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Abdominoplasty (Tummy Tuck)

Abdominoplasty is a major surgical procedure to remove excess skin and fat from the middle and lower abdominal area and to tighten the abdominal muscles. This procedure can dramatically reduce the appearance of a protruding abdomen and results in a smoother, flatter tummy.

Who are the best candidates for abdominoplasty?

The best candidates for abdominoplasty are men and women who are in relatively good shape but are bothered by a large fat deposit or loose abdominal skin that won't respond to diet and exercise.

We suggest that patients who are considerably overweight postpone the surgery and try to lose weight first. Women who plan future pregnancies should also wait until after childbearing, as muscles in the abdomen that are tightened during surgery can separate during pregnancy. If you have scarring from previous abdominal surgery, your doctor may recommend against abdominoplasty or may caution you that scars may be unusually prominent.

The American Society of Plastic Surgeons website has before-and-after photos of abdominoplasty patients.

What are the risks?

When performed by a qualified plastic surgeon trained in body contouring, the results are generally satisfying. It does however produce a permanent scar across the lower abdomen which is easily camouflaged. There are always risks associated with any surgical procedure and you should discuss all of these risks with your surgeon.

Specific complications associated with this procedure may, but rarely, include postoperative infection and blood clots. Infection can be treated with drainage and antibiotics, but will prolong your hospital stay. Poor healing, which results in conspicuous scars may necessitate a second operation. Smokers are advised to stop smoking, as smoking may increase the risk of complications and delay healing. You can reduce your risk of complications by closely following your surgeon's instructions before and after the surgery, especially regarding when and how you should resume physical activity.

How do I prepare for surgery?

During your initial consultation, your surgeon will evaluate your health, determine the extent of fat deposits in your abdominal region, and carefully assess your skin tone. There are different kinds of procedures that your surgeon might recommend based on the extent of your fat deposits. If, for example, your fat deposits are limited to the area below the navel, you may require a less complex procedure called a partial abdominoplasty, also known as a mini-tummy tuck. This procedure can often be performed on an outpatient basis. You may, on the other hand, benefit more from partial or complete abdominoplasty done in conjunction with liposuction to remove fat deposits from the hips, for a better body contour. Or maybe liposuction alone would create the best result.

Be sure to tell your surgeon if you smoke, and if you're taking any medications, vitamins, or other drugs. You should arrange for someone to drive you home after your surgery and to help you out for a day or two after you leave the hospital.

What happens during the surgery?

Abdominoplasty is usually performed under general anesthesia. Some surgeons use local anesthesia, combined with a sedative to make you drowsy; you'll be awake but relaxed, and your abdominal region will be insensitive to pain (you may feel some tugging or occasional discomfort with this).

An incision is made just above the pubic area. Next, the surgeon separates the skin from the abdominal wall all the way up to your ribs and lifts a large skin flap to reveal the vertical muscles in your abdomen.

The vertical muscles in the abdomen are tightened by pulling them close together and stitching them into their new position. This provides a firmer abdominal wall and narrows the waistline.

What happens after surgery?

For the first few days, your abdomen will probably be swollen and you're likely to feel some pain and discomfort which can be controlled by medication. You may be released within a few hours or you may have to remain hospitalized for two to three days. Your doctor will give you instructions for showering and changing your dressings. You may not be able to stand straight at first, but you should start walking as soon as possible. Surface stitches will be removed in five to seven days, and deeper sutures, with ends that protrude through the skin, will be removed in two to three weeks.

It may take you weeks or months to feel like your old self again. Some people return to work after two weeks, while others take three or four weeks to rest and recuperate. Exercise will help you heal better. People who have never exercised before, you should begin an exercise program to reduce swelling, lower the chance of blood clots, and tone muscles (vigorous exercise should be avoided until you can do it comfortably). Scars may actually appear to worsen during the first three to six months as they heal, but this is normal. Expect it to take nine months to a year before your scars flatten out and lighten in color.

Will the surgery be covered by my insurance?

In most cases, health insurance policies do not cover the cost of abdominoplasty, but you should always check your policy to be sure.

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