Archive for category: Tummy Tuck

A tummy tuck — also known as abdominoplasty — improves the appearance of your entire midsection. Excess skin is removed, the underlying abdominal muscles are tightened, and the procedure even gets rid of hard-to-lose fat. 

But how safe is this surgery really? Is a tummy tuck dangerous?

Here’s where it’s important to look at the facts. And we’ll do that in just a moment. But first — let’s quickly get our bearings and go over what you can expect during and after tummy tuck surgery.

What Is a Tummy Tuck?

A tummy tuck is a major surgical procedure that slims and smooths the abdomen, removing excess skin and tightening the abdominal muscles in the process. The procedure involves general anesthesia (being put under for surgery by an anesthesiologist), incisions made in the abdomen, and a substantial recovery period.

The surgery itself varies from patient to patient. Generally speaking, however, most tummy tucks are performed as follows:

First, you will be put under general anesthesia via an IV. Next, your plastic surgeon will make two incisions:

• One on the lower abdomen, beneath the bikini line, from one hip to the other
• One around the belly button

The abdominal skin will then be lifted, and the abdominal muscles will be manipulated and tightened for an ultimately smoother and sleeker tummy. Liposuction will be performed if necessary. The abdominal skin will then be gently pulled down, and the excess will be cut off. The belly button will be repositioned, and the incisions will be carefully closed.

You will then be taken to a recovery room where you will stay for a few hours, and after that you will be allowed to go home. At home, you’ll have several weeks of intense recovery during which time you will not be able to exercise, lift anything heavy, or really do any activity other than rest and take care of yourself. 

Even after this initial recovery period, you will have several more months where you’ll need to take it easy. With guidance from your surgeon, you will slowly be able to reintegrate your normal activities back into your daily life.

Is a Tummy Tuck Safe?

When headlines and news stories stir up concern about the safety of plastic surgery procedures like tummy tucks, patients get worried. They may have been all-in for the procedure at one point, but suddenly, they have misgivings. They want to know: “Is a tummy tuck dangerous? Is a tummy tuck safe?”

Generally speaking, yes, tummy tuck surgery is safe. With that said, there are inherent risks whenever any type of surgery is performed, and this includes tummy tucks. 

Again, we must turn to the facts.

First, there’s always a risk when incisions are made during surgery. It is extremely rare, but in some cases, an incision may end up opening up during the recovery period or not healing well in general. Ongoing bleeding is another risk. Though, again, it is extremely rare.

Fluid collection (seroma) is another risk. However, this is also a rare complication because drains will be placed below the patient’s incisions to allow excess fluid to drain out during recovery. There is also the risk of infection (as with any surgery), but antibiotics administered both during and after surgery are reliably good at preventing this.

Finally, blood clots (or deep vein thrombosis/DVT) are another serious risk, but again, this is the case with any abdominal surgery including C-sections, hysterectomies, and abdominoplasty. Surgeons also have preventive strategies in place to avoid DVT, including the use of SCDs (sequential compression devices to promote circulation), anticoagulants, compression garments, and more. 

It is always recommended that patients ambulate (get up and moving) as soon as possible after their tummy tucks, which can also help prevent clots from forming. This does not mean you’ll be running sprints! Rather, you should stand up frequently and take a few slow walks around your house as soon as you are able.

Tummy Tucks Aren’t for Everyone

Part of determining the safety of tummy tuck surgery for a given patient is looking at their general health. Not every patient is a good candidate for a tummy tuck. Is a tummy tuck safe for someone with a chronic illness like diabetes or high blood pressure, for instance? Most likely, no. Patients with chronic illnesses are often at higher risk for complications when it comes to a surgery. 

Likewise, certain lifestyle choices may preclude you from surgery for your own safety. Patients who smoke and cannot stop for a duration before and after the procedure, for example, will not be cleared for surgery.

In the end, if you’re still not sure if a tummy tuck is right for you, that’s okay! This is where going to a quality plastic surgeon is important. Before committing to this procedure or any other, it is your prerogative — and, certainly, it is in your best interest — to do your research, ask questions, and take some time to weigh your options.

Ultimately, if you do decide to move forward with tummy tuck surgery, the best way to ensure your safety during this procedure is to choose a plastic surgeon who’s board-certified and has extensive experience. 

Dr. Matthew Schulman is board-certified and has been performing successful tummy tucks in New York City for over twenty years. His experience, combined with his expertise and professionalism in the field of plastic surgery make him the ideal surgeon for your upcoming tummy tuck. 

Dr. Schulman is also one of the most sought-after plastic surgeons in New York City because of the care and attention he gives to each and every patient. Even if you’re still on the fence about tummy tuck surgery, Dr. Schulman is a great resource. He would be happy to speak with you about your options and answer all of your questions at a consultation appointment. 

It’s good to be curious about the safety concerns surrounding tummy tuck surgery before deciding to move forward with this procedure. Being curious and using your resources to find the answers to your questions is a great way to get the facts straight and make the right decision for you.

To find out if you are a candidate for surgery and to learn more about the tummy tuck procedure itself, give our NYC office a call and book your consultation appointment today.

References

https://www.plasticsurgery.org/cosmetic-procedures/tummy-tuck/safety

The goal of a tummy tuck is to get rid of excess skin on the abdomen and restore a weakened core by tightening the abdominal muscles. Tummy tuck New York City are a great surgery for women after they’re done having children and for men and women who’ve lost a significant amount of weight. 

One of the most common questions we receive from our patients concerns tummy tuck recovery time. Patients want to know how long they’ll be in recovery from this procedure and when they’ll be able to return to their normal activities. Below, we’ve distilled tummy tuck recovery time down into five main stages. Let’s take a look at what you can expect at every stage.

Tummy Tuck Recovery Time in 5 Stages

Not all patients experience the same tummy tuck recovery time line. Those undergoing other procedures in addition to a tummy tuck, for example, will naturally require a longer recuperation period. 

Overall, however, there are five main stages of healing you can expect after a tummy tuck.

1. Immediately after surgery

The tummy tuck procedure itself usually takes around two to three hours, but it can take up to three to four hours if the patient has a larger stomach or will be having thigh and hip contouring. The procedure is almost always outpatient, however, so patients can go home on the same day.

Right after your tummy tuck, you will be taken to a recovery room. There, you will be cared for by our highly experienced staff. You’ll spend just a few hours in this room before being able to leave. 

You will be discharged with thorough instructions on how to care for yourself at home. You will also be given a list of signs and symptoms of potential post-surgery complications to look out for. Make sure you fully understand your recovery instructions before going home.

Of course, it’s important to have someone at the facility who can help you get home as well. This person or someone else should also be nearby to help you get around during your recovery. 

2. Your first 48 hours at home

You’ll need some prescriptions filled directly after your surgery, including antibiotics and pain medication. You can fill these on your way home or have someone else pick them up. Or, you can also get them filled before your surgery to save you time. 

During the first 48 hours after surgery, you can expect some soreness, swelling, and bruising. Your abdomen will be covered with dressings, and you’ll also have a compression garment over the bandages to reduce swelling and help avoid blood clots. Wearing your compression garment is extremely important as it also helps your abdomen heal smoothly and evenly, optimizing your results. Drains may be left in your incisions as well, which will help remove excess fluid or blood. 

You’ll need to take it especially easy during this time as too much activity can potentially damage internal sutures. This may not only affect your cosmetic results, but it can also cause serious medical complications.

Avoid moving around too much at home, and do not do any lifting, including lifting children. Again, enlist the help of a family member or friend. You’ll need help getting to the bathroom, emptying your drains, making food, and doing other tasks. If you do have children at home, it’s important to have someone there to watch over them. You won’t be able to care for others during these first few days and will instead need someone to care for you.

Most patients can shower 24 to 48 hours after their procedure if they do not have drains. Our staff will provide showering instructions, including how to remove your dressings properly. Patients with drains need to wait until they are removed before showering. This may take up to a week or more, so during this time, you’ll want to take sponge baths to stay clean. 

