Tummy Tuck (Abdominoplasty)

Description
Abdominoplasty, known more commonly as a 'tummy tuck,' is a major surgical procedure to remove excess skin and fat from the middle and lower abdomen and to tighten the muscles of the abdominal wall. The procedure can dramatically reduce the appearance of a protruding abdomen, but bear in mind, it does produce a permanent scar which, depending on the extent of the original problem and the surgery required to correct it, can extend from hip to hip.

The best candidates for abdominoplasty are men or 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 or exercise. The surgery is particularly helpful to women who, through multiple pregnancies, have stretched their abdominal muscles and skin beyond the point where they can return to normal. Loss of skin elasticity in older patients, which frequently occurs with slight obesity, can also be improved.

Patients who intend to lose a lot of weight should postpone the surgery. Also, women who plan future pregnancies should wait, as vertical muscles in the abdomen that are tightened during surgery can separate again during pregnancy.

Preparing for Surgery
If you smoke, plan to quit at least one month prior to your surgery and not to resume for at least two weeks after your surgery. Avoid over-exposure to the sun before surgery, especially to your abdomen, and do not go on a stringent diet, as both can inhibit your ability to heal. If you develop a cold or infection of any kind, your surgery will probably be postponed.

Surgery
The surgery is performed in a hospital and the patient stays overnight, Dr. Lev prefers general anesthesia. Complete abdominoplasty usually takes two to five hours, depending on the extent of work required. Partial abdominoplasty may take an hour or two.

A long incision is made from hipbone to hipbone, just above the pubic area. A second incision is made to free the navel from surrounding tissue. With partial abdominoplasty, the incision is much shorter and the navel may not be moved, although it may be pulled into an unnatural shape as the skin is tightened and stitched.

Next, the skin is separated 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. These muscles are tightened by pulling them close together and stitching them into their new position. This provides a firmer abdominal wall and narrows the waistline.

The skin flap is then stretched down and the extra skin is removed. A New hole is cut for your navel, which is then stitched in place. Finally, the incisions will be stitched, dressings will be applied, and a temporary tube may be inserted to drain excess fluid from the surgical site.

After Your 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. Some people return to work after three weeks, while others take four to six weeks to rest and recuperate.

Your 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. While they'll never disappear completely, abdominal scars will not show under most clothing, even under a bathing suit.

You must stay at least two weeks in Costa Rica following a tummy tuck. There's a 50/50 chance that you will have to go home with the drain still in if you are still draining more than 30 cc's in a 24 hour period. Everybody drains differently and that is why it's difficult to tell for sure if two weeks will be long enough to allow you to go home without the drain still in place. You have a better chance the longer you can stay postop.

It seems that the patients who end up having to keep the drain in longer than usual are the patients who've had previous abdominal surgeries, or patients who've lost a great deal of weight (more than 50 pounds.)

Obviously, the best choice for tummy tuck patients, if you can arrange it, is to stay in Costa Rica for three weeks postop so Dr. Lev can continue to see you until he can safely remove the drain and send you on your way.

Complications
Thousands of abdominoplasties are performed successfully each year. Nevertheless, there are always risks associated with surgery and specific complications associated with this procedure.

Post-operative complications such as infection and blood clots are rare, but can occur. Infection can be treated with drainage and antibiotics, but will prolong your hospital stay. You can minimize the risk of blood clots by moving around as soon after the surgery as possible.

Poor healing, which results in conspicuous scars, may necessitate a second operation. Smokers should be advised to stop, as smoking may increase the risk of complications and delay healing.