Abdominoplasty

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A flat and well-toned abdomen is a common goal many strive for through diet and exercise. But sometimes these efforts are not enough to correct excess skin and fat from pregnancies, weight fluctuations, or heredity. Abdominoplasty, known as a "tummy tuck," is a major surgical procedure to remove excess skin and fat from the middle and lower abdomen and to tighten the muscles of the abdominal wall. The procedure can dramatically reduce the appearance of a protruding abdomen. But bear in mind, it does produce a permanent scar, which can extend from hip to hip.

If you're considering abdominoplasty, this will give you a basic understanding of the procedure-when it can help, how it's performed, and what results you can expect. Abdominoplasty produces excellent results for patients with weakened abdominal muscles or excess skin. In most cases, the results are long lasting, if you follow a balanced diet and exercise regularly.

If you're realistic in your expectations and prepared for the consequences of a permanent scar and a lengthy recovery period, abdominoplasty may be just the answer for you

THE BEST CANDIDATES FOR ABDOMINOPLASTY

The best candidates for abdominoplasty are men or women who are in relatively good shape but are bothered by a large fat deposit or loose abdominal skin that won't respond to diet or exercise. The surgery is particularly helpful to women who, due to multiple pregnancies, have stretched their abdominal muscles and skin beyond the point where they can return to normal.

Abdominoplasty can enhance your appearance and your self-confidence, but it won't necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with Dr. Holland.

Patients who intend to lose a lot of weight should postpone the surgery. Also, women who plan future pregnancies should wait, as vertical muscles in the abdomen that are tightened during surgery can separate again during pregnancy. If you have scarring from previous abdominal surgery, Dr. Holland may recommend against abdominoplasty or may caution you that scars could be unusually prominent.

THE SURGERY

Most commonly, Dr. Holland makes a long incision from hipbone to hipbone, just above the pubic area. A second incision is made to free the navel from surrounding tissue. Next, the skin from the abdominal wall is separated all the way up to your ribs and a large skin flap is lifted to reveal the vertical muscles in your abdomen. 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. Liposuction may be used to complement the new waistline. Finally, the incisions are stitched, dressings applied, and temporary tubes are inserted to drain excess fluid from the surgical site. Abdominoplasty usually takes two to four hours, depending on the extent of work required.

GETTING BACK TO NORMAL

It may take you weeks or months to feel like your old self again. For the first few days, your abdomen will probably be swollen and you're likely to feel some pain and discomfort, which can be controlled by medication.  If you start out in top physical condition with strong abdominal muscles, recovery from abdominoplasty will be much faster. Some people return to work after two weeks, while others take three or four weeks to rest and recuperate.

Your scars may actually appear to worsen during the first three to six months as they heal, but this is normal. Expect it to take nine months to a year before your scars flatten out and lighten in color. While they'll never disappear completely, abdominal scars should not show under most clothing, even under bathing suits.

ALL SURGERY CARRIES SOME UNCERTAINTY AND RISK

There are always risks associated with surgery and specific complications associated with this procedure. Post-operative complications such as infection and blood clots are rare, but can occur. You can minimize the risk of blood clots by moving around as soon after the surgery as possible.

Poor healing, which results in conspicuous scars, may necessitate a second operation. Smokers should be advised to stop, as smoking may increase the risk of complications and delay healing.