Tummy Tuck

What is a tummy tuck?

A tummy tuck is an operation that:

• Removes excess fat and loose skin from the belly (abdomen).
• Creates a flatter, firmer tummy and smaller waist.
• Tightens the stomach muscles.

The medical term for tummy tuck is abdominoplasty. It is a type of cosmetic surgery.

When is it done?

A number of things can make your tummy flabby:

• Weight loss, or weight gain and a loss of muscle tone from not getting enough exercise, can cause a flabby tummy. After several pregnancies, a woman's muscles and skin can become stretched past the point where they can return to their previous shape.
• As you get older, your skin loses its elasticity and your stomach may look flabby and fat.

Diet and exercise can help, but you may want to consider a tummy tuck to get the look you want. Men or women who are in good shape but bothered by loose skin or abdominal fat are the best candidates for a tummy tuck.

Liposuction is another procedure for removing fat. A tummy tuck tightens the abdominal muscles in addition to removing fat and skin.

Before you get a tummy tuck:

• Find out the risks and benefits.
• Get as much information as you can about the procedure.
• Find out the results you can expect.
• Check the credentials of your surgeon. Always select a board-certified plastic surgeon with experience.
• Call your health plan to find out if the procedure is covered. (Health insurance does not usually cover cosmetic surgery.)

How do I prepare for this procedure?

When you first meet with the surgeon, he or she will:

• Check your overall health.
• Look at where fat is stored on your belly.
• Look at your skin tone.
• Talk about where the surgery will be done.
• Talk about what type of anesthesia will be used.

You need to tell the surgeon:

• the medicines you are taking, including any vitamins or other nonprescription drugs or natural remedies you may be using
• if you smoke
• any surgeries you have had in the past.

Before the surgery:

• Quit smoking at least 2 weeks before the surgery if you are a smoker.
• Do not spend a lot of time in the sun. This can change the skin color of your abdomen.
• Your surgeon may have you stop taking certain vitamins or medicines.
• Your surgeon may give you special instructions that you must follow.
• Find someone to drive you home after the surgery.

What happens during the procedure?

The surgery can be done in an outpatient surgical center, your healthcare provider's office (if it is equipped for surgery and all emergencies which may arise), or a hospital. If it is done in a hospital, your provider may want you to stay there for several days.

You will probably be given a general anesthetic. A general anesthetic relaxes your muscles and causes a deep sleep. It will prevent you from feeling pain during the procedure. In some cases you may be given a local anesthetic instead of a general anesthetic. A local anesthetic numbs just the area of the surgery. With the local, you will be given another medicine (a sedative) to make you sleepy.

A complete tummy tuck usually takes 2 to 5 hours. Here are the basic steps:

• A long cut (incision) is made from hipbone to hipbone, just above the pubic area. Another cut is made around the belly button to free it from surrounding skin.
• The large skin flap created with the cuts is separated from the abdominal wall and lifted all the way up to the ribs to reveal the muscles.
• Some fat may be removed, and the muscles are pulled close and sewn together to tighten and narrow the waistline. The skin flap is then stretched down and excess skin is trimmed away.
• After the extra skin has been removed a new hole is cut for your belly button and skin is stitched into place.
• The cuts are closed with stitches and an elastic bandage is put in place.

If most of the flabby skin is below the belly button, a partial tummy tuck is sometimes done. For this surgery, the skin is tightened from the pubic area to the navel and the procedure takes only an hour or two.

What happens after the procedure?

Depending on the extent of the surgery, you may stay in the hospital for a few hours or up to several days.

Outer stitches are usually removed in 5 to 7 days. Light activity is encouraged, but you should avoid vigorous exercise until your surgeon tells you it is OK. You may need to wear support garments for several months.

There is usually not a lot of scarring. Within 9 months, the scars flatten and lighten in color.

If you follow a healthy diet and get regular exercise, your tummy may stay flatter and firmer for a long time.

What are the benefits of this procedure?

The benefits of this procedure are cosmetic. They include:

• a flatter stomach
• a smaller waist
• firmer abdominal muscles
• less abdominal fat.

You may feel better about yourself and how you look.

What are the risks of this procedure?

The main risks and complications are:

• infection of the wound
• blood clots (in veins or in the lung)
• nerve damage
• breakdown of the skin around the surgical site (necrosis)
• blood or fluid collection around the surgical site (hematoma or seroma).

When should I call my healthcare provider?

Call your provider right away if:

• You have chest pain.
• You have trouble breathing.
• You have fever or chills.
• You suspect infection because the wound is red, tender, or draining pus.
• You have pain that is getting worse.

Call during office hours if:

• Your pain medicine is not working well.
• You have numbness or tingling around the surgical site.
• You have other questions about the surgery.