3. One to two weeks after your tummy tuck

As the days go by, you will notice a progressive reduction in swelling, bruising, and soreness. 

Somewhere during this period, you’ll be able to discard your bandages. If you had drains, they will also be removed during this time. This will be at the discretion of Dr. Schulman. You should continue taking your medications as directed by Dr. Schulman and according to your pain levels. 

For the first two weeks at least, you should not submerge your abdominal area in water, so no baths, hot tubs, pools, or lake or ocean swimming. During this time, continue to avoid strenuous activities. Dr. Schulman may simply want you to take some gentle walks around the house.

Most patients can go back to work around 10 to 20 days after surgery.

4. Four to six weeks post-surgery

By this point in your tummy tuck recovery time line, you should be standing fully upright, and the internal healing process will be complete. Much of the swelling will have gone down so that you’ll be able to see a firmer, slimmer abdomen. Still, you’ll need to continue to wear your abdominal compression garment until around the six to eight-week mark. 

At this time, Dr. Schulman may also okay you to return to exercise. You may need to modify your usual routine, however, so discuss the activities you’d like to do with Dr. Schulman to be sure they’re safe. 

5. Approaching full results at six months

You will be very close to seeing the full results of your tummy tuck approximately six months after the procedure. In many cases, however, your incision may not fade completely for a year or more. 

This does not mean it will disappear entirely, but it will fade significantly by the one year-mark and will be lighter in color compared to the pink color it was during the first few months. Dr. Schulman will provide scar-care instructions during this time to ensure your scar is not stressed and fades as smoothly as possible. 

Tummy Tuck New York City: Book Your Consultation

Are you ready to schedule a tummy tuck consultation? Board-certified plastic surgeon Dr. Matthew Schulman utilizes the latest techniques and technologies to perform tummy tucks for patients in New York City. Contact our office today to book your appointment.

References

https://my.clevelandclinic.org/health/treatments/11017-abdominoplasty-tummy-tuck

https://www.healthline.com/health/tummy-tuck-recovery

https://www.plasticsurgery.org/cosmetic-procedures/tummy-tuck/results

A tummy tuck New York City, or abdominoplasty, is one of the most common plastic surgery procedures performed. It is a procedure designed to restore the appearance of the abdominal region by removing excess skin, tightening underlying muscle separation, and removing extra fat. The American Society of Plastic Surgery (ASPS) reports over 100,000 Tummy tucks, or abdominoplasties, are performed each year.

However, there are still many common misconceptions about tummy tucks. Let’s take a closer look at some of the most common myths surrounding the tummy tuck procedure. 

Tummy tucks are for women only – MYTH

Because women more commonly experience changes in their abdominal region due to aging, weight fluctuations and pregnancy, a tummy tuck is most commonly performed on women. However, anyone with excess skin and loose abdominal muscles can be a tummy tuck. This means that even men can successfully undergo a male tummy tuck New York City procedure.

The most common reasons for men to desire a tummy tuck is weight loss. Weight loss can result in excess skin that hangs below the belt line, as well as laxity of the abdominal wall. So even though 90% of tummy tuck patients are women, that still means that men can successfully undergo this operation if indicated.

Tummy tucks are designed to help you lose weight – MYTH

Much like most plastic surgery procedures, a tummy tuck is not a weight loss operation – it is a shaping procedure, specifically designed to shape the abdominal area. This means that the best candidates for tummy tucks are men or women who are not overweight, and complain of excess skin usually from previous weight loss. The procedure itself will remove the excess skin and fat. The number of pounds removed is minimal.

In fact, even patients who have a large amount of skin removed during their tummy tuck operation, should only expect to lose a few pounds on the scale. Excess skin just doesn’t weigh as much as you would think. Only in extreme cases of massive weight loss ,in which the patient is left with massive amounts of hanging skin, should you expect any significant reduction in the number on the scale. Now it is true that after a tummy tuck procedure most patients will lose weight on their own.

This is because they are more likely to continue with a healthy lifestyle, given that they just spent money and subjected themselves to themselves to the pain of a major operation. Also, people find it harder to eat large amounts of food after a tummy tuck because the skin of their abdomen is tighter and they naturally feel fuller faster.

