A Tummy Tuck (abdominoplasty) is a plastic surgery procedure designed to flatten the abdomen by removing excess skin and fat, and to tighten the abdominal wall.
Women and men who have excess skin and/or fat around the abdomen which does not respond to diet and exercise are candidates for abdominoplasty. Many patients complain that they cannot flatten their abdominal muscles through exercise, which also means a tummy tuck may be right for them. Abdominoplasty candidates have:
Other tummy tuck patients may recently have lost a lot of weight and need to have excess skin and tissue removed. Many women choose to have an abdominoplasty following pregnancy. Older patients may be candidates for a tummy tuck due to reduced skin elasticity.
A variety of tummy tucks are available. Patients who only need a tightening of the abdominal muscles or removal of a small amount of skin may be best treated with a “mini-tuck.” Patients who have undergone massive weight loss, on the other hand, will probably require more extensive surgery.
An abdominoplasty is usually done under general anesthesia. An incision is made along the lower abdomen at about the pubic hair line, and another incision is made around the belly button which stays attached to the muscle.
Mini-abdominoplasty tightens the lower abdominal wall and skin below the umbilicus, belly button, only (shortest scar).
Modified abdominoplasty addresses conditions where just the muscle wall or just the abdominal skin requires repair.
Standard abdominoplasty tightens all of the abdominal wall skin and muscles above and below the belly button. The scar can be altered or lowered to be hidden by most panty lines and bathing suits. (Standard scar).
Extended abdominoplasty tightens the abdomen and the flanks or sides (longest scar extending around the flanks onto lower back.)
A general anesthetic is most common, although mini-tucks may be done with local anesthetic and intravenous sedation. A standard abdominoplasty is generally an outpatient procedure, but extended abdominoplasty may require a short hospitalization of 1–2 days.
Additional procedures that may enhance the result are Liposuction, Breast Procedures, or Thigh Lift.
Within a few hours following surgery, abdominoplasty patients will walk in a slightly bent-over position. Strenuous activity and lifting of more than 10 pounds should be avoided for six weeks after surgery. Most patients are able to return to work and daily activities within two weeks of surgery.
It may take several months for a tummy tuck patient’s scars to soften, for sensation to return, and for relaxing of the tight sensation in the abdomen. In the case of extensive surgery, abdominoplasty recovery can be uncomfortable and may take longer. Our expert surgeons can tell you specifically how long your recovery will take.
Silicone drainage tubes are used by trained Plastic Surgeons for many different operations. The purpose is to drain extra fluid that other wise might otherwise accumulate under the skin, fat or muscle following an operation. Patients generally find this annoying and uncomfortable and they can impede mobility and therefore slow aspects of healing. Over the years, surgeons have improved procedures and found ways to eliminate the need for these drains in a variety of operations.
As examples, I have stopped using drains for facelifts, breast reduction, breast lifts, and most breast revision surgeries. Abdominoplasties are the most recent of my procedures that I have eliminated the use of drainage tubes.
This choice was based on numerous studies and changes in surgical techniques that all had promising results. I have found that most of my patients do very well with the exception of those have large areas of liposuction or lipo-abdominoplasty. I may use drains on a case by case basis for these patients.
A newer option now can include the use of tissue glue to glue the abdominal skin to the muscle at the end of the case eliminating any space that previously required a drain
Controlling pain after surgery provides a more comfortable healing experience but also quicker healing. When patients are painfree after a tummy tuck, they are able to get out of bed and move around more easily. This decreases the chance of DVT or blood clots in the leg veins, pneumonia and muscle weakness that comes from inactivity after any surgery.
In the past , in addition to a combination of oral medications to control pain , I have used injections of long acting Marcaine which would last several hours. Over the years, a variety of Pain-pumps became available. These were also plastic tubes much like drainage tubes that would be placed at the surgical site and drip a topical anaesthetic for up to 3 days. This was a great improvement in pain control.
In recent years , Exparel , was developed. This is a long acting injectiable medication, (bupivicaine, Marcaine) that was formulated to last for about three days.
This is injected all along the muscle and skin to provide pain relief. I have termed the Pain-less, Drainless Tummy Tuck. It is not completely pain free but there is definitely much “less-pain”
If you go to a doctor who uses drains, or if your situation requires that I use a drains, they usually stay in 3-5 days but may be required to remain in longer.
RealSelf Patient Reviews of Jed H. Horowitz, MD, FACS
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