Tummy tuck (technically abdominoplasty) is an operation that can correct the saggy tummy. But it must be kept in mind that the operation should be customized to the patient. With a “full tummy tuck”, there is laxity or looseness of the muscle or fascia, these are tightened with stitches, and the skin from the belly button to the pubic area is removed. With a “mini tummy tuck” just a piece of skin from right over the pubic area is removed. In between these is an operation that can be designed to meet the patient’s specific needs. If the saggy skin is wide and reaching the stomach area, the more skin needs to be removed,side-to-side direction the scar has to go.
Main aim with this operation is about tightening the skin, and not fat. Patients who are overweight will still be overweight after the surgery. Just only fat underneath the excess skin will be removed. Thats better to loose weight before a tummy tuck operation.
Good candidates for tummy tuck are healthy, emotionally-stable men or women who are in relatively good shape but are bothered by loose abdominal skin that won’t respond to diet or exercise and large fat deposit, and who are realistic about what the surgery can accomplish. The surgery is particularly helpful to women who had multiple pregnancies, have stretched their abdominal muscles and skin beyond the point where they can return to normal.Men and women loosing bir amount of weight ending with a saggy skin will also benefit from this surgery.
Patients who plan to lose weight or plan future pregnancies should postpone this operation. Patients who have much sagging skin may have just skin removal like a "honey moon" operation without a muscle tightening before a further pregnancy.
Consultation for the tummy tuck surgery is important to discuss the reason, expectations, desired outcome, medical conditions, drug allergies, previous medical treatments, current medications, vitamins, herbal supplements, alcohol, smoking, drug use, previous surgeries and family cancer story. You will be asked about your general health status and any pre-existing health conditions or risk factors. Your surgeon will examine your body and abdomen in detail, skin quality, and placement of your anatomical structures. Your photos will be taken. At the end your aesthetic surgeon will discuss your surgery options and other additional procedures like a liposuction which may help to improve the overall result and risks or potential complications. Make sure you understand the scarring that will result. He or she should also explain the anesthesia to be used, the type of facility where the surgery will be performed, and the costs involved.
You’ll also get specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. Getting prepared for the operation: blood tests must be done, medications for chronic problems you’re on should be estimated with your surgeon and your doctor dealing with, smoking must be stopped, aspirin, vitamin E, gingko and ginseng containing stuff and certain anti-inflammatory drugs that can increase bleeding should be avoided.
Tummy tuck surgery risks include: anesthesia risks, bleeding, fluid collection seroma, infection, poor wound healing and skin loss, opening of the wounds and delayed healing, unfavorable scarring, prolonged swelling, skin irregularities and discoloration, unsatisfactory results may include: asymmetry, unsatisfactory surgical scar location and unacceptable visible deformities at the incisions. Tummy tuck does leave noticeable, permanent scars, although they’ll be covered by your underwear or bathing suit. (Poor healing and wider scars are more common in smokers.) The procedure can also leave you with unevenly positioned, or a permanent loss of feeling around the scars. (It may be necessary to perform an additional surgery to improve your results)
These risks and others will be fully discussed prior to your consent. It is important that you address all your questions directly with your cosmetic surgeon.
Tummy tuck is preferred to be performed under epidural-spinal anesthesia with sedation or general anesthesia. It may take 2-3 hours according to the possible additional procedures. Incision and techniques may change due to the patient’s appearance, patient's expectations and surgeon's judgment. Techniques vary, but the most common procedure involves an incision from hipbone to hipbone. A second incision will be done around the belly button to release from the tummy skin. Skin will be gently lifted from underlying abdominal wall muscles all the way up to your ribs, excess skin will be removed. These muscles are tightened by pulling them close together and stitching them into their new position. This provides a firmer abdominal wall and narrows the waistline. The skin flap is then stretched down and the extra skin is removed. A new hole is cut for your navel, which is then stitched in place. Finally, the incisions will be stitched, dressings will be applied, and a temporary tube may be inserted to drain excess fluid from the surgical site.
In mini tummy tuck, the skin is separated only between the incision line and the belly button. This skin flap is stretched down, the excess is removed, and the flap is stitched back into place.
After the tummy tuck operation, for the first few days, tummy will probably be swollen and patients likely to feel some pain and discomfort which can be controlled by medication.The pain and recovery time is related to the stitches in the muscle and the goal of making the belly as tight as is safe. If you have a job that requires lifting, you may be off work 2-3 weeks. Depending on the extent of the surgery, patient may be released within a few hours or generally have to stay at the hospital for the first night. As the patient may not be able to stand straight at first, should start walking as soon as possible. After the control and dressings change, instructions will be given. Medications will be prescribed and follow up checks will be planned. Generally 6-7 days after patients may have a whole body shower. Bruises fade away in 7-15 days and swellings diminish in the following weeks.
Surface stitches will be removed in seven days, and deeper sutures under the skin, will be absorbed in the following months. The support garment will be used for 3 weeks at least. Healing is a gradual process. Although you may be up and about in a day or two, don’t plan on returning to work for a week or more, depending on how you feel. And avoid lifting anything over your head for three to four weeks. If you have any unusual symptoms, don’t hesitate to call your surgeon.
You will be given detailed instructions for resuming your normal activities. You may be instructed to avoid strenuous sports for about six weeks. After that, you can resume these activities slowly. Your surgeon will make every effort to make your scars as inconspicuous as possible. Still, it’s important to remember that scars are extensive and permanent. They often remain lumpy and red for months, then gradually become less obvious, sometimes eventually fading to thin white lines. Fortunately, the scars can usually be hidden in the underwear.