Exercises can repair abdominal muscle separation – MYTH

One of the main things that a tummy tuck addresses is the separation of the abdominal muscles. The separation generally occurs during pregnancy as the baby grows. There are some people who believe that there are some abdominal exercises that can reverse this separation. While there are some exercises specifically designed to do this, the truth is that the improvement will be limited. You can strengthen muscles through exercise, but you can’t “move” them.

It may be possible to close small gaps in the abdominal muscle, such as 1 to 3 cm, with targeted exercises. However, it is common for abdominal muscle separation to exceed 5or 6 cm. No amount of exercise can reverse this. During a tummy tuck, those muscles are sewn together using sutures. This is a key part of the tummy tuck procedure and is also the part that causes the most discomfort and restrictions after the surgery.

The scar is too big – MYTH

Many people are hesitant to have a tummy tuck procedure because of the scar. The scar length will depend on the amount of excess skin that needs to be removed. This means that if you have a lot of skin laxity, your tummy tuck scar may extend from hip to hip. While you may think this is “huge”, it is what is required to perform the surgery appropriately. Shorter scars will remove less skin and have less internal tightening. The key to the scar is not the length, but the location.

Plastic surgeons take great effort in placing the scar low so that it is hidden beneath underwear and bikini bottoms. This means that even if your scar is hip to hip, it should be low and completely hidden with minimal clothes. Only you can decide if this scar is too large for you and not worth the operation. In my experience, most people find that the improvement in the shape and contour of their abdomen is well worth any scar that is necessary.

I don’t need a tummy tuck, I can just get liposuction – MYTH

A tummy tuck and liposuction New York City are two different procedures with two different purposes. Liposuction will remove excess fat. This is a great procedure for people who have excess fat but no excess skin. If you have excess skin, then liposuction will not help you. In fact, it can make things worse. A tummy tuck is designed to remove the excess skin. Often times liposuction is combined together with a tummy tuck to improve your results.

So, if your issue is excess skin, muscle separation, and some extra fat, then a tummy tuck is the appropriate operation for you. Liposuction will only make the excess skin worse and will do nothing to improve the underlying muscle separation.

You can be too old for a tummy tuck – MYTH

Much like all elective cosmetic procedures, age itself is not a reason not to do it. The main concern is whether or not you are healthy and can undergo a surgical procedure without elevated risk of complications. The main concern is your overall health. Therefore, to have a tummy tuck, you will need to be in good health without medical issues such as uncontrolled high blood pressure, cardiac disease, diabetes, anemia, or lung issues.

All patient will undergo a full medical evaluation prior to having a tummy tuck. There certainly will be people who are now not candidates for tummy tuck based on their medical history, but this has nothing to do with age. Most plastic surgeons have performed tummy tucks on patients in their 60s and 70s. We have all seen 60 year olds who are in better physical health than some 25 year olds.

Any plastic surgeon can perform my tummy tuck – MYTH

 As I said earlier, tummy tucks are one of the most common plastic surgery procedures. This means that every plastic surgeon has had some training in performing a tummy tuck operation. But, this does not mean that every plastic surgeon is good at tummy tucks. As plastic surgeons we all specialize in specific aspects of plastic surgery. Some specialize in face procedures and some specialize in body procedures.

Some perform reconstructive surgery while other focus on cosmetic surgeries. When choosing your plastic surgeon for your tummy tuck, make sure that they are experienced with this specific procedure. You want to make sure that this is an operation that they perform regularly and you should look at their before and after results. This is the same advice you would be given for any surgical procedure ,since not every plastic surgeon is good at every plastic surgery procedure.

To find out more about tummy tucks and whether or not this is the right operation for you, contact Dr. Matthew Schulman, a New York City board-certified plastic surgeon.

