Tummy-Tuck

(Abdominoplasty)

Abdominoplasty (commonly known as a "tummy-tuck") is a surgical procedure that can significantly reduce the appearance of a protruding belly by removing stubborn fat deposits that don't respond to diet or exercise and by tightening stretched muscle tissue. It's often effective in restoring firmness to women who, after several pregnancies, have abdominal muscles and skin stretched past the point where they return to normal on their own.

It's important to realize that abdominoplasty is not a trivial procedure. Your doctor needs to know your medical history in detail before advising you on whether the procedure is right for you. Patients are usually very pleased with the results, but it's important to have informed and realistic expectations: you're likely to be left with a permanent scar, which, depending on the extent of the original problem and the surgery required to correct it, can extend from hip to hip just above the pubic area. The surgeon's skill and careful planning can do much to reduce the noticeability of the scar, however, and it will fade considerably over time.

There are alternatives to complete abdominoplasty: a procedure called partial abdominoplasty is sometimes more appropriate when the area that needs correcting is limited. Liposuction can also re-contour the body if the problem is simply a stubborn deposit of fat.

Abdominoplasty is performed with general anesthesia, so you'll be asleep throughout the procedure.

The surgeon 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 surgeon separates the skin from the abdominal wall as far up as your ribs and lifts a large skin flap. The vertical muscles in your abdomen 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 excess skin removed. The navel is repositioned at a natural-looking level. Finally, the incisions will be closed with stitches. A temporary tube may be inserted to drain excess fluid that might accumulate in the days immediately after surgery.

Partial abdominoplasty, as the name implies, involves less of the abdominal region. The incision is much shorter and the skin is separated only up to the navel, which most likely won't need to be repositioned. The vertical abdominal muscles may be drawn closer together and sutured in placed. The skin flap is stretched down, the excess is removed, and the flap is stitched back into place.

Full abdominoplasty typically takes two to five hours; partial abdominoplasty might take as little as an hour or two.

For the first few days, you're likely to feel some pain and probably need some medication to relieve it. You may have to spend one or two days in the hospital or after-care facility if your surgery was extensive. The stitches will be removed in one to two weeks. The doctor might recommend a support garment to protect the area of surgery after the bandages are no longer needed. You might be able to return to work in two weeks, but the doctor might advise another week or more of recuperation.

It will be uncomfortable to stand straight at first, but gentle stretching and some walking will help speed your recovery. Soon you'll be encouraged to begin more regular exercise to help reduce swelling, lower the chance of blood clots, and strengthen your muscles. Avoid the temptation to begin strenuous exercise, however, until the doctor tells you it won't risk setting back your recovery.

It may take several months before the scar flattens out and blends in with adjacent skin color. Under most clothing, including bathing suits, the scar shouldn't be noticeable.

This has been only a general overview of abdominoplasty surgery. To find out more, you should talk over the specifics of your case with Dr. Sheng. Simply call his office at (310) 288-0269 to make an appointment. He will be happy to take the time to make sure you are fully informed.

Copyright © 2003 Francis C. Sheng, M.D. All rights reserved.