• Abdominoplasty

    (Tummy Tuck)

    Definition

    Abdominoplasty is a cosmetic surgical procedure. It is performed to remove excess fat and skin from the lower abdomen. Abdominal muscles and supporting structures may also be tightened to give a slimmer appearance.

    Reasons for Procedure

    Abdominoplasty is performed to improve the appearance of the abdomen. It may be done to correct sagging or overhanging skin, and weak or protruding muscles that do not go away with proper diet and exercise. These concerns may be brought about by:
    • Significant weight loss, which may occur after bariatric surgery
    • Multiple pregnancies
    • Changes in extreme weight gains and losses
    • Normal aging
    • Genetics
    In some cases, an abdominoplasty can be done at the same time as other surgical procedures, such as liposuction, umbilical hernia repair, hysterectomy or breast surgery.

    Possible Complications

    Potential problems are rare, but all procedures have some risk. Your doctor will review potential problems, like:
    • Excessive bleeding
    • Infection
    • Incision separation (dehiscence) or wound development
    • Death of skin or fat tissue (necrosis)
    • Fluid accumulation (seroma)
    • Blood clots
    • Asymmetrical appearance of the abdomen
    • Nerve damage
    • Collection of blood under the skin (hematoma)
    • Additional corrective surgery
    • Belly-button (umbilicus) loss
    Before your procedure, talk to your doctor about the following factors that may increase your risk of complications, such as:
    • Smoking
    • Drinking
    • Chronic disease, such as diabetes or obesity
    • Previous abdominal surgery

    What to Expect

    Prior to Procedure

    Your doctor may do the following:
    • A physical exam, which includes an evaluation of the skin and abdomen
    • Blood tests
    Your doctor will talk to you about your expectations from the surgery.
    Leading up to the procedure:
    • Talk to your doctor about your current medications. Certain medications may need to be stopped up to one week before the procedure.
    • Let your doctor know of any allergies you have.
    • Arrange for a ride to and from the procedure.
    • Arrange for help at home.
    • Don’t eat or drink anything after midnight, unless otherwise instructed.
    Abdominoplasty is not advised for everyone. Talk to your doctor if your future plans include:
    • One or more pregnancies
    • Continued weight loss
    Smoking interferes with wound healing and increases the risk of scars. If you smoke, you will need to stop smoking for a period of time before and after the procedure. Most surgeons recommend smoking cessation for at least 4 weeks prior to surgery and 4 weeks after surgery.
    Talk to your doctor about ways to successfully quit.

    Anesthesia

    General anesthesia is often used. Some surgeons may perform this procedure under sedation. Sedation is a medication that will help you relax and probably sleep throughout the procedure.

    Description of the Procedure

    The exact steps of the procedure will depend on the goals of each surgery. Some common steps include:
    • An incision will be made in the lower abdomen. The length of the incision depends on the extent of surgery needed. The largest incision can extend from the hipbone to hipbone.
    • Sometimes the belly button is separated out. Once the skin is adjusted a new hole for the belly button is created in the area of skin now over the belly button. The belly button is then pulled through the new hole and stitched into place. In a mini-abdominoplasty, the belly button unaffected and not moved.
    • In certain situations, internal stitches may be placed down the center of the abdominal muscles from the breastbone to the pubic area to help bring the muscles back together.
    • When underlying tissue work is completed, your body will be flexed, or bent, at the hips and the skin is pulled down and any excess skin is removed.
    • Liposuction may be done during this surgery to remove excess fat under the skin.
    Once the work is complete, drainage tubes will be placed in the abdomen. These tubes will work to remove excess fluid from the abdomen.
    The incisions are closed with stitches, adhesive, tape, or clips and covered with a bandage.
    Liposuction of the Abdomen
    exh36517 97870 1 cropped
    Copyright © Nucleus Medical Media, Inc.

    Immediately After Procedure

    You will be taken to the recovery room and monitored.

    How Long Will It Take?

    2-5 hours

    How Much Will It Hurt?

    Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.

    Average Hospital Stay

    In some cases, abdominoplasty is an outpatient procedure. You will be able to go home after you recover from anesthesia. In other cases, an overnight stay is required. If you have any problems, you may need to stay longer.

    Post-procedure Care

    At the Hospital
    Right after the procedure, you will be in a recovery room where your blood pressure, pulse, and breathing will be monitored. Recovery may also include:
    • Pain medications
    • Medication to prevent blood clots
    The hospital staff may have you walk around as you are able. This will help circulate blood and prevent blood clots.
    During your stay, the hospital staff will take steps to reduce your chance of infection such as:
    • Washing their hands
    • Wearing gloves or masks
    • Keeping your incision covered
    There are also steps you can take to reduce your chances of infection such as:
    • Washing your hands often and reminding visitors and healthcare providers to do the same
    • Reminding your healthcare providers to wear gloves or masks
    • Not allowing others to touch your incision
    At Home
    Recovery time will depend on the extent of the procedure and your overall health. Arrange for help at home for the first few days. Some activities will be restricted during your recovery, though walking is encouraged to help the healing process.
    What to expect:
    • Remaining flexed at the hip for several days after surgery. Avoid straightening out to prevent extra tension on the abdomen.
    • Do not lay flat at night to sleep for several days after surgery.
    • Drains may remain in the abdomen for up to one week.
    • Bruising, swelling, and discomfort may be present for up to 6 weeks.
    • Supportive devices like a binder may be needed. A binder is a compression garment that supports the abdomen during healing.

    Call Your Doctor

    It is important for you to monitor your recovery. Alert your doctor to any problems right away. If any of the following occur, call your doctor:
    • Signs of infection, including fever or chills
    • Fluid leaking from the wound
    • Pain that does not go away with the medications you’ve been given
    • Your stitches come apart
    • Bleeding that does not stop after 10 minutes
    • New or worsening symptoms
    If you think you have an emergency, call for emergency medical services right away.

    RESOURCES

    American Association of Plastic Surgeons http://www.plasticsurgery.org

    American Society of Anesthesiologists http://asahq.org

    CANADIAN RESOURCES

    Canadian Society of Plastic Surgeons http://www.plasticsurgery.ca

    Health Canada http://www.hc-sc.gc.ca

    References

    Abdominoplasty. Encyclopedia of Surgery website. Available at: http://www.surgeryencyclopedia.com/A-Ce/Abdominoplasty.html. Accessed February 26, 2015.

    Abdominoplasty (tummy tuck). University of Pittsburgh Medical Center website. Available at: http://www.upmc.com/Services/aesthetic-plastic-surgery-center/our-services/body-contouring-and-reshaping/Pages/abdominoplasty.aspx. Accessed February 26, 2015.

    Tummy tuck. American Society of Plastic Surgeons website. Available at: http://www.plasticsurgery.org/cosmetic-procedures/tummy-tuck.htm. Accessed February 26, 2015.

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