Tummy Tuck Surgery
For many patients in Los Angeles, a Tummy Tuck, or ‘Abdominoplasty’ is an excellent option to remove the ‘pudge’ below the belly button, particularly after pregnancy when the muscles separate. This is often combined with liposuction. The unwanted fat from lipo can be used to plump up the buttock with fat grafting (Brazillian Butt Lift). Or, the unwanted fat can be placed into the face to restore youth facial fat grafting or buttock augmentation. See facial fat grafting or transfer here.
Abdominoplasty can dramatically reduce the appearance of a protruding abdomen. The results are immediate and dramatic.
Smoking habits, age and obesity are some of the factors the physician considers when evaluating a candidate for this procedure. Smokers should be off all cigarettes (or nicotine patches) at least 4 weeks before surgery. Why? Smoking constricts blood vessels and compromises wound healing. If you smoke and have a tummy tuck there is a good chance your incisions will open up. Nicotine patches and Nicorette gum are not solutions because it is the nicotine in smoking that constricts small blood vessels.
Who is a Good Candidate?
The best candidates for abdominoplasty (also called tummy tuck) are men and women who are in relatively good physical shape but are bothered by a fat deposit or loose abdominal skin that has not responded to diet or exercise. Or in some cases in women, pregnancy stretches the muscles of the abdominal wall (called diastasis) and all the dieting and exercising in the world won’t help return the belly to its pre-pregnancy state. The muscles need to be tightened. This is what an abdominoplasty accomplishes. In other cases, loss of skin elasticity with age, or weight fluctuation, can also be improved.
Importantly, people who intend to lose a lot of weight should postpone the surgery. Best results are in men and women who have had a stable weight for at least 6 months. It makes little sense to undergo a big operation only to lose more weight following surgery. Weight loss, particularly rapid weight loss, can cause skin laxity. In addition, once the “pudge” is removed, one can still gain weight after surgery. For most people, the body transformation from an abdominoplasty encourages them to exercise more.
Another note about rapid weight loss: Sometimes the skin doesn’t catch up to the volume loss. And as we age, our skin loses elasticity making our body more like a beach ball than a balloon. With poor skin tone, sometimes the only solution is skin resection. For men and women who lose a lot of weight fast such as gastric bypass surgery or lap-band surgery, the skin issue is generally not isolated to the belly. Tummy tucks in this population could and should be combined with other skin resection procedures such as a body lift or mastopexy.
What is the downtime for abdominoplasty?
Since the muscles are tightened and need to heal, one should avoid strenuous activity for 2 weeks. They should refrain from activity that will use their abdominal muscles for 4 weeks. People are generally sore for up to 3 days after a tummy tuck. They may walk hunched over. But for the most part, pain is well controlled with oral medications. Abdominoplasty is almost always an out patient procedure. This means patients will go home the same day. However, if one prefers to stay overnight in a facility with a nurse, that can be arranged through the office.
When the fat deposits are limited to the area below the belly button, you may require a smaller procedure called a partial abdominoplasty, also known as a mini-tummy tuck. A mini-tuck can often be performed on an outpatient basis. That is, you might be able to go home the same day after surgery. For full tummy-tucks, patients are often best suited to be observed in an after care facility for a night.
When you meet with Dr. Neavin, a complete medical history will be obtained including a complete medication list. Because abdominoplasty is a 3 to 4 hour surgery, it is important that one is in relatively good shape. Any ongoing medical conditions may have to be discussed with your primary care doctor for clearance. Skin quality as well as fat deposition will be examined. Loos skin alone does not make one a good candidate for this procedure. Sometimes, as in the case with massive weight loss patients, loose skin is circumferential (around the entire body), and thus addressing only the abdomen may create a patch-work like result. For some people that is satisfactory, but body lifting with skin excision in the love handles and lower back may yield a more powerful result.
If you have weakened abdominal muscles or separation of the muscles (diastasis), then muscle tightening will be offered. Many times when men and women simulate how they would like their abdomen to look, they “suck it in”. Essentially, the tightening of the rectus abdominus muscles can have a very similar effect.
If skin elasticity is relatively good, then liposuction of the love handles will often be suggested to create a more hour glass shape in women and a more stream line shape in men.
Dr. Neavin will also examine you for a hernia. Hernias can exist in many areas of the body, but as it relates to abdominoplasty, hernias of the abdomen (ventral) or belly button (umbilicus) may need to be repaired during the procedure.
What are the scars associated with abdominoplasty?
The aim of scar placement is to hide them in common swimwear. Generally, the incisions are placed low enough to be concealed even in underwear. If there is a large resection of skin, then there will need to be an incision (and scar) around the belly button. There are several techniques that plastic surgeons utilize to reduce scar exposure of the belly button. Dr. Neavin takes great pride in tis particular part of the operation and has his own technique to minimize scar visibility and create an attractive, slight depression to accentuate the center of the abdomen. All scars go through phases. Usually by months they will start to fade. Darker skinned individuals may scar poorer than light skinned people. Dr. Neavin will discuss with you his thoughts on scarring based on your skin and scar history.