References

• https://www.plasticsurgery.org/photo-gallery/procedure/tummy-tuck
• https://www.plasticsurgery.org/cosmetic-procedures/tummy-tuck/recovery
• https://www.plasticsurgery.org/cosmetic-procedures/tummy-tuck/results

One of the most popular procedures performed by Board Certified Plastic Surgeons is a Tummy Tuck, or abdominoplasty. This is a procedure that almost every plastic surgeon has performed. In fact, recent statistics from the American Society of Plastic Surgeons indicate that over 93% of plastic surgeons report that this is a procedure they routinely perform. This explains why about 200,000 tummy tucks performed each year in the United States. It is a very powerful procedure designed to transform the abdomen and torso.

What is a Tummy Tuck?

A tummy tuck is a procedure that addresses the abdominal skin, fat, and muscles in a one operation. This is why it is such a powerful procedure. The result is a firmer, flatter, and smoother abdomen.

Specifically, a tummy tuck includes:

• Removal of excess abdominal skin
• Tightening of loose or separated abdominal muscles
• Removal of excess fat with liposuction
• Rejuvenation of the belly button

Who is a Good Candidate for a Tummy Tuck?

A tummy tuck is so popular because it offers advantages for so many different people, all in different situations. A tummy tuck may be indicated for people who have lost weight, have skin changes associated with aging, or have abdominal changes from pregnancy

• Weight Changes

Commonly, weight changes results in laxity of the skin. Weight gain will stretch out the skin as the amount of underlying fat increases. Subsequent weight loss that reduces the underlying volume of fat can lead to loose skin, since the skin may remain stretched. It is true that skin can adjust to weight loss and tighten over time. However, the more significant the weight loss or the more rapid the weight loss, the less your skin will be able to tighten. Also, constant up-and-down in weight that constantly occurs with people will likely lead to more loose skin as the elasticity is decreased. After loss, it is common to have a section of hanging skin along the waistline. Think of this like a rubber band. Continuous stretching of the rubber band will eventually lead to its loss of elasticity. The skin acts in a similar way. During a tummy tuck after weight loss, the excess skin is removed. This is not always accompanied by internal muscle repair or liposuction, since these may not be needed.

• Aging

Aging causes many changes within the skin of the entire body. Advancing age often causes loss of collagen and disruption of elasticity. This is why people get saggy skin as they age. The skin of the face begins to be wrinkled and sags, as does the skin of the body. So, aging will cause the abdominal skin to become loose, and wrinkled which is removed during a tummy tuck. Also, aging affects how your body stores excess fat. As you get older, your body is more likely to store fat in places such as your abdomen and flanks. This is the result of hormonal changes, decreasing metabolism, and decreased activity associated with the normal aging process. This excess fat can be addressed by performing liposuction during your tummy tuck.

• Pregnancy

Pregnancy is the most common reason why people desire a tummy tuck. There are so many changes that occur within the body during pregnancy. These changes are basically a combination of those described above. The stretching of the skin that happens with a growing baby, plus the rapid loss of volume when the baby is born, results is skin laxity similar to that seen with a rapid weight loss. There are hormonal changes that make the skin thinner and more loose, as well as making stretch marks appear. Also, the weight gain associated with pregnancy can result in storage of excess fat in the abdomen and flanks.

One major change that is unique to pregnancy is abdominal muscle separation, or rectus muscle diasthasis. This is the separation of the abdominal muscles that occurs in the midline from the expansion of the growing baby. When the muscles separate in the middle, the abdominal wall does not work as well at holding in the contents of the abdomen (like the organs). This results in a round belly, oftentimes giving the appearance of still being pregnant. During a tummy tuck after pregnancy, these abdominal muscles are put back together with internal sutures. This muscle repair is one of the most powerful improvements a tummy tuck offers. If the muscles are separated, but a muscle repair is not performed, the abdomen will never be completely flat.

Determining what specific type of Tummy Tuck you need:

The first step is an evaluation by a Board Certified Plastic Surgeon, experienced in a tummy tuck procedure. During your evaluation, your surgeon will take your medical history and perform a physical examination. The reason for the changes in your abdomen is important in coming up with an appropriate surgical plan. He or she will specifically examine your abdomen, looking carefully at the amount of excess skin, the quality of that skin, underlying muscle separation, and the presence of excess fat. This will help your surgeon determine what specific type of tummy tuck you will require.

