Abdominoplasty (Tummy Tuck)
Due to weight gain or pregnancies, some people develop excess abdominal skin that hangs and is not improved by exercise. Some people also have separation of the abdominal muscles, known as “diastasis”, which causes protrusion of the abdomen. Abdominoplasty (“tummy tuck”) is a procedure that removes the excess abdominal skin and fat and also corrects the separation of the abdominal muscles, leading to a tight, flat, abdomen. Typically, this involves an incision line around the bellybutton and from hip to hip. With meticulous surgical technique and operative planning, these incisions are very well hidden, and patients can often wear two-piece bathing suits without any visible signs of surgery.
For patients with excess fat in addition to skin, liposuction can be combined with abdominoplasty to accentuate the waistline and enhance the abdominal contour. For many patients, I can achieve the best results with circumferential trunk liposuction which enhances the contour of the lower back and buttocks in addition to the waistline. Liposuction combined with abdominoplasty can be risky if not performed by a skilled surgeon because it can disrupt the blood supply to the abdominal skin potentially leading to skin loss.
Diastasis recti is the partial or complete separation of the rectus abdominis, or “six-pack” muscles. These muscles meet at the midline of your stomach. When these muscles are together, the abdomen is flat. Partial or complete separation of these muscles can make the abdomen protrude. Diastasis recti is very common during and following pregnancy. Correction of diastatis recti is one component of a tummy tuck. These muscles, once separated can be difficult, if not impossible repair with exercise alone. Some patients come in saying they feel like they still look pregnant. Even women with low body fat, good skin tone and good muscle tone elsewhere on the body can have diastatis recti. During an abdominoplasty, I can bring these muscles back together creating a flat abdominal wall. I then remove excess skin and fat as needed to provide a smooth contour to the abdomen which can make women actually come down several sizes in their clothing. Diastasis recti repair alone won’t make a woman lose any weight, but it can shrink the waist size significantly and give the appearance of weight loss. The muscle repair is performed internally so there are no visible incisions on the surface of the abdominal skin aside from the lower abdominal incision that is used for skin removal and the incision used to reposition the belly button.
Will abdominoplasty improve my stretch marks?
Any stretch marks that are located low in the abdomen, beneath the belly button, are removed during abdominoplasty. Stretch marks higher on the abdomen are shifted to a lower position but cannot be completely removed.
Most patients require a drain that stays in place for 1-2 weeks after surgery, especially when abdominoplasty is combined with liposuction. The drain is necessary for preventing a post-operative fluid collection and achieving the best possible result. Some patients are good candidates for a “drainless tummy tuck.” In this procedure, internal sutures called “progressive tension sutures” can be placed and the use of a drain can be avoided.
Abdominoplasty is a procedure with a significant recovery compared to other cosmetic procedures. At Blue Water Plastic Surgery Partners we do everything we can to make recovery as pain-free and comfortable as possible. Typically, we use a pain pump for the first few days which delivers local anesthetic into the surgical site continuously. We use an ERAS protocol for pain control to reduce the need for narcotic pain medications. We encourage an active recovery from day one but exercise is limited for the first few weeks with a gradual increase in activity level afterwards. Many patients return to work after 1-2 weeks after surgery.