Abdominoplasty, often called a "tummy tuck," is a popular procedure used to flatten and shape the abdomen by removing excess fat and skin and tightening muscles. Our doctors have been performing tummy tucks with excellent cosmetic results for many years. Patients love the look of their new flat stomachs after surgery under our doctors’ exceptional care.
Who is a good candidate for a tummy tuck?
The best candidates for a tummy tuck are in good physical condition with pockets of fat or loose skin that haven’t responded well to traditional diet and exercise. This procedure can also benefit older, slightly obese people whose skin has lost some of its elasticity.
Tummy tucks can also be useful for women with stretched skin and muscles from pregnancy. Results from the tummy tuck procedure will likely diminish if women continue to bear children, so we advise patients who plan to become pregnant to consider postponing this procedure until they are done having children.
We also encourage patients who intend to lose a lot of weight to wait before undergoing the procedure, since skin in the abdominal area typically loosens after substantial weight loss.
Customized Treatment for Optimal Cosmetic Results
We take the time during every pre-operative consultation to learn what patients want to achieve from a tummy tuck both for their bodies and for their self-confidence. By listening to what patients have to say and closely examining them rather than performing a one-size-fits-all procedure on every person, we provide patients with a completely customized treatment that takes into account their specific goals.
The Tummy Tuck Procedure
Tummy tucks take approximately two to five hours and are performed under general anesthesia. This procedure may be performed on an in-patient or outpatient basis, depending on the complexity of your surgery and Dr. Morrissey’s recommendation.
Your Dr.Morrissey will make two incisions: one from hipbone to hipbone close to the pubic area, and another around the navel. He will separate the skin from the abdominal muscles, which are then pulled together and stitched into place for a firmer abdomen and narrower waist. The skin flap is then stretched down and over the newly tightened muscles, excess skin is removed, and the navel is reattached in a natural position. Finally, Dr. Morrissey will close the incisions and apply sterile surgical dressings over the sutured areas.
After surgery, compression garments are worn and a temporary tube may be inserted under the skin to drain excess fluid from the surgical site. Recovery time ranges from two weeks to a few months. You should limit strenuous activities for at least six weeks, and may need to take off from work for up to a month. Your doctor will give you specific instructions for your individual recovery. Following these instructions can help speed up your recovery and reduce the risk of any post-surgery complications.
Tummy Tuck Results
A tummy tuck leaves patients with a flatter, more toned abdominal area that fits the natural contours of your body. It can improve a patient’s appearance and confidence by helping them look and feel younger and slimmer. The results of this procedure are visible right away and will continue to improve. With a balanced diet and regular exercise, results are long-lasting. Scars will fade with time, leaving your stomach sleeker and more defined than ever before.
A tummy tuck will leave a scar spanning the lower abdomen from hip to hip. We are very careful to make the incision low enough for even a bikini to conceal the scar.
Risks of a Tummy Tuck
Though rare, post-operative complications from any surgical procedure are possible. They may include infection, blood clots, and poor healing, which may require further surgery.
Patients who have had previous abdominal surgery should know that their old scars could be raised, stretched or generally more noticeable after the tummy tuck procedure. A scar revision procedure after a tummy tuck can help minimize the appearance of unsightly scars.
Partial Abdominoplasty (Mini Tummy Tuck)
Partial abdominoplasty, or "mini tummy tuck", is similar to the regular tummy tuck procedure, except it involves a shorter incision and the skin is only lifted to the navel, which does not have to be moved. This procedure is ideal for patients who need just a little improvement in order to reach their desired results. You can discuss the differences between these procedures, as well as weigh their benefits and risks with Dr.Morrissey in order to decide which procedure is best for you.
Abdominoplasty (Tummy Tuck) After-Care
You have had your tummy tuck surgery and have been discharged to home. Now what do you do??
It’s the day after your surgery and you’ve been discharged from the hospital. You are wrapped up very snugly in a compression garment and an abdominal binder. A second compression garment (girdle sounds so old fashion) was provided for you. The garment is designed to be worn 24 hours a day. They are designed such that you don’t even have to remove them to use the bathroom!
