Center For Plastic Surgery

Tummy Tuck

Mark L. Mathers, D.O., FACOS

Many of us remember the days when we could wear a swimsuit without feeling embarrassed about our bulging tummy. Some of us still dream of having the flat stomach of our youth, but no matter how much we diet and exercise, that flattened tummy seems unattainable.
A protruding abdomen is usually the result of weak tummy muscles, weight gain or pregnancy. The condition doesn’t respond well to increased exercise or sensible dieting because the skin and underlying muscles have been stretched out. Even though this procedure is more commonly done in women, it is becoming increasingly popular with men.

What is a tummy tuck?
Abdominoplasty, often referred to as a "tummy tuck," is a surgical procedure to remove excess skin and fatty tissue from the middle and lower portions of the abdomen. It also can tighten stretched skin and strengthen abdominal muscles, so that it effectively flattens the lower abdomen. Loss of skin elasticity, which sometimes occurs with slight obesity, can also be improved. Sometimes after a massive weight loss, the patient will have a large apron of loose hanging skin folds and a more extensive procedure called a panniculectomy can be performed to remove this excess skin. Occasionally, there is an abdominal hernia associated with the stretched out muscles, and this can be repaired at the same time.
Recently, a leading women’s magazine did a survey which revealed that 64 percent of the participants were dissatisfied with the shape of their stomachs.

Who is a candidate?
The procedure is not a substitute for weight loss. The best candidate for the surgery is an individual who is of normal weight but has excess skin and fat on the abdomen and associated weak tummy muscles. Some people who are not good candidates for liposuction may benefit from abdominoplasty.
Some of the factors to be evaluated by the surgeon prior to surgery will include age, obesity and smoking habits. Heavy smokers should be aware that nicotine may interfere with the healing process postoperatively.

How is the surgery done?
Generally, an abdominoplasty is done under a general anesthetic with the patient completely asleep. The extent of the procedure depends on the results that the patient desires and what the surgeon thinks is appropriate for that individual’s condition. The surgery itself takes two to three hours.
The incisions can be placed in such a way that they can easily be hidden in a swimsuit. The most frequently used incision is "U" shaped, beginning below one hip bone and going just above the pubic area, ending just below the other hip bone. A second incision is made around the navel or umbilicus. The skin is then separated from the underlying tissues up past the waist and on up to the upper abdomen. The skin is lifted up to expose the muscular layer. If the muscles are lax, they can be sutured to tighten them at this time, giving a firmer abdominal wall and narrowing the waistline, the elevated skin is then lowered, pulled down tautly, and the excess is removed. A new opening is created for the belly button and it is reinstated in the lower abdomen.

What about the recovery period?
After surgery, there will be discomfort and soreness, but this usually is well controlled with pain pills. Depending on how extensive the procedure is, the patient may spend the night of surgery in the outpatient facility. Because of the increased tightness in the abdominal area, patients are advised to walk with their backs bent to avoid tension in the operative area for a few days. They are encouraged to be up to the bathroom the day of surgery and can walk around the house some the next day. The surgeon will decide when normal activities can be resumed based on the extent of the surgery, but most activities can be resumed in ten days. Strenuous exercise or heavy lifting should be avoided for three to four weeks.
Although thousands of tummy tucks are successfully completed each year, you should be aware that no surgery is risk-free. Complications from this procedure are rare, however, there is a small risk of bleeding or infection. If problems occur, they are treated conservatively with antibiotics and wound management. Some patients have numbness around the incision line. If the scar heals poorly, a revision of the scar may be done at a later time. Although the scars are permanent, they generally fade significantly with time.