Following pregnancy and weight loss the youthful contours of our abdomen can be lost to muscle laxity and skin excess. Despite your best efforts in the gym, the concave, tight abdomen of youth is replaced by a more unflattering shape with loose, hanging skin sometimes called a “muffin top.” An abdominoplasty, also known as a tummy tuck, can restore those youthful contours and give you back that flat, toned look with a refined waistline and a renewed self-confidence to pursue your active life style.
In most cases, Dr. O’Connell performs an advanced technique of abdominoplasty that does not require drains or permanent sutures.
What is a tummy tuck?
A tummy tuck, also known as an “abdominoplasty”, is a plastic surgical procedure that addresses both skin laxity and muscle separation of the abdominal wall. Excess fat in the abdomen is also commonly treated during a tummy tuck. The most common setting in which loose skin and muscle separation occur is following pregnancy or weight loss. The muscle separation that occurs following pregnancy is known as “diastasis recti” and it is often incorrectly considered a hernia. Some patients also have a true abdominal wall hernia that can be repaired at the time of abdominoplasty. Many patients note a fatty or hanging mons (pubic area) that can also be improved as part of a tummy tuck procedure.
In most abdominoplasty procedures a scar above the pubic area is created, and many tummy tucks also create a scar about the umbilicus (belly-button). In a “reverse abdominoplasty” scarring is created in the creases below the breasts.
Dr. O’Connell is the originator of the BAND-Abdominoplasty which stands for the hallmarks of his technique, “BiDirectional, Absorbable, No Drain.” His technique includes repair of the muscle diastasis utilizing BiDirectional Quill sutures, which are also used to close the skin. In order to reduce the risk of long-term infection, only absorbable sutures are used and no permanent suture material is utilized in most cases. Finally whenever possible, Dr. O’Connell performs a drainless, tummy tuck or “no-drain abdominoplasty” with an advanced technique utilizing progressive tension sutures.
Tummy Tuck Candidates
Good candidates for abdominoplasty should be in good overall health. Tummy tucks produce permanent scarring and prospective patients should be aware of the locations of these scars and the fact that no guarantee can be provided as to the appearance of the scars. While we understand that weight loss can sometimes be extremely difficult, it is best to be at or near your goal weight prior to abdominal contouring.
Abdominoplasty may be an option if you have:
- Loose, wrinkled or hanging skin of the abdomen. This can be unsightly and can even create problems with hygiene.
- Diastasis recti – a separation of the rectus abdominus muscles that can result from pregnancy or the aging process.
- Scarring of the abdomen that you wish to reduce.
- Fatty excess of the abdominal wall in combination with the above.
- A loosened, fatty, unattractive or hanging mons (pubic area).
- An unattractive C-Section scar with skin excess.
Your Tummy Tuck Consultation
As with all plastic surgical procedures, safety is paramount. During your confidential consultation Dr. O’Connell will carefully review your medical history including allergies, medication and tobacco use and especially, any excessive tendency for clotting. Because pregnancy and weight loss can affect each prospective abdominoplasty patient differently, Dr. O’Connell will carefully evaluate the relative contributions of skin excess, muscle separation (diastasis recti) and fatty excess to help you determine which procedures might provide the best aesthetic results for you.
You will have an opportunity to view explanatory videos and interactive diagrams on TouchMD® as well as photographs of prior tummy tuck patients to help you understand your anatomy, the effects of pregnancy, weight loss and the aging process and also to understand you aesthetic goals.
The various options for abdominal contouring, both surgical and non-surgical, will be reviewed along with their risks, costs and likely, potential benefits and you will have ample opportunity to have all your questions answered.
Finally, you will be provided with written materials to help you understand the options for abdominal wall contouring – you can even review your consultation at home with TouchMD.
Types of Tummy Tucks
The various types of abdominoplasties are categorized by the amount of skin that is removed, the location of the scars, the extent of undermining performed during the procedure and whether liposuction is concomitantly performed.
