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Tummy Tuck
(Abdominoplasty)
Abdominoplasty, better known as a "tummy tuck," is a surgical procedure to remove excess skin and fat from the middle and lower abdomen and to tighten the muscles of the abdominal wall. Abdominoplasty should not be considered a substitute for weight loss.
How much does this procedure cost?
The average cost for an adominoplasty in the US is $4,200. However, cost varies from surgeon to surgeon and according to where they practice. In Canada, the procedure costs around $7,000 to $8,000 CDN. There may be additional costs such as anesthesia, operating room facility, prescription medicines, etc.
What happens during a procedure?
A tummy tuck is nearly always performed under general anesthesia, but can be performed under local anesthesia, along with intravenous sedation, or general anesthesia depending on your health, the extent of the procedure and whether you are having other procedures at the same time. Some surgeons perform abdominoplasty in an outpatient surgical center, but most prefer a hospital setting where you can recover overnight. An abdominoplasty usually takes two to five hours, depending on the extent of work required. Partial abdominoplasty may take an hour or two.
During the operation, an extensive incision is made which runs across the lower abdomen. Most commonly, the surgeon will make a long incision from hipbone to hipbone, just above the pubic area. A second incision is made to free the navel from surrounding tissue. With partial abdominoplasty, the incision is much shorter and the navel may not be moved, although it may be pulled into an unnatural shape as the skin is tightened and stitched.
Next, the surgeon separates the skin from the abdominal wall all the way up to your ribs and lifts a large skin flap to reveal the vertical muscles in your abdomen. These muscles are tightened by pulling them close together and stitching them into their new position. This provides a firmer abdominal wall and narrows the waistline.
The skin flap is then stretched down and the extra skin is removed. A new hole is cut for your navel, which is then stitched in place. In partial abdominoplasty, the skin is separated only between the incision line and the navel. This skin flap is stretched down, the excess is removed, and the flap is stitched back into place.
Finally, the incisions will be stitched, dressings will be applied, and a temporary tube may be inserted to drain excess fluid from the surgical site. Firm elastic bandages are then applied to support the area.
Are there risks or potential side effects?
This surgery does produce a permanent scar, which, depending on the extent of the original problem and the surgery required to correct it, can extend from hip to hip. Like all surgeries, there is always a possibility of complications, including infection, a reaction to the anesthesia, hematoma, seroma, nerve damage and the occurrence of asymmetries or irregularities. Should infection occur, your surgeon will prescribe a treatment with antibiotics. Be sure to ask your surgeon about all of the risks associated with the procedure your considering before you make any decision.
As with any surgery, it is also sometimes normal to feel anxious or depressed in the days or weeks following the operation. If there is heavy bleeding or increased pain, be sure to inform your surgeon.
What to expect post-procedure?
For the first few days following surgery, the abdomen will feel swollen and tight. You will feel some pain and discomfort for which your surgeon will prescribe medication. Your will be given instructions for showering and changing your dressings.
At first you may not be able to stand up straight without feeling a tugging sensation, but you should start walking as soon as possible. Though initially you will be stooped over, you will soon be able to straighten up completely as your body accommodates to your newly tightened abdomen. Postoperative bruising is minimal, but swelling is substantial. It takes up to three months for the swelling to disappear. You may also experience numbness of the abdominal skin and it may take several months for the sensation to return.
How soon does normal life resume?
Surface stitches or staples will be removed in five to seven days and lighter bandages will then be applied. These bandages are soon replaced with an abdominal support garment, which is worn for several weeks. During this time, you must refrain from heavy lifting, straining or over-activity. Your surgeon will let you know when to resume your normal activities based on the extent of surgery and your progress.
It may take you weeks or months to feel like your old self again. If you start out in top physical condition with strong abdominal muscles, recovery from abdominoplasty will be much faster. Some people return to work after two weeks, while others take three or four weeks to rest and recuperate.
Exercise will help you heal better. Even people who have never exercised before should begin an exercise program to reduce swelling, lower the chance of blood clots, and tone muscles. Vigorous exercise, however, should be avoided until you can do it comfortably.
Your scars may actually appear to worsen during the first three to six months as they heal, but this is normal. Expect it to take nine months to a year before your scars flatten out and lighten in color. While they'll never disappear completely, abdominal scars will not show under most clothing, even bathing suits.
Are you a good candidate?
A tummy tuck is not an alternative to losing weight. In fact, many board certified surgeons will suggest alternatives for patients who are more than 15 percent over their ideal body weight. The best candidates for abdominoplasty those who are in relatively good shape but are bothered by a large fat deposit or loose abdominal skin that won't respond to diet or exercise. Women who, through multiple pregnancies, have stretched their abdominal muscles and skin beyond the point where they can return to normal are good candidates for this procedure, as well as older patients who have experienced a loss of skin elasticity.
Patients who intend to lose a lot of weight should postpone the surgery. Also, women who plan future pregnancies should wait, as vertical muscles in the abdomen that are tightened during surgery can separate again during pregnancy. If you have scarring from previous abdominal surgery, your doctor may recommend against abdominoplasty or may caution you that scars could be unusually prominent.
As with all elective surgery, good health and realistic expectations are prerequisites, but if you want to change the appearance of abdominal area then a tummy tuck may be appropriate, especially if:
- Your doctor is aware of any medical conditions or allergies you may have and any medication you may be taking.
- You do not smoke.
- You are not diabetic, nor do you have small blood-vessel disease.
- Are over 15 years of age.
- You are not prone to scarring problems such as keloids.
- You have a good understanding of the healing process and the limitations of the procedure.
How to prepare for surgery?
Your doctor will give you specific instructions to prepare for surgery but here are some general guidelines:
- Avoid aspirin, any aspirin containing medication or any other non-steroidal anti-inflammatories (NSAID), such as MotrinŽ or AdvilŽ, for two weeks prior to treatment. Because aspirin thins the blood, it can interfere with normal blood clotting and increase the risk of bleeding and bruising.
- Smoking inhibits the healing process, so stop smoking before your procedure and if you start again, make sure it is after you are completely healed.
- Avoid drinking alcohol a few days before your surgery.
- Make sure to follow any fasting instructions the night before and morning of your surgery. Your doctor may insist on an empty stomach depending on the type of anesthesia.
- Make sure that you arrange for someone to bring you home and to help you out for 24 hours after surgery.
Are there alternatives to this procedure?
An alternative to tummy tuck could potentially be liposuction (liposculpture). The later procedures are can reduce the overall girth but will not correct for and may, in fact, worsen the appearance of loose skin around the abdomen. Although it cannot necessarily produce the same results as a tummy tuck, exercise can dramatically change the appearance of the midriff. The skin of the abdominal area is essentially draped over the muscle and as the muscle is built-up, the appearance of the skin is improved. The abdominal muscles are considered by most trainers as one of the easier muscle groups to tone.
Locate a certified physician with our Doctor Locator.
To view Personal Stories about this procedure contributed by our members, Click Here.
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