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Abdominoplasty
Scenario of Your Abdominoplasty
Abdominoplasty - What happens during your Tummy Tuck?
Mini Abdominoplasty - Mini Tummy Tuck
Before and After Photos
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It is often that patients will seek consultation in my practice for liposuction. In point of fact, it is the most common consultation of our entire patient population and that is true of any cosmetic surgeon who offers full service to his patients. Yet . . . in some of those patients seeking information . . . liposuction is not the answer! Let me explain.

There are patients who are hoping that the liposuction procedure will eliminate, remove or reduce the residual stretch marks of pregnancy . . . it will not! There are patients who hope that liposuction will eliminate, remove or minimize the wrinkling of the lower abdominal skin . . . it will not. There are patients who are hoping that liposuction will improve the redundant or hanging skin of the lower abdomen . . . it will not. So too. . . if you have large abdominal folds, if you have wrinkling around the umbilicus (belly button) or if you have a roundness or convexity of the front abdominal wall due to looseness or laxity of the abdominal muscles. . . liposuction alone. . . is not the solution.

Should any of these above problems be related to you, there here is where we would suggest an abdominoplasty. . . commonly known as a tummy tuck . . . or any of its variations.

Scenario of Your Abdominoplasty
At this point, I would like to elaborate and to portray the scenario, which is usually involved for the patient about to undergo the abdominoplasty surgery. Please keep in mind that this is a general description, which applies to most cases, but there may be variations in some patients.

The operation can be performed in a hospital, in an ambulatory surgery center, or in the case of my practice, I perform almost all procedures in my own surgical centers.

I am fully and totally aware that it is somewhat difficult to ready oneself for an operation that is of a purely elective nature. This can certainly provide anxiety and nervousness, which is understandable and normal. However, you should know that abdominoplasty is not an uncommon procedure in the field of cosmetic surgery; in fact, it is a procedure that is often performed and especially so in my practice. A few days prior to your surgery, I may ask you to undergo a routine physical and history examination as well as some laboratory studies, where your good health and readiness for abdominoplasty will be ascertained. Furthermore, if you are under the care of a physician for any reason, I will contact him so that he may issue you clearance for surgery.

Also, I will arrange for you to be photographed here in our offices and please know that although this is a very private matter, it is very essential and vital information for me. It is as necessary as a chest X-ray would be to an internist or an electrocardiogram to a cardiologist.

On the day of your operation, you will report to my office approximately one hour prior to surgery. My staff will receive and greet you and answer all of your questions. I will then personally escort you to the operating room suite where the anesthesiologist will begin the anesthesia. He will do so by inserting a small I.V. and thus produce a “twilight” state of anesthesia where you will not see, hear, feel, or remember anything! Yet, at the conclusion of the procedure, you will be readily awakened without any hangover sensation. Please understand that this is not general anesthesia where noxious gases are used, or intubation (tubes inserted into the throat). It is a pleasant and highly comfortable form of sedation used for all of my patients. I promise you that the operation will be completely painless.

The duration of your operation will be between 1 ½ to 3 hours, depending upon the problems that you present with at your initial consultation. Yet, no matter how long the operation will endure . . . under anesthesia it will appear to be only a few minutes. Remember, with rare exceptions for which you will be notified, I and I alone will operation on you. The extent of the incisions and the process and procedure of the operation will be explained to you later in this text.

At the conclusion of the operation, you will notice bandages around the abdomen and two drains exiting from the lower part of those bandages. You will then be escorted to the recovery area where you will spend approximately 1 to 2 hours. You will become fully awake and alert, be able to ambulate by yourself and at that time you will be discharged to the person escorting you home. When you arrive home, will you have a great deal of pain? Certainly not. Will there be some soreness? Of course there will. Will you be able to sleep restfully that evening? Certainly.

The next day, you will return to my office where I will remove and change the bandages and possible remove one or both drains. There will be no discomfort in any of this . . . only some soreness for the next day or two which will be well controlled by medication. I will follow you closely through the next 7 days, either by visits to our offices or by phone. My staff will also make sure that you are in constant touch with us.

At to returning to work, as to getting back to your normal routine . . . give yourself at lease one week. In point of fact, 10 days would be even better. I don’t feel it is professionally prudent to try to foreshorten this recovery period . . . it is your time . . . it is your health . . . we want this recovery period to be the time for you!!

