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Frequently Asked Questions about Tummy Tuck (Abdominoplasty)

 

What is tummy tuck (abdominoplasty)?

What are the indications for abdominoplasty?

What causes a patient to need a tummy tuck?

Is tummy tuck (abdominoplasty) considered safe?

What is the best source for information regarding tummy tuck (abdominoplasty)?

Who should perform your tummy tuck (abdominoplasty) consultation?

How much time should my plastic surgeon spend with me for my tummy tuck (abdominoplasty) consultation?

What is informed consent for tummy tuck (abdominoplasty)?

How does the process work to get a tummy tuck (abdominoplasty)?

Will I be awake of asleep when I get my tummy tuck (abdominoplasty)?

What are the options for tummy tuck (abdominoplasty)?

Are the muscles of the abdomen tightened during the tummy tuck (abdominoplasty) procedure?

What are the incision options for tummy tuck (abdominoplasty)?

Can a hernia be repaired at the time of a tummy tuck (abdominoplasty)?

Are the drains used with a tummy tuck (abdominoplasty)?

Can other surgery be combined with tummy tuck (abdominoplasty)?

When can I go back to work after tummy tuck (abdominoplasty)?

Is the tummy tuck (abdominoplasty) a substitute for proper diet and exercise?

Are there any risks associated with tummy tuck (abdominoplasty)?

WHAT IS TUMMY TUCK (ABDOMINOPLASTY)?

Tummy tuck (abdominoplasty) is the surgical removal of skin and fat from the abdomen. The techniques for tummy tuck (abdominoplasty) have improved over the years, and in most patients there is a noticeable improvement. In most patients the lower 1/3 to 1/2 of the abdominal tissue is removed and the space is covered with the tissue from the upper abdomen. Tummy tuck (abdominoplasty) removes fat and also removes skin, which makes the abdomen flatter in most patients. Tummy tuck (abdominoplasty) and liposuction differ in that liposuction removes only fat, and tummy tuck (abdominoplasty) removes fat and skin. In order to perform a tummy tuck (abdominoplasty), a longer incision is made than with liposuction, which uses smaller incisions.

WHAT ARE THE INDICATIONS FOR ABDOMINOPLASTY?

Many patients make the decision to get tummy tuck (abdominoplasty) as a way to flatten the abdomen. The best candidates for tummy tuck (abdominoplasty) are patients that have excess fat in the abdominal area and excess skin as well. The best candidates for tummy tuck (abdominoplasty) are usually not the best candidates for liposuction of the abdomen. The tummy tuck (abdominoplasty) and liposuction are different operations for different problems. If a patient has excess skin and gets liposuction instead of a tummy tuck then there will be more excess skin after the surgery. Most patients do not want more excess skin, so if excess skin is present before surgery, he/she will choose tummy tuck over liposuction. Tummy tuck (abdominoplasty) is a completely different operation from liposuction, and has different indications. The specific situation in patients seeking tummy tuck (abdominoplasty) varies widely. In some patients seeking tummy tuck (abdominoplasty) the problem is mostly excess skin. In other patients seeking tummy tuck (abdominoplasty) there is excess fat and excess skin. In either case, it is best if the patients weight is stable, meaning he/she has not gained or lost a lot of weight recently.

The comments below have been made to Dr. Herring as reasons for getting a tummy tuck (abdominoplasty).

“I want my stomach to look smaller in a bathing suit.”

“I have exercised and been on a healthy diet and cannot lose the weight on my abdomen.”

“I want to get rid of the excess skin on my stomach.”

“I cannot wear tight clothes because my stomach sticks out too much.”

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WHAT CAUSES A PATIENT TO NEED A TUMMY TUCK (ABDOMINOPLASTY)?

Excess skin in the abdominal area is caused by stretching. A common cause of skin stretching is pregnancy. The skin of the abdomen stretches as the baby grows, and after childbirth the skin usually remains in excess. The amount of skin excess can vary widely, depending on the size of the baby, the size of the patient, weight gain during pregnancy, and the number of pregnancies. There is also probably some genetic component, which is a specific characteristic that you inherit from your ancestors. Another cause of skin stretching is weight gain. This can occur due to slowing of metabolism with aging, over eating, lack of physical activity, or a combination of those factors. As with skin stretching, there are probably also genetic factors to being overweight. If a patient loses weight after gaining weight then the skin stretching becomes very obvious. Many patients that are overweight get the gastric bypass procedure. In this group of patients, there can be an extreme excess of skin, and this can usually be treated by tummy tuck (abdominoplasty).

IS TUMMY TUCK (ABDOMINOPLASTY) CONSIDERED SAFE?

As with all types of surgery, risks for tummy tuck (abdominoplasty) can be divided into 2 categories. One is the risk associated with anesthesia. For anesthesia techniques that involve the use of intravenous drugs, some plastic surgeons work with trained anesthesia professionals. By doing this, the tummy tuck (abdominoplasty) procedure is the only focus of the plastic surgeon, and the anesthesia aspects are performed by the anesthesia professional. As with any surgery, there are always risks with anesthesia, but the risks are considered small in healthy patients. The second type of risk associated with tummy tuck (abdominoplasty) is related to the surgery itself, and these general risks are present with all types of surgery. In addition, there are specific risks related to the tummy tuck (abdominoplasty). Dr. Herring will answer your question about the risks for tummy tuck (abdominoplasty) at your personal consultation.

