TUMMY TUCK (ABDOMINOPLASTY)
Tummy tuck surgery can benefit patients who have loose abdominal skin and fat that is concentrated in the abdomen. Often, pregnancy or substantial weight loss may cause abdominal skin to become stretched out and excessive. A tummy tuck removes the excess skin below and around the belly button, and also tightens the abdominal muscles that have been separated and weakened in these cases. The procedure can eliminate some stretch marks that are located below the belly button, as the affected skin is removed as part of the operation.
Good candidates for this procedure:
Patients who have gained and lost weight, such as in pregnancy or weight gain
- Patients with excess skin and some fat in the abdomen
What to expect: Consultation
All cosmetic consultations are complimentary and serve as a great opportunity to gain further insight by voicing your concerns and having questions answered. During the initial consultation, Dr. Hsu will ask some questions to get to know you and determine if you are a good candidate for a tummy tuck.
During the consultation, Dr. Hsu will first ask about the area in question and determine what kind of goals you have for the surgery. He will examine your abdominal area to see if you have excess skin and muscle laxity in the area. He will also ask about your medical history, including existing medical conditions, past surgeries, tobacco usage, daily medications, supplements, and allergies. If he determines that you are a good candidate for the procedure, Dr. Hsu will explain the next steps in going forth with the procedure. In order to reach your aesthetic goal, both you and Dr. Hsu will work together to decide all the necessary details that will ultimately give you the best results.
On the day of surgery, come in early to fill out paperwork, meet the anesthesiologist, and the staff will prep you for surgery. Dr. Hsu will meet you in the pre-operative area before surgery to make markings on the areas planned for surgery and answer any last questions you may have.
The surgery will take about two and a half hours. Very commonly, patients will also request to get liposuction of the flanks in conjunction with their tummy tuck procedure. In this case, the liposuction will add about half an hour of procedure time. The incision site for the tummy tuck is around the bikini line. If you previously had a C-section, the incision site will usually incorporate your C-section line so that you do not have a separate second scar. The incision is longer than the C-section scar, but it will be around the same area, placed as low as possible with the goal of hiding it in your underwear or bikini line.
Depending how much excess skin there is, a wedge of skin in the shape of an ellipse will be removed, and the remaining skin will be stretched down to tack onto the incision site. Since Dr. Hsu will be removing the skin below the belly button, any stretch marks in that region will be removed. For some patients with a lot of excess skin, any stretch marks above the belly button will also be removed. Dr. Hsu will take as much skin as possible while allowing enough leftover to close the incision without causing any healing difficulties.
Most people think pregnancy only stretches the skin, but in actuality the muscle layer also has some laxity. For most patients Dr. Hsu will not only remove excess skin, but also pull the abdomen muscles to tighten it, therefore tightening the muscle layer and skin layer. Dr. Hsu will pull the skin down and create a new opening for your belly button to be exposed, so that you retain your unique belly button and it remains in the exact same place on your abdomen.
Recovery & Post-operative Instructions:
Following the surgery, you will wear a compression garment for a couple of weeks to aid the healing process. The surgicenter nurse will teach you how to take care of the drains/tubes after your operation that Dr. Hsu will place. You will need to measure the amount of fluid that comes out of the drains every day. Once that amount drops below a certain level, Dr. Hsu will take them out. The vast majority of patients usually keep the tubes in for two weeks; however, this time frame may vary for each individual. If you have any inquiries after surgery, Dr. Hsu is available 24 hours to address any immediate concerns.
During the initial healing period, it is encouraged to exert some gentle walking around the house to quicken the healing process and to minimize blood clots. It is also advised that you sleep on your back for two weeks following the procedure. Most importantly, you should keep the surgical area dry until Dr. Hsu gives his approval to shower. To clean the rest of your body, you can bathe or use wipes until clean. Swelling & bruising will peak about 48 hours after surgery but will then decrease significantly in the first two weeks. Most patients can return to work after two weeks, but many patients return even sooner. The biggest limitation for post-operative patients is driving, which should be avoided while taking pain medication. Patients usually stop taking pain medication after five to seven days and plan their work schedules accordingly. Six weeks is usually an appropriate time to return to most types of exercise and activity.
Dr. Hsu likes to follow patients after surgery for an extended period of time to make sure the patient are healing well. Most follow up appointments are scheduled immediately after surgery and for up to a year afterward.
Dr. Hsu's view on Tummy Tucks.
I think that the tummy tuck procedure (abdominoplasty) can really work well for patients whose problem is excess skin. As mentioned above, there is often a misconception that this is an operation to remove excess fat; in fact, it really is an operation to remove excess skin. The best candidates for this procedure have lost all of the weight that they want to or are able to, and want to remove as much of the excess skin as possible. Also, I often see patients who would like a tummy tuck, but are still considering having children in the future. For those patients, I ask them to wait until they are reasonable sure that they do not want to have any more children! I tell those patients that the benefits of the tummy tuck will be lost if they have another child, so I would recommend waiting so that they do not need to go through recovery twice.
The biggest concern about tummy tuck is usually the scar. My approach is to place the scar as low as possible, while making sure it is not so low that there are issues with healing. That is the balance that is required -- if the incision is placed very low, the skin closure can sometimes be very tight, and that can cause pulling on the incision that can complicate healing, or can also lead to widened scars in the future.
As with most of the procedures I do, my approach is to be conservative, and to minimize any pulling forces across the wound so that the incision heals as thin as possible and stays that way over time. That, coupled with a special scar massage technique that I teach my patients, in addition to use of specific scar creams, have made for some very successful results for me and my patients.