Tummy Tuck Procedure
|Average Cost||$8,350 – $9,800+|
|Return to Daily Activities||7-14 days|
|Return to Work||2-4 weeks|
|Procedure Length||1-6 hours|
|Procedure Location||Physicians Medical Center|
The abdominoplasty, or tummy tuck, produces some of the most dramatic changes in the body contour of any cosmetic procedure. The surgery is designed to remove excess abdominal skin.
The tummy tuck is a rejuvenation procedure, i.e. produces a more youthful shape, compared to liposuction which simply makes one look thinner. Some of the youthful changes include the umbilicus assuming a vertical orientation (instead of horizontal), elevation of the pubic area, accentuation of the waistline, and the abdominal contours becoming smooth and youthful.
The typical patient is 35-55 years of age and more commonly a woman. They have completed their childbearing and despite “abdominal exercises”, cannot seem to get rid of the “pooch”. Alternatives such as liposuction may be considered but the limiting factor is often the condition of the skin. When there are multiple stretch marks or the skin has poor elasticity, liposuction can actually make the condition worse. Liposuction is also unable to correct the lower abdominal “pooch” often caused by the weakened abdominal muscles.
Modern abdominoplasty techniques were developed in the 1960’s. The combination of significant truncal liposuction and classic abdominoplasty, however, is not recommended due to the increased risk of complications. Although the surgical principles of classic abdominoplasty have stood the test of time, the assumptions regarding the acquired deformity of the abdominal skin have proved to be inaccurate. The high lateral tension abdominoplasty is a relatively new technique based on the anatomy of the superficial fascial system.¹
The superficial fascial system is a strong protein layer located in the subcutaneous fat layer. There are anchor points within this layer, which have been identified in anatomical dissections that serve as the basis for the reconstruction. Reconstruction of this layer using permanent sutures and the anchor points account for the predictability and reliability of the high lateral tension abdominoplasty.
The effect of reconstructing the superficial fascial system goes beyond the abdomen itself – a “Chinese finger trap” type pulling extends into the thigh and pelvic areas. With a majority of the tension absorbed by this layer, there is less tension placed on the skin. This produces a thinner scar line and decreases the chance of wound healing complications.
In order to produce the desired contour, the abdominal muscles must be “tightened”. It is not unusual to find that the rectus abdominis muscles have migrated apart due to previous pregnancy or surgery, prior weight gain, or a congenital deformity. In the process of correcting the loose fascia, the muscles move back to a more suitable position near the midline. As a result, the abdominal wall is flat and prepared for the excess skin to be removed.
One of the distinguishing features of the high lateral tension abdominoplasty is the liberal use of adjunctive liposuction in the upper abdomen and the lateral and posterior trunk. This is a significant advantage over the classic abdominoplasty. The tightening effect observed in the upper abdomen is a direct result of the significant lateral truncal skin resection, and reconstruction i.e. the Chinese finger trap.
The umbilicus is repositioned on the abdominal skin and reoriented to a vertical direction. A youthful “hooding” of the top half is an important part of the rejuvenated appearance. The skin is smooth and adheres closely to natural contours of the abdominal musculature.
Each patient will have drainage tubes which exit in the suprapubic area. The drains remain in place for 7-10 days, then they are removed in the office. A compression garment is required in the postoperative period for 6 weeks. These garments are usually applied after the first week so the initial wound healing is not compromised.
One of the most important aspects of this procedure is the level of commitment required by the patient. This is a major surgery thus there are more significant potential complications. I emphasize the recovery aspect of this surgery because of the time required before returning to “normal” function. Because of the fascial tightening that is performed during surgery, it takes about two weeks before the patient is able to stand up straight. It is at least four weeks before one can expect energy levels to return to pre-surgery levels.
Despite the early postoperative discomfort, each patient is expected to be ambulatory (able to walk). It is important to have support assist you (physically and emotionally) and to have made arrangements to avoid any lifting, such as children. A walker or cane is suggested to assist ambulation around the house for the first 10-14 days.
You can expect that it will require at least 3 weeks before one can begin any type of extended walking. No driving is recommended for 2 weeks following abdominoplasty. After 6 weeks, you may return to a full exercise regimen. Although many patients will begin to see their results early in the postoperative period, it will be several months before any type of result assessment can be determined. Fluctuations in swelling, asymmetry in the abdomen, and occasional shooting pains are typical during the initial recovery.
Some of the potential complications of abdominoplasty include bleeding and infection (2-5%), seroma (a fluid collection under the skin), asymmetry, and wound healing complications. One of the more rare complications is deep venous thrombosis (DVT), or blood clots in the veins. This can lead to a more serious problem such as pulmonary embolus. The chance of DVT is minimized by using intermittent compression stockings in the operating room and either walking or elevating the legs in the immediate postoperative period.
The procedure may be performed as an outpatient, however I recommend an overnight stay at the facility where your surgery is performed. Pain control and anti-nausea medications may be administered using an IV. A hospital bed provides the proper positioning to minimize pain and decrease tension on the reconstruction.
The surgery is performed at a licensed facility. The anesthesia services are provided by board certified anesthesiologists.
Other types of Tummy Tucks
Other types of abdominoplasty include the “limited”, or “mini-abdominoplasty”, and endoscopic.
Mini Tummy Tuck
The mini-abdominoplasty is indicated for patients who have a limited deformity in the lower abdomen during this procedure and the excess skin is excised. Umbilical incision is usually not required. Despite the abdominal incision being several centimeters shorter than the full abdominoplasty, the recovery is similar to that previously described.
Endoscopic Tummy Tuck
The endoscopic technique is indicated for patients who have a “pooch”, or loss of lower abdominal musculofascial tone, but have retained their skin elasticity and do not require any skin excision. The fascia is tightened with a special suturing technique using an endoscope and two small (5cm) incisions. The skin will retract over the tightened foundation. Once again, the recovery will be similar to the full abdominoplasty which was previously described.Back To Top