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WHAT IS THE BEST SOURCE FOR INFORMATION REGARDING TUMMY TUCK (ABDOMINOPLASTY)?

In general, the best source for information on tummy tuck (abdominoplasty) is a personal consultation with a Plastic surgeon. The more information the patient gets about tummy tuck (abdominoplasty) the better, but it is important to get accurate information. Plastic surgeons that are trained to perform tummy tuck (abdominoplasty) can give you accurate up to date information, but more importantly, can relate that information to your specific situation. The best source of information regarding tummy tuck (abdominoplasty) is a personal consultation with a Plastic surgeon trained to perform this procedure.

WHO SHOULD PERFORM YOUR TUMMY TUCK (ABDOMINOPLASTY) CONSULTATION?

Your tummy tuck (abdominoplasty) consultation should be done by a Plastic surgeon that is trained to perform this procedure. General information can be obtained from many different healthcare providers, but only the Plastic surgeon is formally trained to actually perform the procedure.

HOW MUCH TIME SHOULD MY PLASTIC SURGEON SPEND WITH ME FOR MY TUMMY TUCK (ABDOMINOPLASTY) CONSULTATION?

Your Plastic surgeon should spend as much time as needed to answer your questions regarding tummy tuck (abdominoplasty). You may have questions regarding tummy tuck (abdominoplasty) which will be answered at your personal consultation. If you have more questions after the consultation for tummy tuck (abdominoplasty), then an appointment for additional consultation(s) can be scheduled.

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WHAT IS INFORMED CONSENT FOR TUMMY TUCK (ABDOMINOPLASTY)?

Informed consent for tummy tuck (abdominoplasty) is a process whereby a patient becomes knowledgeable about a procedure so that he/she can make an informed decision. The informed decision process is a shared responsibility of the Plastic surgeon and the patient. The Plastic surgeon should provide written materials to you, and after reading the materials, answer your questions. If more materials are desired regarding tummy tuck (abdominoplasty), you can request them from Dr. Herring. The extra information might include peer review articles (articles in scientific journals), diagrams, images, and scientific textbooks about Plastic surgery. You should be comfortable that you understand the procedure, and most importantly, understand your specific situation. It is very important that you understand your specific situation because that is a primary determinant of your final outcome with tummy tuck (abdominoplasty).

HOW DOES THE PROCESS WORK TO GET A TUMMY TUCK (ABDOMINOPLASTY)?

The first step is to make an appointment and come in for a personal consultation. After the consultation and the informed consent process a surgery date is scheduled which can be as soon as 1 to 2 weeks after the initial consultation. The decision to get a tummy tuck (abdominoplasty) is considered elective for most patients, which means that the surgery is not necessary. One advantage of elective surgery, including tummy tuck (abdominoplasty) is that you can take as much time as you desire to make a decision.

WILL I BE AWAKE OR ASLEEP WHEN I GET MY TUMMY TUCK (ABDOMINOPLASTY)?

The tummy tuck (abdominoplasty) is not performed with the patient awake by the majority of Plastic surgeons certified by the American Board of Plastic Surgery. The patient typically has 2 types of anesthesia to get a tummy tuck (abdominoplasty). First, the patient is given intravenous sedation by a formally trained anesthesia professional. Second, the patient is given local anesthesia (similar to the medicine the dentist use) to numb the area. The combination of these 2 techniques allows the tummy tuck (abdominoplasty) procedure to be performed with great patient comfort and a high safety margin. Patients typically have no memory of the procedure, and the area of surgery is still numb when he/she wakes up.

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WHAT ARE THE OPTIONS FOR TUMMY TUCK (ABDOMINOPLASTY)?

The tummy tuck (abdominoplasty) can be described as two different types of procedures. There are many variations of tummy tuck (abdominoplasty) operations, and the variations generally fit into one of these two types of procedures. One is the full tummy tuck (abdominoplasty), and the other is the “mini” tummy tuck (abdominoplasty). The definition of these 2 surgical procedures may vary some from surgeon to surgeon, but the general concepts are the same. The full tummy tuck (abdominoplasty) is the bigger procedure and it removes the most fat and skin. The full tummy tuck (abdominoplasty) is usually done for patients that have excess skin and fat above and below the belly button. The “mini” tummy tuck (abdominoplasty) is usually done for patients that have excess fat and skin below the belly button. During your in person consultation with Dr. Herring the difference between the two procedures will be explained in relation to your specific situation.

ARE THE MUSCLES OF THE ABDOMEN TIGHTENED DURING THE TUMMY TUCK (ABDOMINOPLASTY) PROCEDURE?