While we perform a tummy tuck, we create a huge surgical skin flap. It is a possibility. . . although remote. . . that there could be a partial loss of skin. This could possibly occur near the incision site. Although I’ve never had a serious skin loss, it could possibly happen. Is it anticipated? Absolutely not! As mentioned above. . . I never had a transfer to a hospital. . . and therefore, phenomenon such as emboli and blood clots are very, very rare complications.

Please feel free to discuss further and at length every one of these complications or any one of your concerns. That is the reason I am here. . . not to frighten you. . . but to advise and comfort you. I am here to advise and comfort you . . . not just on your first visit . . . or your last visit before surgery . . . but in every visit and as many visits you may need.

Lastly, as I tell every single patient in my practice . . . scheduling an operation is a very important aspect. Yet . . . despite all precautions . . . if on the day of your surgery, you have a cold . . the operation is cancelled. If you are feeling ill and we examine you and feel we should not go forward . . . the operation is postponed. In other words, we don’t take chances with your health.

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Abdominoplasty - What happens during your Tummy Tuck?
On the previous page you saw a graphic representation of the midsection of the body. In this case the female torso, but the same would apply for a male as well.

Please take note of the dotted horizontal incision in the lower part of the abdomen and just above the pubis. This is the standard incision required for a typical abdominoplasty, and please know that although it’s a nicely concealed incision, covered by undergarments or a bikini bottom, this is the extent of the incision in almost all cases. In some patients who are requiring only a mini tummy tuck, the extent of the incision may not be as wide.

In the center of the illustration, you will notice the umbilicus . . . commonly known as the belly button. In the standard tummy tuck all of the skin from the belly button. In the standard tummy tuck all of the skin from the belly button down to the pubic will be removed and so too will the stretch marks and wrinkling that go along with it. The skin just superior to the belly button will be brought down to the pubis bone. All of the stretch marks, all of the sagging skin, all of the wrinkling skin from the belly button down. . . that bothers so many patients. . . will be removed and the skin above the belly button will be brought down to the pubis. So too, if you have a midline vertical scar from a C-Section or from a previous abdominal surgery . . . that too will be gone. This produces a great deal of satisfaction to our patients!

Yet, more importantly, underneath that skin, running from the rib cage down to the pubic bone, are a pair of ongitudinal muscles . . . known as the rectus abdominous muscles. . . and it is here where a great deal of work is done. How’s that? Well, let me tell you! When you are pregnant, and your abdomen expands, it is those muscles that are stretched; when you have weight gain in the abdomen, it is those muscles that are stretched and weakened and resultant to that they go from the normal flatness and tightness of youth, to the looseness and roundness of post pregnant females or obese makes. It is that roundness or convexity that is very bothersome to patients! Well, during your tummy tuck operation, I will tighten these muscles by suture technique and thereby greatly improving the abdominal contour. This is one of the least understood and certainly amongst the least appreciated phenomenon in all of tummy tuck surgery . . . the tightening of the rectus abdominous muscle.

An incision will be made around the belly button and as the skin below it is removed and the skin above it is brought down to the pubis, the belly button will remain in the same position. Only post operatively it will be present on a much flatter abdomen. Also . . . and as a byproduct of this abdominal muscle tightening, there is a narrowing or cinching of the waist. The patients also find this a very pleasing result of their tummy tuck operation.

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Mini Abdominoplasty - Mini Tummy Tuck
There are some patients who have problems with their abdomen which are not solved by liposuction but yet do not require a full abdominoplasty. Here is where we employ the mini tummy tuck.

Patients in this category often do not have extensive stretch marks or extensive midline abdominal incisions but only a rather moderate amount of hanging skin and a looseness of the abdominal muscle only in the lower half of the abdomen producing a roundness or bulginess that is disturbing to them. It is here that we perform a mini abdominoplasty.

The scenario is essentially the same in our surgical center with the exception that the operative may be abbreviated somewhat, the incision is somewhat smaller in extent and the recovery period is also somewhat foreshortened. I think the main difference from a major abdominoplasty is that here there are no incisions around the belly button and only part of the lower abdominal skin is removed and only the muscles of the lower abdomen are tightened.

Lastly, I can get you back to work and in your normal routine a few days earlier with this procedure that with a major abdominoplasty.

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