You are likely to have two drains connected to a bulb. You were instructed as to how to measure, empty and keep track of the drainage output by the nurses in the hospital. See Drain Care Instructions for a refresher. A safety pin is best for pinning the drain to the abdominal binder so that it does not hang and pull, which can be uncomfortable.
On post operative day number 2, that is, the day after you go home, you may take a shower.
Remove the abdominal binder, the compression garment and the dressings. The steri-strips will remain attached along the lower abdominal incision. To keep the drains from pulling, use an old bath robe belt or neck tie and lay it behind your neck. Safety pin each drain to an end. This will keep the drains from pulling and free your hands to wash your hair. Use a non scented soap such as Dial or Ivory which does not have alcohol in it, which could sting.
After your shower, pat dry and replace a clean compression garment. The soiled one can be machine washed and allowed to drip dry. The lower incision/steri strips do not need a new dressing. The belly button may be dressed with some antibiotic ointment around the suture line and a light gauze dressing. Do this for the belly button daily for three days and then just a clean dry dressing can be placed.
At your first post operative office appointment, usually 7-10 days after surgery, the drains will be removed, provided that they are draining less than 20 cc/day.
Contact us today to schedule a tummy tuck consultation and find out if you can benefit from this effective procedure.
TUMMY TUCK /ABDOMINOPLASTY FAQ
When can I shower after my tummy tuck?
- It is safe to shower after a tummy tuck on post-operative day number 3. By this time the incision is water proof. It is important to remove the compression garment and the gauze dressings before getting in the shower. To keep the drains from dangling and pulling, an old neck tie or a bathrobe belt can be laid behind your neck and the drain bulbs can be safety pinned to the ends. This will free your hands and allow you to wash your hair. After the shower, pat dry and replace a clean compression garment and the abdominal binder over it.
How long will my drains be in place?
- Drains are usually kept in place for 5-7 days. Record the drainage on the provided record sheet twice daily at 12 hour intervals. This will chronicle the decreasing drainage so that the drains can safely be removed when there is less than 20-25 cc of drainage in a 24 hour period.
When can I stand up straight?
- The tendency after a tummy tuck is to stand and walk hunched over a bit with your hands holding your tummy for the first few days after a tummy tuck. This is a natural tendency. Truth be told, you will not cause any damage or more pain if you stand up straight after your tummy tuck. Over the first several days, you will feel more comfortable and will be able to stand up straight without discomfort.
How long do I need to wear the compression garment and abdominal binder?
- The compression garment (think of medical grade Spanx) is to be worn continuously, except when in the shower, for 3-4 weeks. After your first office visit at one week, a determination will be made regarding the abdominal binder. The compression garment should feel snug, but not overly tight. If it feels too tight and is uncomfortable please let me know.
When can I drive?
- You may drive when you know longer require pain medication that can make you sleepy, like Tylenol with codeine, Ultram or hydrocodone. When you can comfortably transition to Tylenol or Motrin and are comfortable, you may drive. This is typically at the 7-10 post operative day.
How do I avoid constipation?
- Pain medications can slow the digestive tract and lead to constipation. It is important to drink lots of water. A gentle laxative such as Milk of Magnesia or Dulcolax stool softener can also be helpful. Stool softeners work by drawing more water into the colon (the last part of the digestive tract) to make having a bowel movement easier.
What is a diastasis of the rectus?
- Diastasis of the rectus is the medical term that describes the separation between the rectus abdominus muscles (sit-up muscles) that typically occurs in women after pregnancy. In the later stages of pregnancy, the sit-up muscles can splay apart to accommodate the growing baby. This can cause some weakness in the abdominal wall and can cause the lower abdominal (pooch) that many women note after pregnancy. As part of the tummy tuck procedure, the muscles are brought back together in the midline with permanent suture to enhance core tone and “tighten” the abdomen. Some refer to this as muscle repair, which is a bit of a misnomer. A diastasis is NOT a hernia. A hernia is when there is a hole in the abdominal wall through which a loop of intestine can protrude through. Occasionally, an unexpected hernia is encountered during a tummy tuck. Plastic surgeons are well equipped to deal with this and it can be repaired directly during the tummy tuck procedure.
