Tummy tuck, or abdominoplasty is one of our most sought-after procedures! Patients who have had pregnancies, particularly multiple pregnancies or twins/triplets, significant weight loss, or previous C-sections or abdominal surgery often have excess skin and muscle separation that can only be fixed with surgery. Excess skin of the lower and upper abdomen, loose abdominal muscle and lower back discomfort are typical issues we see with patients. Pregnancy stretches out the abdominal wall and separates the rectus muscles. After delivery, tissue contracts but often the rectus muscle is not functioning properly which results in straining the back. In addition, the excess skin does not go away with weight loss and exercise. In such cases, a patient may wish to consider a tummy tuck (or abdominoplasty). A tummy tuck is the surgical removal of excess skin from the abdomen, along with the repair of the diastasis rectus, bringing the muscles back into position so they can function properly. Liposuction of the hip area can be done as well to contour the area.
Reasons for Considering an Abdominoplasty:
Excess skin of the lower and or upper abdomen following pregnancy
Excess loose skin following weight loss.
Diastasis recti or separation of the abdominal rectus muscles after pregnancy causing a weak core and back strain
Scars of lower abdomen from previous surgery or skin draping over C section scars after pregnancy
Full Abdominoplasty--Abdominoplasty surgery takes about 4 hours and is done under general anesthesia. With full abdominoplasty we generally recommend a one night stay in the hospital. To begin the procedure, an incision is made in the lower abdomen and around the umbilicus. The skin is then elevated away from the abdominal wall, up to the level of the rib cage leaving the belly button in place. The rectus abdominus muscles are then repaired in the midline restoring the core muscles to their proper position. Two drains are placed to expedite healing and the skin is redraped and the incision is closed with dissolvable sutures. The belly button is brought out through an opening in the skin and sutured into place. Soft padded dressings and an abdominal binder are applied.
Umbilical Float Abdominoplasty--this is a variation on a full abdominoplasty that is beneficial when there is a very low previous C section scar, or there is minimal skin in the upper abdomen, but still excess skin in the lower abdomen. To avoid pulling the pubic skin up too high, or making the skin closure too tight, umbilical float avoids the incision around the belly button, does the same elevation of the skin up to the rib cage, and repairs diastasis rectus if needed. A more conservative amount of skin is removed from the lower abdomen, allowing the scar to be low on the abdomen. Dr. Buenaventura will advise you if this is preferable for you.
Mini abdominoplasty--This involves the lower abdomen only and no changes are made to the upper abdomen. Liposuction can be done on the lower abdomen and excess skin is removed. The skin is then closed with dissolvable sutures. A drain may or may not be used in this procedure. It is a quicker recovery, as no muscle repair is needed. The length of the scar is about the same as above, and liposuction of the hip or abdominal area can be done. This would be recommended to you if there is no muscle repair needed and no excess skin in the upper abdomen. This is done as an outpatient procedure.
Post operative recovery involves rest and keeping the abdominal skin in a stretched position so it can heal properly. We recommend avoiding the sitting position, and prefer lying down, standing up or reclining in the early healing period. Hydration is important and drains will be removed the second week. Constipation is possible, so we recommend stool softeners daily and mineral oil if needed. You will empty your drains once a day and keep your abdominal binder on. Once drains are removed (which does not hurt!) you may wear a high waisted compression garment. You will be prescribed antibiotic and pain medication though most patients only need it for a few days. The first 2 weeks are important to take it very easy. We recommend no vigorous exercise or travel for about 6 weeks. It is worth it! While insurance does not cover tummy tuck, it is in many ways restorative surgery and can be life changing.