ABDOMINOPLASTY - QUESTIONS AND ANSWERS
Because informed patients are so important to the success of any plastic surgery, Dr. Robert H. Stubbs, a Canadian and American Board Certified Plastic Surgeon has prepared this web info for you. The web info will give you a basic understanding of the procedure - when it can help, how it is performed and what results you can expect. It can not answer all your questions, since a lot depends on the individual patient and the surgeon. Please ask a certified Plastic Surgeon about anything you do not understand.
A: Abdominoplasty, known more commonly as a "tummy tuck," is a major surgical procedure to remove excess skin and fat from the middle and lower abdomen and to tighten the muscles of the abdominal wall. The procedure can dramatically reduce the appearance of a protruding abdomen. It 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.
A: Abdominoplasty can enhance your appearance and your self-confidence, but it won't necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations - they must be realistic.
The best candidates for abdominoplasty are men or women who are in relatively good shape but are bothered by a large fat deposit and/or loose abdominal skin that will not respond to diet and/or exercise. The surgery is particularly helpful to women who, through multiple pregnancies, have stretched their abdominal muscles and skin beyond the point where they can return to normal. Loss of skin elasticity in older patients, which frequently occurs with slight obesity, can also be improved.
Patients who intend to lose a lot of weight should postpone 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, we may recommend against abdominoplasty or caution you that scars may be unusually prominent.
A: All surgery carries some uncertainty and risk. Abdominoplasty is normally safe, as long as patients are carefully selected, the operating facility is properly equipped and the physician is a certified Plastic Surgeon.
Post-op complications such as infection and blood clots are rare, but can occur. Infection can be treated with drainage and antibiotics, but hospitalization may be required. You can minimize your risk of blood clots by moving around as soon after surgery as possible. Poor healing, which results in conspicuous scars, may necessitate a second operation. Smokers should be advised to stop smoking, as smoking will increase the risk of complications and delay healing.
A: In your initial consultation, we evaluate your health, determine where your abdominal fat deposits lie and assess your skin tone. Alternative body-contouring methods that may be appropriate - such as liposuction are reviewed. If your fat deposits are limited to the area below your navel, you may require a less complex procedure called a partial abdominoplasty or mini-tummy tuck.
Be honest in discussing your expectations. We will be frank with you, describing the procedure in detail and explaining its risks and limitations. We will also explain the anesthesia used, the location where surgery will be performed and the total costs involved. During this consultation, be sure to tell us about any medications (especially aspirin or other pills that affect clotting), vitamins or other drugs you are taking. Smokers should consider giving up the habit before and after surgery. Then, a complete physical along with blood and urine analysis is arranged.
A: The patient should not have had anything to eat or drink after midnight prior to surgery. Pre-op medications should have been taken. Also, transportation and post-op care arrangements should have been made.
Abdominoplasty surgery is performed under deep sedation and local anesthesia or under full general anesthesia in a hospital. The type of anesthesia and the location where the surgery is performed is determined by the extent of the surgery and the patient risk factors. The surgery usually takes 3-4 hours, but the time required may vary considerably depending on the amount of work being done. During this time the patient is carefully monitored.
At the end of surgery, the incisions are closed, drains are inserted, a light dressing is applied and a compression garment is fitted. The patient is then monitored in the recovery area for a few hours prior to discharge. A mini-tuck involves less extensive surgery with less scarring, no navel shifting and less or no muscle tightening.
It is mandatory for a patient who has had deep sedation to have someone stay with them the first night after surgery. The medications may affect judgment and co-ordination for 24 hours.
A: Follow-up visits vary according to the patient and the procedure. Early post-op instructions usually include taking prescribed medications, wearing the elastic compression garment and ambulating (to prevent blood clots). A snug elastic dressing or girdle must be worn over the treated area to control swelling and bleeding, and to help your skin mold to fit your new contour. You may need to wear this garment for up to six weeks. The operated areas will be swollen and bruised and you may feel discomfort which can be controlled with pain medications.
It may take weeks or months to feel like your old self again. If you start out in top physical condition recovery will be much faster. Some people return to work after two weeks, while others take three or four weeks to rest and recuperate The healing process is gradual. While most of the swelling and discoloration will be gone a month or two after surgery, some swelling can remain for six months or more. Scars may take up to a year or more before they finally soften and fade. Strenuous activities are best avoided for at least 4-6 weeks post-op.
A: Most patients are very satisfied with the results of their tummy tucks. As long as your expectations are realistic, you should be very happy with your new shape. See the Surgical Art Gallery for examples of this procedure.
