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The abdominal region should be flat, free of stretch marks, without extra skin, and provide solid muscular support. Pregnancy, weight gain, and the aging process work against this ideal. Abdominoplasty strives to return the “tummy” to its ideal state. -Andrew Barnett, MD
Both fashion and our more active lifestyles have placed increased importance on the size and shape of our bodies. We are also more conscious of the importance of weight control to our health. Consequently, more and more interest is directed towards surgery to improve one’s figure. While most media attention in the past few years has been directed towards the excellent procedure of liposuction to contour the body, abdominoplasty, or the “tummy tuck” operation, remains the correct surgical solution for excess skin and weak muscles in the abdominal area.
What actually causes the problem with the abdominal region?
The three main culprits causing wrinkling and bulging of the abdominal region are pregnancy, weight gain and loss, and age. Rapid weight gain and loss stretches the skin and at times, the underlying muscles. Abdominoplasty reshapes the tummy region by removing excess skin and tightening the muscles, while abdominal lipectomy removes the excess fat.
How is the surgery performed?
An incision is made, generally along the lower abdomen and upper thighs, the so-called “bikini line”. This is followed by lifting the skin of the abdominal region. Excess fat is eliminated, and the abdominal “sit-up” muscles are tightened. The skin is then pulled down and the excess is removed. At times, the navel will need to be repositioned to a higher level. After the surgery, a bandage is placed on your abdominal region to give you support.
Why do you have to tighten the abdominal muscles?
The main support in the tummy region comes from the “sit-up” muscles, scientifically referred to as the rectus abdominis muscles. These two muscles run immediately next to each other, from the breastbone to the pubic bone, and form an internal girdle to hold the tummy in. During pregnancy, the two muscles are split apart and move to the sides to allow for growth of the baby. After the baby is born, the muscles frequently stay apart, making it impossible for you to have a tight lower abdomen. The scientific term for this is diastasis recti or separation of the rectus muscles. No matter how much exercise you do, muscles never come together. During the abdominoplasty, the muscles are brought together, eliminating the weakness. Interestingly, patients with diastasis recti frequently have problems with constipation and lower back pain, which can sometimes be eliminated with an abdominoplasty. If you suffer from these problems, your insurance company may cover a substantial portion of the cost of your surgery.
What about the stretch marks, can they all be removed?
Many patients refer to their tummy as a “prune belly”, describing the looseness and stretch marks. Depending on the distribution of the stretch marks, many if not all, can be removed. The tradeoff, however, is the necessary scar which occurs at the incision site.
What do you mean “scar”? I thought plastic surgeons didn’t make scars.
The body has only one way of healing: through the formation of scar tissue. Whenever an incision is made, a scar will form. As a plastic surgeon, I pride myself on producing the smallest, thinnest, least visible scar possible. As a patient, however, you must decide whether loose excess skin, stretch marks, and a prominent tummy are more desirable than an incision scar.
What about other scars I have on my abdomen, from a Cesarean section or appendicitis?
Frequently, the old scars can be removed at the time of the abdominoplasty, which is a nice added benefit!
What if there’s no fat, but my lower tummy just sticks out?
This is a very common problem with women who’ve had children and are thin and athletic. A “mini” tuck is the solution here, which is a much simpler operation, with a smaller incision and faster recovery time.
What if there is fat, but my skin is smooth and has a good tone?
In this case, you’re probably a candidate for liposuction alone. While some liposuction is done in almost all abdominoplasties, the big question is whether liposuction alone can solve your problem. Only a consultation and examination in my office can provide you with that answer.
What if I’ve lost a tremendous amount of weight, and have a hanging tummy?
Patients who’ve been obese, then lose weight, frequently have a large apron of excess skin and fat. This is seen in men and women alike. It can be corrected with a procedure called an abdominal lipectomy which removes not only the excess tummy, but the love handles and excess skin on the back as well.
Is abdominoplasty painful?
The surgery is performed with general anesthesia, so there’s no discomfort during the operation. Afterwards, some pain is present for a number of weeks, but it is generally well controlled with medication.
How long does it take to recover?
In general, patients spend one day in the hospital after surgery. While vigorous activities are limited for six weeks, many patients are able to return to work in seven to ten days.
Are there any risks to abdominoplasty?
As with any surgical procedure, there are risks. Bleeding, infection and scarring may occur. Occasionally, fluid may collect, or a small area of skin at the incision line may be lost. While uncommon, patients occasionally have pain in the abdominal region which lasts for an extended period. Blood clots may form in the leg, though this is unusual. This information is given not to frighten you, but to help you make an informed decision. We will discuss the full range of risks at your consultation. Although abdominoplasty is generally a very safe procedure, it should not be taken lightly.
Is abdominoplasty right for me?
That’s a question only you can answer. At your consultation, speak frankly, ask questions, and explain your expectations. We’ll work together to help you make the decision that’s right for you.
To learn more about what you can expect during a Tummy Tuck Procedure, or to schedule your consultation with Dr. Barnett at either his San Francisco or Walnut Creek office, please complete the form on this page or call (415) 362-1221