Once stretched by pregnancy or weight gain, the abdomen often fails to return to its original shape. Stretched beyond the capacity to return to normal, these tissues will also fail to respond to exercise or diet programs.
In these cases, abdominoplasty can provide a long-lasting solution. Abdominoplasty (commonly called a tummy tuck) is a frequently performed procedure used to tighten overly stretched abdominal muscles and skin for a smoother, flatter appearance. If you're considering abdominoplasty, the following information will provide you with a good introduction to the procedure. For more detailed information about how this procedure may help you, we recommend that you schedule a consultation with Dr. Kremer.
Frequently asked questions about Abdominoplasty (Tummy Tuck) by Dr. Michael A. Kremer:
Abdominoplasty can dramatically tighten the abdominal muscles, as well as the sagging, excess skin and accumulated fatty tissue. Not only will the abdomen be firmer and flatter, but the waist will be smaller as well.
The amount of improvement depends upon the extent of surgery and the patient's skin tone, body build, and healing process. Most people are happy with the results, and report a better body image after the surgery.
During the consultation, you and Dr. Kremer will discuss the changes that you would like to make in your appearance. He will explain the different options available to you, the procedure itself, the risks and limitations, and the type of anesthesia that will be used. Dr. Kremer will also evaluate your health, determine the extent of fat deposits in your abdominal region, and carefully assess your skin tone.
Be sure to ask all the questions you have about the surgery. Learning everything you can about your options, risks and benefits is the key to making an informed decision.
There are several different abdominoplasty techniques. The most common procedure is performed under general anesthesia. In the full abdominoplasty procedure, an incision is made across the lower abdomen, just above the pubic area that extends laterally along the so called bikini-line. Another incision is made around the belly button to free the surrounding skin, and the all of the skin is separated from the abdominal wall. Then Dr. Kremer pulls the loose muscles from the left and the right sides and sutures them together. This tightens the muscles to create a stronger abdominal wall and a smaller waist. Excess skin is removed, and a new opening is made for the belly button at the right position. After insertion of drainage tubes, the incisions are closed with sutures, and gauze is placed over the incision area.
If your only problem area is below the belly button, you may benefit from a less complex procedure called a partial abdominoplasty, which can often be performed on an outpatient basis, under local anesthetic with light sedation.
Or, Dr. Kremer may recommend either a partial or complete abdominoplasty done in conjunction with liposuction to remove fat deposits from the hips, for a better body contour. Sometimes liposuction alone offers good results.
Abdominoplasty generally takes about 2-3 hours, depending on the extent of the repair. A partial abdominoplasty takes about 1 or 2 hours.
One overnight stay after the surgery is most common. Depending on the extent of the surgery and the technique used, you may have to remain hospitalized for two to three days. If the area of repair is minimal, you may be able to go home the same day. This is usually discussed and decided by Dr. Kremer during the initial consultation.
For the first few days, your abdomen will feel tight, and you're likely to feel some pain and discomfort which can be controlled by medication. You will feel that you abdominal wall is being stretched when you stand up and walk. However, there is generally no major pain, mostly discomfort.
Bed rest for 24 hours is recommended. While in bed, your legs should be bent at the hips in order to reduce the strain on the abdominal area. You will be provided with a firm abdominal binder to offer support to the tightened areas. You will have to wear compression stockings and receive a daily shot against thrombosis and pulmonary embolism.
Dr. Kremer will give you instructions for showering and changing your dressings. And though you may not be able to stand straight at first, you should start walking as soon as possible.
Wound drains will normally be pulled about 2-3 days after surgery.
It may take you several weeks to feel completely back to normal. If you are in top physical condition, recovery will be much faster. Some people return to work after two weeks, while others take four weeks to recuperate.
After about three days, you may begin light activities. Even if you've never exercised before, you should begin a light exercise program to reduce swelling, lower the chance of blood clots, and improve muscle tone. However, vigorous exercise, especially lifting, should wait until you can do it comfortably and Dr. Kremer gives you permission.
Your scars may appear to worsen during the first few months, but this is normal. It may take up to a year before your scars flatten out and lighten in color. While they'll never disappear completely, these scars will be placed so that they'll be covered by your clothes, including most bathing suits.
As long as you keep your weight relatively constant, eat a healthy diet, exercise regularly, and follow Dr. Kremer's instructions about how to resume physical activity, the long-term results from this procedure are generally excellent.
In general, the best candidates for abdominoplasty are:
- 18 years of age or older
- In relatively good shape, except for the abdominal area
- Not pregnant or planning to become pregnant
- Not severely overweight
- Not smoking.
- Not planning to lose a considerable amount of weight
- In good health
- Wanting to improve their appearance and/or comfort
- Realistic in their expectations
The above is only a partial list of the criteria that Dr. Kremer will consider in determining whether or not this procedure is appropriate for you.
Note: If you have scarring from previous abdominal surgery, Dr. Kremer may recommend against abdominoplasty or may caution you that scars could be unusually prominent. In some patient old scars can be used for the abdominoplasty incision and may thereby be improved.
Strenuous exercise and weight loss alone will reduce the bulk of the abdominal wall and tighten the muscle tone; however, the stretched skin may not be able to contract without surgery. Liposuction has been touted as causing contraction of excess skin, but most often will not be effective enough to achieve results in patients who consider abdominoplasty as liposuction can also not tighten the abdominal wall muscles.
All surgery has some potential risks, including the risks of bleeding, reaction to the anesthetic, and infection. Scars are to be expected, but they will become lighter and flatter with time.
Smoking may increase the risk of complications and delay healing. This could result in larger scars, and a second surgery. You can reduce your risk of complications by closely following Dr. Kremer's instructions before and after the surgery, especially with regard to when and how to resume physical activity.
Abdominoplasty bears a chance of thrombosis and its possible complications even though preventive measures will be undertaken during and after surgery.