Some common types of abdominoplasties are:
- Full abdominoplasty – skin is removed from the umbilicus (belly-button) to the pubic area with repair of muscle separation (diastasis recti) sometimes accompanied by fat removal via liposuction. Scarring is usually in the bikini line area (“hip-to-hip”) and about the umbilicus.
- Partial or modified abdominoplasty – skin is removed from the pubic region upward but stops well short of the umbilicus. Muscle repair and liposuction is commonly performed. Scarring in the suprapubic or bikini area is shorter than in full abdominoplasty and there is usually no scar about the umbilicus.
- Mini-abdominoplasty – skin is removed in a limited area just above the pubic area and is usually not accompanied by muscle repair. Scarring is limited to a small region of the suprapubic area, resembling an extended Cesarian-section scar. This can be an excellent alternative for women with a slight amount of overhang just above their C-Section scar.
- Lipoabdominoplasty – a type of full abdominoplasty where more limited undermining is performed and replaced with more extensive liposuction.
- Reverse abdominoplasty – a type of abdominoplasty where the excess skin is distributed upward into the area of the creases below the breasts.
Preparing for Tummy Tuck
As part of the preoperative process you may be asked to:
- Obtain bloodwork to evaluate your blood counts and clotting system.
- Stop taking aspirin, anti-inflammatory drugs, vitamins, supplements and other medications that can increase the risk of bleeding.
- Stop smoking.
- In some cases you will be asked to obtain a medical evaluation from your primary care physician.
- In most cases, abdominoplasty is an outpatient procedure and you must have a responsible adult drive you home from your surgery and stay with you for at least the first 24 hours.
Tummy Tuck Procedure Steps
In most cases, Dr. O’Connell performs abdominoplasties under general anesthesia and patients return home the day of surgery. Most commonly a full abdominoplasty is performed. At the Aesthetic Center mini-abdominoplasties are usually performed under local anesthesia, again as an ambulatory, outpatient procedure.
Most full abdominoplasties, including Dr. O’Connell’s BAND-Abdominoplasty, utilize a gently curved incision in the bikini area to obtain access to the lower abdominal wall. The umbilicus is also encircled with a separate incision. The separation of the rectus muscles is visualized and securely repaired. The excess skin and fat in the area below the umbilicus is removed and progressive tension sutures are placed to eliminate the need for drains. In some cases, the mons is secured in a higher, more aesthetic, location prior to closing the incision in layers. While the umbilicus is the same belly-button you started with, it now has a scar about its periphery and sometimes the belly-button is shortened or modified to make it more attractive.
Liposuction can be performed as part of the procedure and any true hernia of the upper abdominal wall can usually be repaired at the time of abdominoplasty.
Tummy Tuck Recovery
Following abdominoplasty you will rest in the “beach chair” position but encouraged to ambulate immediately after surgery. Our patients initially wear an abdominal binder with gauze padding. You will be provided with pain medication and medications to prevent nausea and vomiting as well as detailed written instructions. Most patients are allowed to shower at 48 hours.
Most patients are able to drive in about 7 days and can return to sedentary work in about 10 days. For many years Dr. O’Connell has allowed his patients to resume gym work-outs at 21 days following surgery (provided that no true hernias were repaired during the procedure).
Dr. O’Connell will see you several times during the postoperative period to insure that healing is progressing normally, to review your care and address any questions or concerns that you might have.
Tummy Tuck Cost
According to recent statistics from the American Society of Plastic Surgeons the average cost of a tummy tuck is $5,493. It is important to understand that the cost of tummy tuck surgery can vary widely and the average fee noted above does not include facility and anesthesia costs or other related expenses such as medications, garments and medical tests. Because most full and modified abdominoplasties are performed under general anesthesia in hospitals or other licensed outpatient facilities, the facility and anesthesia costs can easily account for 50% or more of the total cost.
