| Dr. Susan E. Otero is a plastic surgeon certified by the American Board of Plastic Surgery. Here the Doctor has answered some of the common questions bizymoms visitors have about Tummy Tuck.
Q. What is a Tummy Tuck?
A. Abdominoplasty is another name for tummy tuck. The purpose of the procedure is to remove the excess abdominal tissue and to tighten the abdominal muscles.
Q. What are the benefits of a tummy tuck?
A. The benefits are basically cosmetic in that the patient looks and feels better. Some people may have persistent rashes under the hanging skin, and that is usually improved as well. In most people, especially after having children, the abdominal muscles separate, and may cause some abdominal weakness. This is called a diastasis recti. It is not a true hernia. Tightening them up may help this weakness.
Q. How is a tummy tuck performed?
A. An incision is made in the lower abdomen, usually from one hip bone to the other. The tissue is dissected off the abdominal wall to the rib cage, and then the excess tissue is excised.
Q. How long does tummy tuck surgery take?
A. The surgery usually takes between two and three hours depending on how big the patient is, and how much extra tissue there is. I generally have my patients spend the night, and go home the next morning.
Q. Are there risks and complications to a tummy tuck?
A. There certainly are some possible complications from this procedure. The first possible complication would be to stop bleeding. Most people place drains at the time of surgery, and so the excess fluid may drain through them. If the patient gets a large collection of blood, called a hematoma, they would have to go back to the OR to have it drained. The next possible complication would be infection. Any time one has surgery, there is a possibly of infection. Patients are treated with antibiotics at the time of surgery. Most patients will get some redness and drainage that can be treated locally. If it is a severe infection, the patient may have to go back to the OR to have it drained. If the skin is pulled too tight when closing, some of the skin may die, and you could end up with separation of the skin edges or even a large open wound. This would have to be treated either with dressing changes until the wound closes, or with surgery to close it. .Obviously, you can’t cut the skin without having a scar. Most people heal well with minimal scarring, but sometimes the scar may be wide and raised. Because the skin is cut off the underlying abdominal wall, most people will have some degree of numbness on the abdominal wall, mostly below the belly button. If a woman has an abdominoplasty, and if they should ever get breast cancer, they would not have that tissue to make a new breast. There are other ways to reconstruct the breast with implants, but they give up having a muscle flap from the abdomen for reconstruction. Sometimes, after the drains are removed, the patient may collect serous (clear) fluid under the skin. Generally, the fluid will go away with time, or can be aspirated in the office. If the seroma persists, then the patient may have to go back to the OR for debridement and closure, and placement of a drain. Finally, this procedure is only as good as the day it is done. I try to get my patients to get to their ideal weight before surgery. If they gain or lose weight (more than five to ten pounds), it will change the result.
Q. Will Smoking slow down the Healing Process?
A. Smoking also constricts the blood supply to the skin, and can increase the risk of the skin dying. Most surgeons will not do an abdominoplasty on a patient until they have stopped smoking for at least six weeks.
Q. What are the different types of tummy tuck procedures?
A. An abdominoplasty is a fairly standard procedure. Some surgeons may alter the placement of incisions. Others will do liposuction on the hips and flanks. For patients who have had massive weight loss, sometimes the incision will go vertically in the mid abdomen as well. If the patient just has excess skin and tissue below the belly button, they may undergo a mini-abdominoplasty. In that case, the dissection does not go above the belly button, and the muscle may or may not be tightened. Mostly, it’s just the excess skin and subcutaneous that are removed.
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