TUMMY TUCK / ABDOMINOPLASTY
Perhaps no other surgical procedure in plastic surgery provides as much satisfaction to the patients as tummy tuck.
What is it?
Tummy tuck is also referred to as Abdominoplasty. It means reshaping the abdomen or the belly region along with flanks to get rid of loose flaps and restore the waist line. At the same time, the abdominal wall muscles are tightened to restore the lost tone. If a patient has excessive fat deposits on the abdomen, then it can be removed by liposuction done at the same time. But, cosmetic surgery cannot help everyone with bulging abdomen especially those with relatively thin, snug skin but large abdominal contents. This procedure is done when the tummy gets loose, flabby or pendulous following child birth or weight reduction. Such conditions result in flaps of skin hanging below the navel or umbilicus. Extra fat around belly and flanks rounds off the normal waist line resulting in so called ‘love handles’. The person thus attains a cylindrical figure. Loss of normal body contours surely hampers the attractiveness of an individual. Inability to hide these flaps in the tight dresses and inability to move around actively can at time be quite depressing for a person. This tends to lower the self esteem as well. Such problems can be solved by Tummy Tuck or Abdominoplasty. Best results are seen in females having lots of stretch marks and loose skin after child birth or fatty individuals with loose skin flaps.
It takes about 3-4 hours for this surgery and it requires general anesthesia. The usual hospital stay is 3-5 days depending upon the individual’s response to the surgery.
In most instances, a long horizontal incision just above the pubic bone from one hip to the other hip is used. The umbilicus is repositioned so that there is no loose fold of skin above the umbilicus. In the other common way, in addition to a short horizontal incision, a vertical incision upto the umbilicus is added. In both the types, the skin is separated and lifted from the abdominal muscles all the way upto just below the lower part of the breasts. The skin is pulled down, the excess resected and sutured. During this process of lifting the abdominal skin from the muscles, the umbilicus is separated from the surrounding skin and is left in its original place. After lifting the skin and pulling it down, the upper abdominal skin now lies over the umbilicus. A small hole is made in the skin overlying the umbilicus and umbilicus is brought out through this hole and sutured all around. Many a times, during abdominoplasty, liposuction is done from the upper abdomen and the sides of the abdomen to contour these areas.
Before suturing, drains are placed under the skin and brought out on the sides and left under the dressings. These drains are removed after 3-7 days. After surgery, the patient when on bed is required to keep the head elevated and the hips folded to some extent. This is done for 2-3 weeks, so that there will not be any tension on the suture line. Patients are requested to get out of the bed and take frequent short walks from the evening of the day of the surgery. Sutures are removed in 2-3 stages starting from the 7th day after the surgery.
Routine activity can be resumed a week later. Full strenuous activity can be undertaken after 6 weeks of the procedure. The person is required to wear pressure garments that aid in reduction of swelling and support the abdomen for about 6 weeks in the post operative period. These garments are not noticeable and are worn under the normal dress.
Tummy tuck or Abdominoplasty is one of the most commonly done procedures. Life threatening complications are extremely rare. Other reported complications are the same as with any other surgical procedure. Sometimes small touch up redo procedures are required to attain the best results. After abdominoplasty 75-85% of the patients are very happy with their results, but the remaining are not totally satisfied, because of their high expectations, technical limitations, healing problems, fluid collections etc. If a transverse incision is used, the resulting scar is usually thin, acceptable and well hidden by the bikini. Some people are poor scar formers, and they could form thick, wide prominent scars than the usual patients. The scars fade and flatten by three months to 2 year. Smoking and consuming alcohol must be totally stopped 2 weeks before the operation, as they impair wound healing.
Pre Op. Instructions:
Wash whole body with Betadine surgical scrub 24 hours prior to surgery and on the morning of the surgery.
Nothing by mouth (not even water) for 8 hours prior to surgery.
Take medicines according to the instructions given.
No Aspirin or Aspirin containing drugs or Vitamin E or Birth control pills for 2 weeks before the surgery.
Stop smoking or drinking alcohol at least 2 weeks before the surgery.
Post Op. Instructions:
1. Liquids and solid foods can be taken from the next day of the surgery if there is no nausea or vomiting.
2. See the doctor as advised in 3-5 days after the surgery.
3. Take medicines according to the instructions given in the prescription.
4. Do not take Aspirin or Aspirin containing drugs or Birth control pills for 2 weeks after the surgery.
5. Do not get the areas of surgery wet till further instructions.
6. Keep the head elevated at all times (use 2-3 pillows) for 3 weeks.
7. Keep the foot end of the bed elevated for 3 weeks.
8. Do not lift heavy objects for 8 weeks.
9. Do not undertake any strenuous activities or exercises for 8 weeks.
10. Elastic support garments should be worn in place of surgery for at least 6 weeks.
11. Short distance travel may be undertaken after 10 days of surgery and long distance travel can be undertaken 20 days after the surgery.
12. Walk slightly bent forwards for 3 weeks after the surgery.