Tummy Tuck, (abdominoplasty) is a procedure that addresses excessive and/or stretch mark blemished skin and fat from the abdominal wall, which can be the sequel of pregnancy, aging, or substantial weight loss. There are subtypes: a) Major, including neoumbilicoplasty (making a new opening for the belly button); b) Mini, in which the umbilicus remains unaltered and a smaller amount of skin above the pubic hair line is removed; c) Endoscopically assisted, is suitable for women whose abdominal skin is not excessive or stretch-marked but have laxity of the abdominal wall muscles. It is frequently combined with liposuction of the hips to improve the entire contour of belly and flanks. Adjacent areas, such as the groin and pubis are often addressed by reducing excess fat and skin.
The results of a Tummy Tuck are long lasting provided patients don’t experience weight fluctuations or have additional pregnancies. The longevity of great results is largely under the control of the patient, who should maintain a healthy lifestyle, including participating in a program of regular exercise and observing a balanced diet. Patient selection takes into account ongoing health conditions, attitude towards scars, and smoking status, which can cause delays in wound healing and sufficient support to ensure a problem free convalescence.
Abdominoplasty can be scheduled with Monitored Anesthesia Care (“twilight”). The average operating time ranges between 2-4 hours. Procedures which are frequently suggested include liposuction of the hips, waist, and upper abdomen. The objective is to sculpt the entire torso.
Fashion has influenced the position and length of scars. Since the introduction of “low riders”, incisions are usually made lower, just above the pubic hairline. The length of the scar is determined by the amount of skin excess and every attempt is made to conceal these in a patient’s preferred lingerie and/or bathing suits. After making the suprapubic incision, the abdominal (skin & fat) flap is elevated above the fascia (fibrous covering overlying the abdominal muscles) to the level of the umbilicus (belly button), which is dissected free to its origin on the abdominal wall. The abdominal flap is further elevated up to the rib cage, enabling the extent of abdominal wall weakness to be diagnosed. Repair of the splayed muscles is accomplished by suturing the fibrous tissue (fascia) overlying the separation (diastasis recti) using permanent sutures. The redundant abdominal skin and fat flap is trimmed. A new opening for the belly button is fashioned and the incision repaired, in multiple layers of absorbable sutures, over drains, which remain for 3-7 days. Abdominal binders or girdles are used to support the abdomen; patients usually transition to Spanx after the drains are removed. Often Neodyne Embrace Scar Therapy is recommended to improve the scar appearance.
Minimal activity and movement in the abdomen area is required for the first 2 weeks. During your regular follow-up appointments, Dr. Chong will provide guidance with additional post care instructions catered to your specific needs.
Dr. Chong is committed to providing optimal care that will help you look and feel your best. She will be happy to personally consult with you to discuss your goals and to help you determine a treatment plan that is the best for you.
Can I get pregnant after?
Absolutely. A full-term pregnancy is possible, but you may experience some relapse of your results, i.e. recurrent bulge & excess skin.
What happens to my belly button?
It is left attached to its original position if a mini tummy tuck (TT) is performed, but the position and appearance may be somewhat lower than desired. A new belly button is made by fabricating a new opening, in a standard TT, carefully planning the position, size & inverted appearance.
Will I still have stretch marks?
Perhaps. Depending on their location, stretch marks may be eliminated or relocated.
I have heard that it’s hard to have regular bowel movements afterwards. Will I damage anything if I have to push to eliminate?
Everything we do tends to provoke constipation: pain, drugs (antibiotics, pain meds), dehydration, being off your regular activity schedule, etc. In order to facilitate TT patients’ recovery, we routinely recommend eating lightly, (full liquids), 2days pre-op, clear liquids 1 day pre-op & laxatives both days. It’s not a formal bowel prep, but it does help to off-load the colon, which in turn has benefits: 1. Reduction of abdominal distention enables tighter repair for the separation of muscles; 2. Easier return of bowel function; and 3. Reduces the risk of pelvic vein compression (PE). Even if you have to “push” to get started, don’t worry about undoing your TT; the repair has multiple layers & will not unravel.
What is the difference between a mini and a standard tummy tuck?
Mini TT removes excess skin between the pubic hairline & belly button as well as tightens weak abdominal muscles. Standard TT enables repair of the abdominal muscle weakness from the breastbone to the pubis, more complete reshaping of the excess and/or stretch mark damaged skin, recreation of the belly button, and repair of any umbilical hernias at the expense of a slightly longer scar.
How long do I wear the garment for?
Abdominal binders are worn for 2 weeks or until the drains are removed. The compression garment assists in conforming the abdominal skin flap onto the repaired abdominal wall, which will remind the patient to observe activity restriction & will provide a surface to secure the drains. Some patients prefer to wear a Spanx type garment for up to a month afterwards.
When can I go swimming/tanning?
Sports & activities requiring core strength should be postponed for at least 6-8 weeks. Tanning can be resumed sooner, 4-6 weeks but remember that you may not have the protective sensation of your lower abdominal flap for several months and can get sunburnt!
Will my scars show when wearing a bikini?
Good pre-op planning and being close to your ideal BMI is helpful. Aesthetic surgery is influenced by fashion and as the emphasis has shifted to low riders, our challenge is to conceal scars
What is a seroma? Will I get one?
A seroma is a collection of blood tinged fluid which accumulates when a skin flap is raised off its usual position. Placement of drains, wearing an abdominal binder & limiting physical activity will usually prevent this complication. Massive weight loss patients are at higher risk for seroma, so “quilting” sutures are added. Treatment of a seroma requires frequent needle aspiration (removal), compression, limited activities & occasionally antibiotics.
How long do I need to take off work?
The appropriate recovery time depends on your duties (heavy lifting) and when you can resume driving. On average, 2 working weeks will suffice.