Where is the Procedure Performed?

A tummy tuck is a surgical procedure that needs to be performed in an accredited ambulatory surgery center or hospital. These are regulated facilities with the appropriate safety standards and appropriately trained staff. The procedure is usually performed on an out-patient basis, meaning, you are able to go home the same day. In situations where other procedures are being done at the same time, you may be required to stay overnight for monitoring.

The Surgery

• The Anesthesia

The procedure is performed under intravenous sedation or general anesthesia. This anesthesia is administered by a Board Certified Anesthesiologist and you will be monitored the entire time. You breathing and heart rate will be monitored, as well as your oxygen level.

• The Incision

A tummy tuck is performed using a low incision the curves beneath your underwear of bikini line. This incision is used to lift up the skin and expose the muscles of the abdominal wall. The incision also allows removal of the excess skin. A lot of effort is made to keep this incision well hidden beneath clothes, since the incision is what creates the scar. During your pre-operative visit, your Plastic Surgeon may ask you to bring in underwear and bikini bottoms. This helps to determine the best placement of the incision, since modifications of the incision can be made depending the type of clothes you prefer to wear.

The length of the incision, and ultimate scar, will depend on the amount and distribution of excess skin. If your excess skin is mostly in the front of your abdomen, you may require a shorter incision than if you had extra skin more on the sides by your flanks. Of course, everyone prefers a short scar, but the shorter the incision, the less skin that can be removed. There is a balance. Your surgeon will draw the planned incision on you so you can visualize where the scar will be located and how long it will be.

• Repairing the Muscles

After the incision is made, the skin of the abdominal wall is lifted. This exposes the underlying muscles. If there is separation of the abdominal muscles as described earlier, the muscles will be repaired using internal sutures. Carefully placed sutures are placed in the abdominal muscles, bring the muscles back to the midline. This serves as an internal corset, flattening the belly and narrowing the waistline. This muscle tightening, or plication, is done all the way form the breast bone to the pubic bone.

• Removing the Skin

After the muscles are tightening, the skin of the abdominal wall will be pulled downward. The excess skin will be marked and then cut off. Usually all the skin between the initial incision and the top of the belly is removed. Any stretch marks on this skin is also removed. Multiple layers of sutures will be placed connecting the remaining skin back together, resulting in a low, smooth scar.

• The Belly Button

Up to this point, the belly button was left attached to the abdominal wall. The next step is to bring your old belly button out through a new opening. The location of your belly button is marked and a small opening is made. The belly button is then brought through this opening and secured in place with meticulous sutures. The creation of the belly button is a critical step in your tummy tuck, since it is essentially the only scar anyone will see. Overly large or overly round belly buttons tend to appear “surgical” and are a tell-tale sign of a tummy tuck. The ideal belly button tends to be a vertically-oriented oval belly button that is not too large.

• Liposuction

If you are storing excess fat in the abdomen and sides, liposuction is often performed. It may be true that you don’t have any excess fat and your issue is 100% excess skin. If this is the case, then liposuction would be an unnecessary part of your tummy tuck.

Recovery

After a few hours in the recovery room, you will be allowed to go home with your escort. You will have pain medication and antibiotics. The first few days is usually the worst, since you will be “hunched over” and in pain, but it will be manageable. After about a week, most people feel better, but not great. You should plan on having help at home for a few weeks. You are encouraged to walk throughout this process to promote good circulation. While everyone is different, most patients will require about 3 weeks off from work and 6 weeks off from heavy exercise.

• See Also Common Reasons to Undergo a Breast Reduction

Combining a Tummy Tuck with Other Procedures

It is very common to combine a tummy tuck with other procedures. Most commonly, tummy tucks are combined with breast implants, breast lifts, or breast reductions. This is because breasts, like the abdomen, are very susceptible to changes associated with aging, weight fluctuations and pregnancies. Breast and tummy procedures combine well together and can be performed in a single operation, assuming you are healthy. Combining multiple procedures together is commonly called a Mommy Makeover. Other procedures commonly combined with a tummy tuck include a Brazilian Butt Lift, where your own fat is used to increase the size and improve the shape of your butt and hips.

