For many people, a flat tummy can be impossible to achieve naturally. Even with good diet and exercise, the last bit of stomach weight often stays put. What’s more, size changes from weight loss and pregnancy frequently leave loose skin. Many people are quite disappointed after a large weight loss only to find that the abdomen continues to protrude or sag from the remaining skin. Particularly after pregnancy, many problems are also caused by diastasis recti, a very common condition in which the abdominal muscles have separated and pooch out when relaxed rather than holding everything tightly in.
A tummy tuck, also known as abdominoplasty, can correct a sagging or prominent stomach by removing excess skin and fat. It also tightens weak or separated abdominal muscles to aid in a tight, toned-looking midsection. Good candidates for abdominoplasty include people who are at a fairly stable weight and have loose or wrinkly abdominal skin as well as small to moderate amounts of excess abdominal fat.
Depending on what is decided at the initial consultation with Dr. Masri, you tummy tuck can be performed with either general anesthesia or local anesthesia combined with a sedative to keep you still and relaxed. Once the procedure starts, there are two basic options: A full tummy tuck or a mini tummy tuck.
Patients who have less sagging skin and whose abdominal fat is confined to a pouch below the belly button often opt for the mini or partial tummy tuck. The exact size and position of the incision will depend on the location and extent of the problem area, but in general, it is made just above the pubic bone running approximately from hip bone to hip bone to allow the removal of excess fat and skin bellow the navel. During a full tummy tuck, an additional incision will be made around the belly button to allow removal of extra fat and skin above that point.
After the incisions have been made, the abdominal skin will be lifted in order for Dr. Masri to perform any necessary muscle repair. Then the upper abdominal skin will be pulled down to tighten it, at which point excess skin can be trimmed off. The skin is sutured in place, and, during a full tummy tuck, a new opening created for the navel. Drainage tubes may then be placed to help remove excess blood or fluid that might collect. The whole procedure typically takes between two and five hours.
For the first few days, your abdomen will be quite swollen, making it difficult to see the true results of the surgery. Depending on how much work was done on the abdominal muscles, it will probably also be very difficult to stand upright, since your core will need time to heal. Within a week or two, you should be able to stand tall and see most of the results in the mirror, although some swelling, bruising, and numbness will remain for a few more weeks. Your bandages, drains, and stitches will be removed within the first week in most cases, at which point most desk jobs can be resumed, but it will take another 3-4 weeks before you’ll be able to exercise. Most patients can expect some numbness to remain for about six months, and it will often take up to a year or more for the scar to fade to its final level of visibility.
Although abdominoplasty is considered to be a safe procedure, it does carry some specific risks in addition to the typical risks of bleeding and infection that go with any surgery. The most common issue is fluid collection under the skin once the drains have been removed. While irritating, this is easy to correct by removing it with a needle. The fluid collection generally stops within a month and does not affect the final results.
Since the procedure requires cutting through a fair amount of skin and nerves, changes in sensation are also relatively common. Most patients experience skin numbness for several months after the surgery, but this usually goes away. In a few cases, there will be some permanent numbness.
In addition to these more common but relatively minor risks, there are also slight risks of more serious problems like suture rupture, leg swelling, and skin necrosis. Dr. Masri will go over the potential risks and their treatments at your initial consultation.
The tummy tuck is frequently combined with other cosmetic procedures. One of the most popular is termed the Mommy Makeover. As the name suggests, this is done after childbearing is finished, and it typically combines a tummy tuck with a breast lift, breast implants, body sculpting, and sometimes even facial fillers or Botox. The exact combination depends on the needs and desires of the patient and can be discussed in your consultation.
For those who are moderately overweight, tummy tucks are frequently also combined with liposuction. A tummy tuck by itself can only remove a limited amount of fat, but the liposuction allows Dr. Masri to remove larger quantities of excess fat at the same time.
Q. What happens if I get pregnant after having a tummy tuck?
A. First, don’t worry. Pregnancy after abdominoplasty is perfectly safe. Ideally, you should wait 4-6 months for everything to heal before becoming pregnant. On the downside, the dramatic change in size will likely ruin the results of your tummy tuck, making another abdominoplasty necessary. In general, if you’re planning on more children it might be better to wait to get your tummy tuck, partially if you’d prefer to avoid having multiple procedures. On the other hand, if you’re dissatisfied with your current appearance but are simply not sure if you’ll be having kids in the future, there’s no real safety reason to avoid it.
Q. Can a tummy tuck be used to repair other pregnancy damage besides loose skin?
A. Pregnancy can do quite a number on the body, leaving behind not just loose skin but also separated abdominal muscles, stretch marks, and scarring for those that require cesarean sections. Abdominoplasty will repair the muscle separation along with the loose skin, and the c-section scar can often be incorporated into the tummy tuck scar, so you’ll still only have one scar to worry about. It will not fix stretch marks on remaining skin, but since 30-50% of the skin is often removed during a tummy tuck, many sections of stretch marks will likely be removed.
Q. I dislike my loose skin, but I still have some weight to lose. Can I get my tummy tuck now or should I wait?
A. If you get your tummy tuck early, you may find repeating the procedure once you hit your goal weight and find even more loose skin. Even worse, if you have the procedure done before your weight has stabilized, you might find the results ruined by regaining weight. For those reasons, patients with more than a couple of pounds to lose are generally advised to wait until they’ve hit their goal weight and maintained it for a period of time.
Q. How visible will the scar be?
A. A tummy tuck is not a scar-free procedure, so there will be a visible scar. It depends on how you heal, but you will typically be left with a lengthy scar that is noticeable but not gruesome. The exact size and shape of the scar will depend on your needs, but it will usually be hidden in an area that is covered by a normal bikini.
Q. What if I just need the excess skin and fat gone but my abdominal muscles are fine?
A. While most people who have a tummy tuck require a bit of muscle work, the same basic procedure minus the muscle work can be done easily and is called a dermolipectomy. It is recommended for slender patients who have good muscle tone but excess fat and skin that needs to be removed to show the existing tone.