Abdominoplasty – Tummy Tuck Procedure
An excess of skin and fat on the abdominal wall is often seen particularly following pregnancy in women and major weight gain and loss in both men and women. This redundant skin and fat may remain despite regular exercise activity and reasonable diet. It can be a source of embarrassment and frustration.
Tummy tuck surgery (abdominoplasty), available from board-certified plastic surgeon Jay Orringer, MD, is a procedure which removes excess skin and fat of the abdominal wall and tightens separated muscles particularly following pregnancy. Unlike liposuction where scars are usually small, because skin is actually removed, much larger scars result with abdominoplasty. The length of the scar(s) will be determined by the nature of the deformity. Patients with considerable skin excess will trade a scar from hip to hip and a scar around the belly button for potentially notably improved contour. Patients with limited skin excess and only muscle laxity below the belly button, may have a scar that is only somewhat longer than their C-Section or hysterectomy scar and may have no scar around the belly button. This procedure is known as a “mini-abdominoplasty,” Tummy tuck scars are designed in an effort to hide them, as possible, below underwear and bathing suit lines, allowing the improved contour to be seen, while attempting to minimize scar visibility in clothing.
- The Consultation
- The Surgery
- The Recovery
- What are some of the particular concerns regarding Tummy Tuck Surgery?
- Making the Decision
Dr. Orringer will typically spend 45 minutes to an hour discussing your medical history and goals. Examination will evaluate current body contour, degree of skin and fat excess, muscle and skin tone and skeletal changes. Any patient more than 50% above their ideal body weight should consult a weight loss specialist. While intending to improve abdominal contour, this is not a weight loss procedure. Patients should postpone tummy tuck until they have completed child-bearing. Smokers must cease smoking for at least one month prior to surgery and must maintain cessation for at least one month following surgery, in an effort to avoid significant healing problems. Every individual has specific goals and unique anatomical considerations. The detailed consultation will address these important issues.
The surgery is performed at the state-of-the art Surgery Center of Santa Monica. This modern accredited facility is located two blocks north of Saint John’s Hospital. Anesthesia is administered by Board-Certified anesthesiologists. The morning of surgery, Dr. Orringer will design the incision with you, taking into account preferred style of underwear and bathing suit. Incisions that centrally are just above the pubic hair and laterally extent upward in “French Cut” style are popular. Areas for fat contouring such as the upper midline will be marked as well. At surgery, excess skin and fat of the abdominal wall will be removed and the muscle tightened. While some stretch marks may remain, considerable reduction is usually achieved. The amount of redundant skin and fat will be decreased, and the muscles tightened. However, an “hourglass” figure will not be obtained. Dr. Orringer will attempt to “sculpt” the abdominal wall as possible. A customized booklet which discusses further the procedure, risks, and pre- and post-operative instructions will be provided for you at your pre-operative visit.
While the surgery is performed under general anesthesia, Dr. Orringer will place local anesthesia during the procedure, as well, to assist with pain control early after surgery. Patients usually spend 1-2 nights at Serenity, a warm, comfortable facility geared for the care of the post-operative plastic surgery patient. Pain is usually well-controlled with oral analgesics. However, stronger pain medication may be given through the I. V., if necessary. Ambulation is encouraged the night of surgery. Pneumatic pumps will be used on the legs in an effort to prevent blood clots until you are ambulatory. Dr. Orringer will see you the day following surgery. Most patients can return to light work activity by 10-14 days. Driving should not be done until oral narcotics are no longer required for pain control. Exercise activity can progress, as directed by Orringer, until at 6 weeks for normal exercise activity is usually permitted. The tissues feel firmer than normal for at least 1-2 months. Most swelling has subsided by 3 months. Scars will typically continue to fade for 2 years.
While patients are usually quite pleased with their improved contour, certain considerations must be taken into account before proceeding. Because of actual skin removal, a permanent scar will result. While it tends to lighten and fade for at least 2 years, the scar is permanent. With extensive skin and fat removal, the scar will be lengthy. With full abdominoplasty, a scar around the belly button is present, as well. A patient must be willing to accept the scars as an acceptable trade-off for potentially improved contour. In most cases, stretch marks are reduced, but some often remain. In addition, marked narrowing of the waist and the appearance of an “hourglass figure” will not be seen. Some temporary and often permanent loss of sensation to areas of the abdominal wall, particularly from the scar to the belly button near the mid-line, is present. Abdominoplasty is a major procedure that carries with it significant potential benefit and risk.
Dr. Orringer wants you to feel comfortable asking questions and voicing concerns about any aspect of abdominoplasty. Whether during your initial consultation, pre-operative visit, or at any other time while you consider this procedure, we want to assist you in determining whether tummy tuck surgery is the best option for your needs. Dr. Orringer believes that taking sufficient time to plan, discuss, individualize, and perform your procedure is necessary and vital for the best possible chances of attaining the results you desire.
Please contact Dr. Orringer for more information on tummy tuck surgery, or to schedule a consultation.
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Before and After Images: