The best candidates for abdominoplasty (known as a “tummy tuck”) are women or men who are bothered by fat deposits or loose abdominal skin that won’t respond to diet or exercise. Pregnancy, weight gain/loss are two of the most common causes for excess abdominal skin and fat. Ideal candidates are reasonably fit, and have maintained a stable, reasonable body weight. Also, patients that have developed a separation of the abdominal muscles in the midline (known as a diastasis) are also well suited for this procedure. Abdominoplasty is in a class of operations known as “body contouring procedures” and can be tailored to each individual’s particular anatomy. The procedure can be performed as a “full or formal” abdominoplasty or in a more limited fashion as a “mini” tummy tuck. The procedure is commonly combined with liposuction. Other body contouring procedures such as mastopexy, breast reduction or breast augmentation are sometimes combined with a tummy tuck. This procedure is well suited to combine with some gynecologic procedures as well. If you are being considered for GYN surgery be sure to ask your gynecologist and be seen by Dr. Lewis to discuss alternatives for a combination procedure. Abdominoplasty is typically a cosmetic procedure. There are rare occasions that patients with truly symptomatic abdominal skin excess following massive weight loss may be considered for insurance coverage. That procedure needs to be pre authorized thru your insurance provider and should be discussed with Dr. Lewis at your office visit.
As Dr. Lewis states,
“Tummy tuck surgery is not an alternative to weight loss. This operation is, however, ideally suited to eliminate diet and exercise resistant abdominal skin excess.”
This procedure is performed on an outpatient basis. You go home after surgery to recover in the comfort of your own home. Arrangements can be made for an overnight stay at the Surgery Center or hospital if that is preferred. Tummy tuck surgery removes excess skin and fat, and tightens abdominal muscles. There is an incision around the belly button and across the lower abdomen at the “bikini line.” Incision location, length and expectations will be reviewed with you by Dr. Lewis at your office consultation. The procedure is performed under general anesthesia and usually takes anywhere from two to four hours depending upon what other, if any, procedures are included. You will have drain tubes in place after the procedure. The care and management of those drains will be reviewed with you before and after the procedure. Usually, both drains are out by two weeks postoperatively. Driving is restricted until approved by Dr. Lewis after surgery. Also, exercise and strenuous activity will be limited up to about four weeks after surgery. Individual limitations and expectations will be reviewed with you before your procedure.
What to Expect
There is mild to moderate discomfort with this procedure. You will be provided a prescription for pain control medications. Usually, by the third-fourth postoperative day there is no further need for prescription pain medication. You will be provided with an abdominal binder and are encouraged to wear some type of supportive garment for up to four weeks post operatively. You will also need a ride to your first postoperative appointment with Dr. Lewis.
You will need a ride to and from the surgery center. You should dress comfortably the day of surgery. You will be contacted by the surgery center and given instructions regarding preoperative preparations. You will visit with Dr. Lewis at least twice before surgery to discuss your desires and expectations.
For the first few days following surgery, you will endure some swelling, bruising and discomfort in the abdominal area. You should plan to rest with your head elevated for several days after the surgery. You will see Dr. Lewis at his office the first or second day after surgery. You may have drain tubes in which will be removed in the office. You can shower within 36 hours after your procedure even with the drain tubes in place. You should plan to be off work for a minimum of two to three weeks and limit your activity during that time period. You should discuss specific work related activities and time off with Dr. Lewis before surgery. You may have a few sutures to remove around the belly button by five to six days after surgery. Generally, most all of your incisions will be closed using absorbable sutures which do not have to be removed. You will see a flatter, trimmer you directly after surgery, but there is a recovery period during which swelling and bruising will be apparent and slowly resolve. Scars can sometimes take months up to a year to fully fade and soften.