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Abdominoplasty (Tummy Tuck)

(Also Called 'Tummy Tuck')

Are sit-ups just not giving you the taut tummy you desire? If you’ve got a little too much flab or excess skin in your abdomen that won’t diminish with diet or exercise, you may want to consider an abdominoplasty, popularly referred to as a tummy tuck. This procedure flattens your abdomen by removing extra fat and skin, and tightening muscles in your abdominal wall.

However, this is a major surgery, so if you’re considering it, please take the time to educate yourself, thoroughly analyze your own situation, and do not rush to make the final decision. A tummy tuck should be the last resort for people who have exhausted all other measures, and the procedure should not be used as an alternative to weight loss.

Who are the best candidates for a tummy tuck?

A tummy tuck is suitable for both men and women who are in good general health overall and are at a stable weight. It is best to be a non-smoker.A tummy tuck should not be confused with a liposuction (the cosmetic surgery used to remove fat deposits), although your surgeon may elect to perform liposuction as part of a tummy tuck. Women who have muscles and skin stretched by multiple pregnancies may find the procedure useful to tighten those muscles and reduce that skin. A tummy tuck is also an alternative for men or women who were obese at one point in their lives, and still have excessive fat deposits or loose skin in the abdominal area.

When should you avoid the surgery?

If you’re a woman who is still planning to have children, you may want to postpone a tummy tuck until you’re through bearing children. During surgery, your vertical muscles are tightened. Future pregnancies can separate these muscles and cause a hernia.

Are you still planning to lose a lot of weight? Then you do not want to consider a tummy tuck until your weight has stabilized.

It’s important to note that a tummy tuck causes scarring on the abdomen. This scar is usually long and might be prominent. If this is something you don’t want, you may want to reconsider. Your doctor will discuss all these options with you when you go for the consultation.

How is a tummy tuck done?

Depending on your desired results, this surgery can take anywhere from one to five hours. The complexity of your particular situation also will determine whether you have it completed as an in-patient or outpatient procedure. You will receive general anesthesia, which will put you to sleep during the operation. It’s important to have someone with you who can drive you home. If you live alone, you also will need someone to stay with you at least the first night after the surgery, if you’re sent home after the procedure.

  • Complete abdominoplasty

    This option is for those patients who require the most correction. The incision will be made low on the abdomen, at about the same level as your pubic hair, and usually extends from hip bone to hip bone. Your surgeon will then manipulate and contour the skin and muscle as needed. You will have an incision around your belly button if you undergo this procedure, because it’s necessary to free your navel from surrounding tissue. Drainage tubes may be placed under your skin; these will be removed in a few days as your surgeon sees fit.

  • Partial or mini-abdominoplasty

    You and your surgeon will discuss your desired results, and he or she will determine the appropriate procedure during your consultation. Mini-abdominoplasties are often performed on patients whose fat deposits are located below the navel and require shorter incisions. During this procedure, your belly button most likely will not be moved. Your skin will be separated between the line of incision and your belly button. This type of surgery may also be performed with an endoscope (small camera on the end of a tube). This procedure may only take up to two hours, again, depending on your own personal situation and the complexity of your needs. As with the complete abdominoplasty, you may have drainage tubes after surgery.

  • Circumferential abdominoplasty

    This option includes the back region. When there is much excess fat in the back as well as the abdomen, you may have either liposuction of the back region or circumferential abdominoplasty.  The latter procedure allows for the removal of both skin and fat from the hip and back region as well, which improves the contour of your body three dimensionally.

Whether you’re having a partial or complete tummy tuck, your incision site will be stitched and bandaged. Your surgeon may have you wear an elastic bandage or compression garment after surgery. It’s very important that you follow all of your surgeon’s instructions on wearing this garment (if you are given one) and caring for the bandage in the days following surgery. Your surgeon will also instruct you on how to best position yourself while sitting or lying down to help ease pain.

If you are an exceptionally physically active person, know that you will have to severely limit strenuous exercise for 4 to 6 weeks. Your doctor will advise you on this as you go through the healing process. You may need to take up to one month off work after the surgery to ensure proper recovery. Again, your doctor will help you determine this based on your personal situation.

How should I prepare for a tummy tuck?

If you smoke, you will have to stop for a certain period as determined by your doctor. It is not enough to just cut down on smoking; you must stop completely, at least for two weeks prior to surgery and for two weeks after. You must stop the use of all nicotine gum and nicotine patches at least two weeks before and after surgery. Smoking can increase the risk of complications and delay healing.

Make sure you eat well-balanced, complete meals and do not try to diet excessively before the surgery. Proper nutrition plays a key role in healing properly.

Your surgeon may instruct you to stop taking some of your medications and dietary supplements for a certain period before and after the surgery. Your surgeon will determine this as part of your pre-operative consultation.

Your home recovery area should include:
  • Supply of loose, comfortable clothing that can be taken on and off very easily
  • Telephone within reaching distance
  • Hand-held shower head and bathroom chair

You know yourself personally, so make sure you set up the safest, most comfortable recovery area before you undergo the surgery to meet your personal needs.

What are the complications and side effects with a tummy tuck?

As expected, you will have pain and swelling in the days following surgery. Your doctor can prescribe a painkiller if needed, and will instruct you on how to best handle the pain.

Soreness may last for several weeks or months. You may also experience numbness, bruising, and overall tiredness for that same time period.

As with any surgery, there are risks. You may have an increased risk of complications if you have poor circulation, diabetes, heart, lung, or liver disease, or if you smoke. Complications can include:

  • Scarring
  • Bleeding (hematoma)
  • Infection
  • Accumulation of fluid
  • Poor wound healing
  • Loss of skin
  • Blood clots
  • Numbness or other changes in sensation
  • Risks related to anesthesia
  • Changes in skin color
  • Long-lasting swelling
  • Fat necrosis (death of fatty tissue located deep in the skin)
  • Wound separation
  • Asymmetry

Return to living

Generally, most people love the new look after they’ve undergone this procedure; however, you may not feel like your normal self for months after the surgery. You’ve gone through a tremendous amount to make this happen. It is a big commitment, emotionally, physically, and financially. It is very important that you follow proper diet and exercise to maintain your new look.

Does insurance cover a tummy tuck?

Be warned: Insurance carriers generally do not cover elective, cosmetic surgery. But your carrier may cover a certain percentage if you have a hernia that will be corrected through the procedure, or if you have had surgery for weight loss. It’s extremely important that you begin communicating with your insurance company early on, and that you discuss your insurance concerns with your surgeon. In most cases, your surgeon will write a letter to your insurance carrier, making the case for medical necessity, if it applies to you. It’s also very important to realize that insurance may only cover certain portions of the surgery, so make sure you get details. With any cosmetic surgery, this may affect future insurance coverage for you, and your premiums may increase.

References

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 7/27/2010...#11017


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