- read about abdominoplasty-tummy tuck
- see before and after photos
- alternatives, risks, benefits & recovery
Abdominoplasty or tummy tuck is an operation that elevates, redrapes and tightens the abdomen and waist. Excess skin is removed via an incision hidden within the bikini line and the muscle is tightened resulting in a shaplier figure and flatter stomach. Liposuction especially of the love handles is usually performed at the same time and stretchmarks below the level of the belly button are removed. Some tightening of the thigh and buttock skin is also achieved.After massive weight loss the amount and extent of tissue removed is usually greater. The excision frequently has to extend towards the back and in many cases has to go all the way around as a belt lipectomy.
This patient lost 100 pounds prior to tummy tuck – abdominoplasty.
This 34 year old, 5’7″ tall patient lost 130 (from 380 lb. to 250 lb.)pounds after gastric bypass surgery.
Read Dr. Stone’s blogs about abdominoplasty and belt lipectomy surgeryAbdominoplasty, thigh buttock lift and belt lipectomy
Cellulite
Abdominal Muscle Tightening and Diastasis Repair
The Difference between Panniculectomy and Abdominoplasty – Tummy Tuck
Abdominoplasty surgery can enhance your appearance and your self confidence. Realistic expectations are important to be happy with any surgery. As each patient is an individual, different results can be expected in each patient.
In these cases there is so much skin excess that there are no good alternatives to abdominoplasty or belt lipectomy. It can only be removed by surgery.Risks
As with any type of surgery there is the risk of infection or bleeding. Additionally there is the risk of seroma or blood fluid collections under the skin, bruising and skin loss especially at the lower edge of the abdominal skin below the belly button. Smokers and those who have undergone massive weight loss prior to surgery are at particular risk for skin loss or clots in the major leg veins. This risks are minimized by careful surgery, use of drains, medical optimization of at risk patients before surgery, early ambulation after surgery, leg compression garment wear during and immediately after surgery and adherence to postoperative instructions.Constipation is a frequent problem following muscle tightening surgery and opioid pain medications after surgery. Dr. Stone has his patients routinely take stool softeners beginning a few days before surgery to minimize this problem.The appearance of the skin incision scars after surgery is highly variable from patient to patient. With good scar control regimens after surgery the visible scarring can be minimal even in Afro-Americans.
There is additional risk of severe anemia after surgery because the skin that is removed obviously contains blood and the more skin that is removed the greater the blood loss. Dr. Stone’s general rule if the skin overhang covers the genitalia patients self donate their own blood beginning a month before surgery. The patient’s own blood is transfused back into them once the skin is removed. 2 to 3 units of blood usually suffice. This ensures a smoother and quicker recovery after surgery. If the overhang lies over and below the genitalia Dr. Stone prefers to autotransfuse blood and perform the surgery in the hospital for safety reasons. In some severe cases it may be safer to do the front at one surgery and the back at a second surgery in order to perform the surgery in an outpatient surgery center and avoid the blood transfusion requirements.
Simultaneous liposuction while routine in regular abdominoplasty may be contraindicated or limited in massive weight loss patients on a case by case basis for safety reasons.
Benefits
The benefits are not being self conscious in a bathing suit at the beach, when wearing midrif exposing shirts or when being intimate and achieving a more hourglass shape for women. Being pleased with your new appearance can be a major incentive to changing your lifestyle, diet and exercise regularity in order to maintain your new look. The muscle tightening typically performed in abdominoplasty can improve posture and resolve sway back. Abdominal wall hernias if present are completely visualized during this surgery and can be repaired without leaving a skin scar directly over the site of the hernia.
Abdominoplasty patients are among the happiest plastic surgery patients because this is one of the few cosmetic procedures that is permanent. You only need one in your entire life if you maintain a pregnancy free healthy lifestyle. Facelifts and breast surgery unfortunately do not last a life time.
Massive weight loss patients have the added benefit of resolving recurrent rashes and infections under the overhang. In fact if they have such a condition before surgery some portion of the surgery is covered by health insurance.
Recovery
Most patients require an overnight stay with nursing care for 1 night after surgery. Some patients opt for 2 nights. If the overhang lies below the genitalia before surgery the patient stays in the hospital for 2 to 3 nights after surgery and is partially reimbursed for this by health insurance. A urinary catheter is left in place overnight and the drains are removed within 3 to 7 days of surgery in most cases. The main factor affecting complication free recovery is the amount of muscle tightening that is performed at surgery. If the muscles were very lax before surgery you may not be able to walk upright for 2 or 3 weeks after surgery. There are exercise and activity restrictions for 3 to 4 weeks after surgery after which patients gradually return to their pre-surgery exercise routines.
Dr. Aaron Stone
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9700 Venice BlvdCulver City, Los Angeles,CA 90232