominoplasty to improve abdominal contour after multiple pregnancies.
Click here for more before and after’s
Who is a candidate for a tummy tuck?
See Dr. Forsberg discuss good candidates for abdominoplasty
How is an abdominoplasty performed?
There are several varieties of abdominoplasty, including full abdominoplasty, high lateral tension abdominoplasty, lipo-abdominoplasty (tummy tuck combined with liposuction), mini-abdominoplasty, circumferential abdominoplasty (lower body lift), and “fleur de lis” abdominoplasty. Dr. Forsberg and Dr. Kelly will discuss each of these procedures with you – their advantages and disadvantages – and which one best suits your unique needs during your consultation.
The most common procedure performed by our surgeons is a full abdominoplasty combined with liposuction. In this procedure, all of the skin, stretch marks, and excess fat in the lower abdomen, between the pubis and belly button are removed.
Typical abdominoplasty incisions in lower abdomen and inside the belly button
Sutures are then placed in the abdominal muscles to tighten them, reduce bulging, particularly in the lower abdomen, and improve abdominal contour – essentially acting as an internal corset to reconstruct the hour glass figure.
Laxity of abdominal muscles before and after suture repair during the tummy tuck
The skin from the upper abdomen is then loosened and stretched down to meet the lower abdominal incision. Finally, an opening is made in the upper abdominal skin that has been re-draped to bring the belly button out and suture it in place.
Excess lower abdominal skin is discarded and a new opening is made for the belly button
Liposuction is also often performed along with abdominoplasty in order to improve contour.
What can I expect in terms of scarring?
The typical abdominoplasty scar is across the lower abdomen in a location well hidden by a bikini or undergarments. In a full abdominoplasty, there is also an incision on the inner border of the belly button that most often heals inconspicuously. Our surgeons take pride in making the belly button appear as natural as possible with minimal scarring as this is the area that can be a tell tail sign of the tummy tuck procedure in underwear or a bikini.
Typical abdominoplasty scar across the lower abdomen and around the belly button
Additionally, in some procedures, such as the mini-abdominoplasty, the lower abdominal incision may be shorter and the incision around the navel can be avoided.
Typical mini tummy tuck scar is shorter and across lower abdomen only
Differences in candidates for full tummy tuck versus mini tummy tuck
In other cases, longer or additional incisions may be necessary, including a vertical incision. In patients where laxity extends around the flanks and into the back, a circumferential abdominoplasty may be performed, leaving a scar around the waistline.
How do I know if I need liposuction or a tummy tuck?
People often debate between liposuction and procedures where skin is removed, such as a tummy tuck, thigh lift, or arm lift. The advantages of liposuction include minimal scaring and a faster recovery. Liposuction is great for reducing the bulge in localized areas of excess fatty tissue. It does very little, however, to improve excess skin. In most cases, the skin will shrink and contract following liposuction, though this varies according to age and natural skin elasticity. While skin removal procedures leave a more significant scar and take longer to recover from, they do directly address the issue of skin excess. After a thorough discussion and examination during your consultation, Dr. Kelly or Dr. Forsberg will give you their recommendations. The good news is that if you decide on liposuction instead of a more involved procedure, you can always remove the excess skin later on if you are concerned about the appearance of loose skin.
Should I lose weight before undergoing a tummy tuck?
For optimal results, it is best to achieve your lowest stable weight prior to undergoing. Losing weight will decrease the thickness of the abdominal wall. Reduction of intra-abdominal fat, which is the fat around the abdominal organs and inside the abdominal wall, can only be achieved with diet and exercise. Decreasing the amount of fatty tissue present prior to surgery will allow your surgeon to remove the maximum amount of excess skin and give you the most desirable result.
It is not uncommon, however, for patients to plateau at a weight above their goal weight even with diet, exercise, and weight loss surgery. A safe and dramatic improvement can still be obtained with abdominoplasty under these circumstances.
See Dr. Forsberg discuss advantages of losing weight prior to abdominoplasty
The patient pictured above is a 43-year-old patient of Dr. Forsberg who was never able to reach her goal weight with diet and exercise following multiple pregnancies. She decided to proceed with abdominoplasty and liposuction and obtained a fantastic improvement of abdominal contour. For this patient and many others, the improvement can provide the motivation needed to lose more weight after surgery.
What should I expect during recovery?
Following a tummy tuck, patients may be discharged home with a responsible adult to help care for them, or admitted to the hospital or nursing facility for observation the first night or two after surgery. Depending on the extent of dissection and skin excision, drainage tubes may be used. The abdomen will be quite sore following this procedure. Various pain medications and internal numbing medications will be given to control the pain. Even though you will be sore, it is important to go for short walks immediately after surgery. You will need assistance with these walks for the first few days after your procedure. You should know that it can take several weeks before you are feeling back to yourself. Most patients take 2 weeks off from work, depending on the nature of their job and how quickly they heal. There should be no heavy lifting or strenuous exercise for 4-6 weeks. It will be several months before the aesthetic outcome of the procedure can be judged because it takes time for swelling to go down and for the scars to soften and mature.
Center for Dermatology and Plastic Surgury
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