The muscles of the abdomen can be moved during the tummy tuck (abdominoplasty) if it is indicated. To be exact, the muscles are usually not tightened during the tummy tuck (abdominoplasty). Muscle tissue is very fragile, and is difficult to repair or move by itself. In order to move the muscles the tough wrapping (fascia) of the muscles is repaired. The connective tissue (fascia) is commonly repaired or tightened during the tummy tuck (abdominoplasty) if it is indicated. In order for the connective tissue (fascia) to be tightened it must be loose before the repair. The connective tissue (fascia) can be loose as a result of pregnancy, loss of weight, or just from the aging process. It is important to understand that the connective tissue (fascia) must be loose before it is repaired during the tummy tuck (abdominoplasty). If the connective tissue (fascia) is tight before the tummy tuck (abdominoplasty) procedure, the tightening procedure can actually add serous risk to the procedure. Whether tightening the connective tissue (fascia) during the tummy tuck (abdominoplasty) is appropriate or not can usually (but not always) be determined at the personal consultation.

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WHAT ARE THE INCISION OPTIONS FOR TUMMY TUCK (ABDOMINOPLASTY)?

There are three general considerations for incisions with tummy tuck (abdominoplasty). The first consideration is the height of the incision. While it is desirable in most patients to have the incision as low as possible, there are limitations as to how low it can be placed. The height of the incision on the abdomen for tummy tuck (abdominoplasty) can vary based on the specific situation of the patient, and to some degree, the desires of the patient. The height of the incision in part determines the general location of the final scar. The second consideration is the shape of the incision. The incision for tummy tuck (abdominoplasty) can be designed in curvilinear (curved) shape, or can be straight. Because many modern bathing suits are cut high on the outside of the thigh, many patients choose a curved incision design. This incision is shaped like a smile so that it is higher the closer it gets to the thigh. In this manner the final scar will be inside or almost inside most modern bathing suits. On the other hand, some patients will choose a straight incision for tummy tuck (abdominoplasty). The straight incision design is sometimes chosen by patients that like to wear “hip hugger” style pants. By making the incision straight, the final scar could be inside low cut pants. The third consideration is the length of the incision. The length of the scar is kept as short as possible in the tummy tuck (abdominoplasty), however, the amount of tissue removed is a primary determinant of scar length. In most patients the incision and the final scar is shorter in the “mini” tummy tuck (abdominoplasty) than in the full tummy tuck (abdominoplasty). Dr. Herring will discuss the options for incision height, shape and length at the time of your personal consultation.

CAN A HERNIA BE REPAIRED AT THE TIME OF A TUMMY TUCK (ABDOMINOPLASTY)?

Yes. Small hernias can be repaired at the time (combined surgery) of a tummy tuck (abdominoplasty). Some Plastic surgeons prefer to stage the procedures if there is a large hernia. Staging means that the large hernia would be repaired first by a General surgeon, and the tummy tuck (abdominoplasty) would be done at a separate and later time by your Plastic surgeon. There are advantages and disadvantages to combined or staged surgery, and Dr. Herring will discuss these options at the time of the personal consultation.

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ARE DRAINS USED WITH A TUMMY TUCK (ABDOMINOPLASTY)?

Yes. Drains are commonly used in conjunction with a tummy tuck (abdominoplasty). The drains for tummy tuck (abdominoplasty) serve two purposes, one obvious, and one not so obvious. The first and obvious purpose is to remove excess drainage from the area of surgery. Without a drain, excess drainage may have to be removed by a different method. The second, and not so obvious purpose of the drain is to allow the Plastic surgeon to monitor the area of surgery. By looking at the drainage, the Plastic surgeon can get a very good idea of the post-operative condition. The drain is usually removed in a short period of time after tummy tuck (abdominoplasty). The decision to remove the drain is based in part on the rate of drainage, and when the rate becomes low, it is removed.

CAN OTHER SURGERY BE COMBINED WITH TUMMY TUCK (ABDOMINOPLASTY)?

Yes. Tummy tuck (abdominoplasty) is commonly combined with other procedures. For example, breast augmentation can be done at the same time as a tummy tuck (abdominoplasty).

WHEN CAN I GO BACK TO WORK AFTER TUMMY TUCK (ABDOMINOPLASTY)?

Most patients go back to work within 48 to 72 hours after tummy tuck (abdominoplasty), as long as the work does not require extreme physical exertion. In 3 to 4 weeks, most patients can increase their activity level to approximate the pre-operative level.

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IS THE TUMMY TUCK (ABDOMINOPLASTY) A SUBSTITUTE FOR PROPER DIET AND EXERCISE?

No. In order to get the best result after tummy tuck (abdominoplasty), proper diet and exercise are necessary. It is important for the patient to maintain a stable weight after tummy tuck (abdominoplasty) to get the best result.

ARE THERE ANY RISKS ASSOCIATED WITH TUMMY TUCK (ABDOMINOPLASTY)?

Yes. There are risks with any type of surgery, including tummy tuck (abdominoplasty). In healthy patients the risk for tummy tuck (abdominoplasty) is relatively small.

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