While most health insurance plans do not cover tummy tuck surgery Dr. O’Connell offers patient financing through Care Credit.
At The Aesthetic Center, most mini-abdominoplasties are performed under local anesthesia and costs are substantially lower.
Tummy Tuck Alternatives
For some patients considering abdominal contouring, the recovery time, risks, scarring and costs can remove abdominoplasty from consideration, at least temporarily. This does not, however, necessarily mean that abdominal contour cannot be improved.
For patients who do not wish abdominoplasty or are not candidates for abdominoplasty, The Aesthetic Center offers the following alternatives:
- Different types of abdominoplasties including modified abdominoplasty and mini-abdominnoplasty.
- Liposuction including Ultrasonic Liposuction – while some skin shrinkage can occur the aesthetic goal is fat removal.
- CoolSculpting® – noninvasive fat removal with no need for anesthesia , no incisions and essentially no recovery time.
- ThermiTight® – radiofrequency based skin tightening with minimal recovery time.
- IntraGen™ – A treatment utilizing GridFractional Radio Frequency™ to smooth and tighten the abdominal skin.
Each of these procedures presents its own unique set of potential benefits, costs and risks and (the last four) can be performed independently of abdominoplasty. It is important to note, however, that for patients who are best served by abdominoplasty, the above referenced procedures involve compromises and modification of the aesthetic goals.
Tummy Tuck risks and safety information
All medical and surgical procedures carry risks and potential complications and the final decision whether to proceed with surgery is a personal one based upon your evaluation of the risks and potential benefits of abdominoplasty.
Some risks of tummy tuck surgery include:
- Bleeding, infection and difficulty with wound healing
- Seroma – an accumulation of fluid beneath the abdominal skin
- Venous thromboembolism (VTE)– e.g. blood clots that can travel to the lungs.
- Unfavorable scarring
- Malposition of the belly button
- Chronic pain
Because of the added risk of VTE associated with abdominoplasty, at the Aesthetic Center all patients are risk stratified with a Caprini score in order to help determine appropriate risk reduction measures .
Tummy Tuck Words to Know
- Abdominoplasty – a surgical procedure to correct skin and fat excess and muscle laxity of the abdominal wall.
- Diastasis recti – separation of the rectus muscles of the abdominal wall
- Drains – tubes that remove blood and serum following surgery. Whenever possible by performing a drainless tummy tuck (or no-drain tummy tuck) Dr. O’Connell avoids the use of drains during abdominoplasty.
- Tummy tuck – a surgical procedure also known as an abdominoplasty
- Liposuction – a procedure also known as suction lipectomy, or lipoplasty, in which fat is removed from an area of the body by suction through small incisions.
- Mons – the area of the genitalia where the pubic hair is located.
- CoolSculpting® – a noninvasive technique to remove fat without need for needles, incisions, lasers or anesthesia.
- ThermiTight® – One of the radio frequency based technologies from Thermi AestheticsÒ that tightens skin through extremely small incisions.
- IntraGen™ – A non-invasive radio frequency based procedure that smoothes and tightens skin.
Tummy Tuck (Abdominoplasty) FAQs
Will there be a tummy-tuck scar?
The scarring from abdominoplasty surgery is designed to be hidden as much as possible by a swimsuit or undergarment. There is often a scar about the belly button which remains visible in two-piece swimwear.
Can liposuction be combined with abdominoplasty?
Liposuction is commonly used during abdominoplasty surgery to help refine the aesthetic result.
Can I go home after my abdominoplasty?
In most instances in our practice, abdominoplasty is performed as an outpatient procedure with our patients returning to their homes on the day of surgery.
Are there drains with abdominoplasty?
Dr. O’Connell performs abdominoplasty utilizing a special technique known as progressive tension suturing without the use of drains.
What is a reverse abdominoplasty?
A reverse abdominoplasty is an uncommonly utilized technique where skin excess is pushed upward and the resulting scarring is placed under the breast area.