If you would like to learn more about whether a tummy tuck is right for you, contact Board Certified Plastic Surgeon, Dr. Matthew Schulman.

One of the most popular procedures performed by Board Certified Plastic Surgeons is a Tummy Tuck, or abdominoplasty. There are almost 200,000 tummy tucks performed each year in the United States. This is a procedure performed by 93% of all Board Certified Plastic Surgeons. The reason for it’s popularity is how powerful it is at transforming the body and erase years off someone’s appearance.

What is a Tummy Tuck?

A tummy tuck is a procedure that addresses the abdomen and mid-section. It simultaneously addresses skin, fat, and muscles in a one operation. The result is a firmer, flatter, and smoother abdomen, Specifically, a tummy tuck includes:

• Removal of excess abdominal skin
• Tightening of lax or stretched abdominal muscles
• Removal of excess fat with liposuction
• Rejuvenation of the belly button

Who is a Good Candidate for a Tummy Tuck?

Because a tummy tuck addresses many aspects of the abdomen and mid-section, it is an operation appropriate for a variety of people. If you have skin that has been stretched out from weight fluctuations, aging, or pregnancy, a tummy tuck may be right for you. If you have a lot of stretch marks on your abdominal skin, a tummy tuck will help. If pregnancy has left you with separation of your abdominal muscles, called rectus diastasis, a tummy tuck will tighten those muscles with the use of carefully placed internal sutures. Because of the wide variety of things that this operation addresses, it can be appropriate for both women and men, young and old.

If any of the following applies to you, you may want to consider exploring a tummy tuck:

• Your abdomen sticks out despite diet and exercise
• Your belly has the appearance of you being pregnant
• There is loose of hanging skin from your belly
• Your skin has significant stretch marks

• See Also Do You Need to Change Your Breast Implants Every 10 Years?

Preparation for Your Tummy Tuck

The first step is an evaluation by a Board Certified Plastic Surgeon, experienced in a tummy tuck procedure. During your evaluation, your surgeon will take your medical history and perform a physical examination. He or she will specifically examine your abdomen, looking carefully at the amount of excess skin, the quality of that skin, underlying muscle separation, and the presence of excess fat. Your surgeon will also examine you for any underlying hernias, or holes in the abdominal wall.

If you are an appropriate candidate for the procedure, your surgeon will discuss specific details about the anesthesia, recovery, and scars. He or she will also discuss the risks associated with this tummy tuck procedure. You will also be sent for medical clearance with your primary medical doctor. This will include a physical examination, bloodwork, and an EKG, along with any other tests required to make sure you are healthy enough to undergo the surgery.

Where is the Procedure Performed?

A tummy tuck is a surgical procedure that needs to be performed in an accredited ambulatory surgery center or hospital. These are regulated facilities with the appropriate safety standards and appropriately trained staff. The procedure is usually performed on an out-patient basis, meaning, you are able to go home the same day. In situations where other procedures are being done at the same time, you may be required to stay overnight for monitoring.

See Also Clearing up the confusion versus Liposuction and Tummy Tucks

The Surgery

• The Anesthesia

The procedure is performed under intravenous sedation or general anesthesia. This anesthesia is administered by a Board Certified Anesthesiologist and you will be monitored the entire time. You breathing and heart rate will be monitored, as well as your oxygen level.

• The Incision

A tummy tuck is performed using a low incision the curves beneath your underwear of bikini line. This incision is used to lift up the skin and expose the muscles of the abdominal wall. The incision also allows removal of the excess skin. A lot of effort is made to keep this incision well hidden beneath clothes, since the incision is what creates the scar. During your pre-operative visit, your Plastic Surgeon may ask you to bring in underwear and bikini bottoms. This helps to determine the best placement of the incision, since modifications of the incision can be made depending the type of clothes you prefer to wear.

The length of the incision, and ultimate scar, will depend on the amount and distribution of excess skin. If your excess skin is mostly in the front of your abdomen, you may require a shorter incision than if you had extra skin more on the sides by your flanks. Of course, everyone prefers a short scar, but the shorter the incision, the less skin that can be removed. There is a balance. Your surgeon will draw the planned incision on you so you can visualize where the scar will be located and how long it will be.