How bad does a tummy tuck hurt?
- Everyone perceives pain differently. So a frame of reference is usually helpful. In my experience, almost all women who have had a c-section and then a tummy tuck have reported that a c-section was more painful and more difficult to recover from. This is probably because there was a baby to take care of as well!!
What if I get pregnant after a tummy tuck?
- Most plastic surgeons always ask if you are finished having children before having a tummy tuck. This, because, as it is a considerable expense, you want to do it just once. I have had two patients who became pregnant after a tummy tuck. Both had uneventful pregnancies and delivered healthy normal weighing babies. They did note, however, that they did not “show” as much. This is likely because of the muscle plication part of the tummy tuck.
Can liposuction be combined with tummy tuck?
- Liposuction of the upper abdomen and flanks is typically part of the abdominoplasty procedure in contouring the entire trunk. Liposuction of other areas, thighs, upper arms, chin can also be performed under the same anesthesia.
Is it necessary to have a general anesthesia for a tummy tuck?
- For safety reasons, I perform all tummy tucks under a general anesthesia in a hospital or certified surgery center. The amount of local anesthesia that would be necessary to comfortably perform a tummy tuck while awake could lead to toxicity. Also, muscle relaxation is required for proper tightening of the rectus muscles, which cannot be performed while awake.
What is a mini tummy tuck? Is it right for me?
- A mini tummy tuck addresses loose abdominal skin that is limited to the area below the belly button. This can typically be addressed with a slightly smaller incision in the lower abdomen and can avoid an incision or scarring around the belly button. IF the belly button is high on the abdomen, it can be disconnected from its stalk and “floated” or pulled downward 2-3 cm or so. Plication of the rectus muscles is still possible with this approach to help improve core tone. Very few women are appropriate candidates for this procedure.
Will my insurance cover a tummy tuck?
- The short answer is no. A tummy tuck is considered cosmetic surgery (because you want it) and not medically necessary and thus is excluded by medical insurance policies.
What is the difference between a tummy tuck and a panniculectomy?
- A panniculectomy is a procedure that is considered medically necessary in people who have loose overhanging skin of their abdomen that is prone to fungal infection, skin breakdown from skin on skin contact and interferes with personal hygiene. This can be due to obesity or following bariatric surgery. This operation is limited to removal of the wedge of loose overhanging skin. It does not address the underlying musculature and the belly button may or may not be able to be preserved. Insurance may cover this if there is adequate documentation of the problems with fungal infection and skin irritation and hygiene problems from one’s primary care physician.
Can a tummy tuck be done at the same time as a hysterectomy?
- These cases are evaluated on a case by case basis. In an otherwise healthy individual, a tummy tuck can be performed at the same time as a hysterectomy. There are a number of different approaches for a hysterectomy, so, coordination with your gynecologist is essential. There is a slightly increased risk of wound healing problems and blood clot formation (deep vein thrombosis) when these are combined and for this reason, it is essential to do a combined surgery such as this in a hospital setting for safety reasons. A hospital stay of several days is typical and preventative measures against blood clot formation are essential. In some circumstances it may be recommended to delay the tummy tuck for several months following a hysterectomy.
What is a seroma?
- A seroma is a collection of fluid (serum) as opposed to blood (hematoma) between the abdominal wall and the skin flap that can occur following a tummy tuck. This is not common but not unusual after a tummy tuck. Drains can be used to help prevent the occurrence of seroma, but they can occur whether drains are used or not. Seromas are treated by needle drainage or placement of a catheter attached to a drain until the fluid stops accumulating. Occasionally a medicine may need to be injected into the seroma cavity to cause irritation of the cavity and obliterate the space that was collecting fluid. Seroma is usually a late complication that occurs beyond two weeks postoperatively.