Ideal Candidates
The ideal candidate for a tummy tuck is a woman or man who is in fairly good shape, but is bothered by excess fat or loose skin that refuses to respond to diet or exercise. It is especially helpful surgery for women who have had multiple pregnancies which stretched their abdominal muscles beyond the point of return, or for older patients who are only slightly overweight, but no longer have much elasticity in their skin.
Surgical candidates who are still losing weight - especially those who plan to lose a lot - and women who are planning future pregnancies are cautioned against having abdominoplasty, as the muscles repaired during surgery are likely to separate again. As well, patients who have had previous abdominal surgery and have scarring from it may find their doctors recommending they not have a tummy tuck, or warning that if they do, the scarring will be more prominent than usual.
Planning and Prep
When planning a tummy tuck it is important that doctors and patients be extremely honest about expectations and likely results, because while this surgery can improve appearance and boost self esteem, it should never be considered a miracle cure. It is also important to remember that abdominoplasty is not an alternative to weight loss.
Aside from general expectations, the consultation will determine the extent of surgery that is required. For example, a patient whose fat deposits are all in the area below their navel may not need a complete tummy tuck, but will be able to have a mini-tummy tuck, or partial abdominoplasty, instead. Alternatively either version of the tummy tuck done in conjunction with liposuction might offer better results, since fat deposits on the hips would also be removed. For that matter, some patients may find that liposuction is all they need.
Whatever version of the tummy tuck is ultimately chosen, preparation is similar. The patient is instructed not to smoke, to avoid certain foods for several days, and, in fact, to avoid ALL food the night before the surgery. While the surgery may be done in an outpatient clinic, it is usually performed under general anesthesia, so having a ride to and from the hospital or clinic is essential, and arranging for someone to help with after-care for a few days is recommended.
The Surgery Itself
A complete tummy tuck procedure generally lasts from two to five hours, while a mini-tummy tuck is shorter, about an hour or two.
In a complete abdominoplasty, the surgeon will usually begin by making a long incision from hipbone to hipbone just above the pubic region, with a second incision freeing the navel from the surrounding tissue. In the less extensive partial procedure the incision will be much shorter, and the navel may not have to be moved, though it may be pulled into an odd shape when the skin is tightened, and then stitched.
The next step involves the separation of the skin from the abdominal wall up to the ribs, as the surgeon lifts a flap of it to expose the vertical abdominal muscles, which are tightened by pulling them closer together and then stitching them into their new position. As well as making the abdominal wall firmer, this procedure results in a narrowed waistline.
The flap of skin is then stretched back down, with any excess removed. A new hole is cut for the navel, and the navel is stitched into its new place. The incisions will be closed with sutures, dressed, and a tube may be inserted to drain any fluid from the surgical site. In a partial abdominoplasty, the procedure is similar, but the skin is only separated from the incision line to the navel.
After the Surgery
For the first few days following a tummy tuck, patients can expect abdominal swelling as well as pain and discomfort which are generally controlled by medication. While most procedures are done on an out-patient basis, a hospital stay of two or three days may be required. Either way, showering will be a tricky procedure for several days, and there will be dressings to change regularly.
Post-surgical patients may have trouble standing straight immediately after the procedure, but are encouraged to begin walking as soon as possible.
Stitches are generally removed after about a week, with deeper sutures following a couple of weeks later. For some patients, support garments are recommended.
While tummy tucks are relatively common, they are still major surgical procedures, and as such there are risks, including infection, complications from anesthesia, scarring and bruising. Patients should consult their surgeons for details about risks are advised to follow given instructions carefully to avoid any ill effects. Abdominoplasty does not instantly change the way the world perceives the post-surgical patient, but it can greatly improve self esteem and body image, changing the way patients present themselves to the world.