• Repairing the Muscles

After the incision is made, the skin of the abdominal wall is lifted. This exposes the underlying muscles. Very commonly after pregnancy, aging, and weight fluctuations, the abdominal muscles separate in the midline. This is called a rectus muscle diastasis and can make the abdomen appear to bulge outward. The muscles are normally responsible for keeping a flat, tight abdomen, but when they are separated, they cannot hold back the internal organs. This can give the appearance of being bloated and pregnant.

Carefully placed sutures are placed in the abdominal muscles, bring the muscles back to the midline. This is the most powerful part of a tummy tuck and serves as an internal corset, flattening the belly and narrowing the waistline. This muscle tightening, or plication, is done all the way form the breast bone to the pubic bone.

• Removing the Skin

After the muscles are tightening, the skin of the abdominal wall will be pulled downward. The excess skin will be marked and then cut off. Usually all the skin between the initial incision and the top of the belly is removed. Any stretch marks on this skin is also removed. Multiple layers of sutures will be placed connecting the remaining skin back together, resulting in a low, smooth scar.

• The Belly Button

Up to this point, the belly button was left attached to the abdominal wall. The next step is to bring your old belly button out through a new opening. The location of your belly button is marked and a small opening is made. The belly button is then brought through this opening and secured in place with meticulous sutures. The creation of the belly button is a critical step in your tummy tuck, since it is essentially the only scar anyone will see. Overly large or overly round belly buttons tend to appear “surgical” and are a tell-tale sign of a tummy tuck. The ideal belly button tends to be a vertically-oriented oval belly button that is not too large.

• Liposuction

In a well-crafted tummy tuck, liposuction is the icing on the cake. It allows the surgeon to perform the final contours. Specifically, any residual fat can be removed. Usually, liposuction is done on the flanks, bra rolls, and upper abdomen. Careful grooves can be made in the midline, creating highlights that accentuate the natural contours of the underlying muscles.

Recovery

After a few hours in the recovery room, you will be allowed to go home with your escort. You will have pain medication and antibiotics. The first few days is usually the worst, since you will be “hunched over” and in pain, but it will be manageable. After about a week, most people feel better, but not great. You should plan on having help at home for a few weeks. You are encouraged to walk throughout this process to promote good circulation. While everyone is different, most patients will require about 3 weeks off from work and 6 weeks off from heavy exercise.

Scar management

Scars never go away, but they will fade. Special care is taken during your surgery to promote good healing and the best possible scar. However, everyone’s skin is different and creates different scars. Some scars are thin and flat, while others are raised and dark. Your Board Certified Plastic Surgeon should be able to assess your skin before surgery in order to determine the types of scar you are likely to produce. In general, the darker the skin, the higher the possibility of thick and dark scars. If you have a history of making “bad” scars, be sure to let your surgeon know about that so proper precautions can be made. There are some things that can be done after the surgery to help your body create better scars These include the early use of silicone scar gels or tapes, and laser treatments. Your scar will continue to evolve over the next 9-12 months. During this time, you should limit the exposure to the sun since UV rays can make the scar appear more red and irritated.

Combining a Tummy Tuck with Other Procedures

It is very common to combine a tummy tuck with other procedures. Most commonly, tummy tucks are combined with breast implants, breast lifts, or breast reductions. This is because breasts, like the abdomen, are very susceptible to changes associated with aging, weight fluctuations and pregnancies. Breast and tummy procedures combine well together and can be performed in a single operation, assuming you are healthy. Combining multiple procedures together is commonly called a Mommy Makeover. Other procedures commonly combined with a tummy tuck include a Brazilian Butt Lift, where your own fat is used to increase the size and improve the shape of your butt and hips.

If you would like to learn more about slimming your abdomen and gaining back the confidence, contact Board Certified Plastic Surgeon, Dr. Matthew Schulman. During your consultation, you can find out if a tummy tuck is right for you.