ABDOMINOPLASTY (TUMMY-TUCK) Posted in: Most Frequent Procedures

It is not uncommon for some patients  trying to maintain their weight or return to a healthy weight, to have persistent deposits of fat that deform their self-image. These accumulations of fat are common in the lower abdomen, near or between the ribs, hips, or in all these places at once. So called “love handles”, are part of a global deformity in the abdomen. In light cases there is a volume increase of belly fat which resembles a pregnancy of 3 to 4 weeks. In more pronounced cases, abdominal tissue hangs like an “apron” of skin and fat. Frequently the abdominal muscles have become separated usually due to abdominal distension that occurs with pregnancies.

Prior to surgery, we will need to take pictures before and after your surgery to help us plan your surgical procedure, record your progress and compare details and results.

The abdominal lipectomy or Abdominoplasty or “Tummy-Tuck” is intended to correct the two situations discussed above. The muscles are strengthened and united in the midline, surgically removing the excess abdominal skin and fat.  This helps to produce a flatter and strong abdominal wall. This requires a long incision from side to side along at the level of the first row of pubic hair.  There is a second small incision around the navel, as the belly button must be re-placed after removing the excess skin and fat. Usually the shape and position of the navel does not change.

As the soft tissues of the abdominal wall will be detached and pulled downward, there will be a little tension in the area of skin closure. Therefore it is important to walk slightly flexed at the hips for 5 to 6 days. Normal erect posture will gradually be resumed one to two weeks after surgery.

An elasticized compression garment is worn for an extended period following the surgery. This garment will provide support to the abdomen as it goes through the healing process.  (http://www.mentorcorp.com/post-surgery-garments/cs_psg_products_ab.htm )
The surgical procedure is done in a hospital under epidural anesthesia. Your hospital stay will be 1 to 2 nights depending on the magnitude and duration of surgery.

You will come out of surgery with drainage tubes, one on each side of your hip, which will collect fluid from inside your operation in a rubber bulb. These drains are not painful, but you must be careful not to get them dirty or accidentally pull them out. The drainage tubes are removed after 4 to 5 days and this is not painful. You will notice that the pubic hair will appear to be pulled upwards; this is normal and will get return to normal once the healing process is stabilized (approximately one month and beyond).

There may still be some oozing once the drains are removed.  It is recommended at this time to rest, use of the compression belt and the 4 to 5 Kg bag that will still be used on top of your waist binder, to exert compression for a few days. Limiting fluid intake for a few days is also beneficial. This decreases the chances of fluid accumulation at the surgical site. Once reviewed 4 to 6 days later, you can resume dinking water normally.
Some numbness occurs at the lower abdomen, which normally lasts between 1 to 3 months. There may also be persistent inflammation around the incision. Using a waist binder or tight pantyhose for one and a half months, during the day, can relieve this. The scar, however, will persist, and in some cases during the first 6 months, may be marked, chipped, or broad. As time passes, both the texture and color of this scar, will improve. (click Skin Types)

Sponge baths are recommended for 10 days or so following surgery. Thereafter, when all the stitches have been removed, you may shower as usual. The more you rest, the better the chances for a good recovery. Although you needn’t spend all day in bed, activities should be minimized to walking only for your three meals and to use the bathroom.

During the first 3 weeks following surgery you should abstain from sexual intercourse. It is important to emphasize that you should not lift heavy children or babies.   Avoid reaching for higher objects during this healing period as this could result in serious problems such as loose stitches, bleeding, inflammation and excessive scarring.

You can drive approximately 2 weeks after your operation, if your recovery is adequate, but only for short periods.

Below are some important pointers regarding “before and after” a tummy tuck operation:

BEFORE SURGERY:
1. Order a compression garment that you should use for 21 days after the operation. In the office we will give you more information on how to get it. (If you cannot order for your garments online, it can be ordered through our office).
2. Do not take aspirin or aspirin products for 2 to 3 weeks prior to surgery. (Click Non recommended Medicines for more information.)
3. For three consecutive nights before surgery wash the entire abdomen with Isodine foam (Betadine in the US) shampoo.
4. Do not eat food or drink any fluids from 12 PM the night before surgery
5. For your own convenience, bring loose comfortable clothes with zippers or buttons.
6. On the day of your surgery, bring your compression garment and weights.

AFTER SURGERY:
1. Go directly home and remain at rest for 24 to 48 hours. You may require assistance in the first week after surgery.
2. You may get up to use the toilet and for meals.
3. The first day at home you should take sips of fluids, gradually increasing to a soft diet. If you do not have nausea, you can eat normally.
4. You should be resting with pillows under your knees and have your back somewhat elevated. Take care not to get up suddenly or to stretch completely during the first week.
5. From the first day you should do leg exercises to avoid problems with your veins. You could also avoid complications of fluid retention under your tummy by placing a bag, 4 to 5 kg of weight on your abdomen in order to bear weight and compression. This will be taught to you so you will know to do this at home.
6. Do not take aspirin or aspirin derivatives after your operation. Also check Non recommended Medicines for details on other drugs. Do not use alcohol while you are taking medications.
7.  You should eat as healthy as possible: cooked vegetables, chicken, fish without skin, broiled, grilled, boiled or baked, not fried or breaded; fruits, natural non-citrus juices.
8. Avoid spicy, hot, irritating, greasy foods or foods high in sugar. For more information, see the section of Plastic Surgery and Health in the Surgery/Plastic Surgery and Health link.
9. Avoid hot environments or sun for the first week post-operatively.
10. Minimize activities. No sex, no heavy lifting, no extended reaching.
To view some cases of this surgery click Photo Gallery

Any questions before and after your surgery may be answered in person by calling the office, 684-2551  (US: 619-730-1917) or my cell 664-283-0976 or click Contact us for more information.

I wish you an excellent experience in Plastic Surgery and a speedy recovery.

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