What is a tummy tuck?

When there is a lot of excess skin on the abdomen, an abdominoplasty, or tummy tuck, is required. This involves tightening the abdominal wall muscles (the rectus abdominis, or the six pack muscle) and then removing the excess skin and fat. I often tighten extra muscles (the external obliques) in order to narrow the waist as much as possible. I like to use the anesthetic pump to help decrease the need for postoperative pain medicine, and platelet gel to decrease postoperative bruising and swelling. The modern abdominoplasty is less invasive and does not cut through as many blood vessels and nerves as the traditional one. The incision is low, in the bikini line. Liposuction is a great body contouring procedure when there is not too much excess skin. I use the new Tickle Lipo tumescent technique (see the youtube video link on the homepage). This fantastic device allows me to perform the procedure in the office, without heavy sedation or anesthesia. There is less bruising and swelling than the traditional liposuction technique, and the downtime is only 1 or 2 days. I like Tickle Lipo more than the laser liposuction devices because it does not generate heat, which can damage the skin. Liposuction is not a weight reducing procedure, only gastric bypass or lap band surgeries are. Liposuction is simply a contouring procedure and the weight of the fat removed is surprisingly low for the amount of correction in volume. Liposuction does not take care of cellulite.

Is anesthesia used during the tummy tuck procedure?

You bet! Even deep "twilight " anesthesia is not sufficient, except in the occasional patient.

How long does tummy tuck surgery take?

About 2 hours in the OR, 1 or 2 hours in recovery, and then you go home.

Are there risks and complications to a tummy tuck?

Yes, but the risks are manageable. Here is a long list that I give to my patients:

a. There are long scars as a result of this surgery. Every effort will be made to conceal or to make them as inconspicuous as possible. There will be a scar around the umbilicus, and its position may not be in the midline. Scars may be unattractive and of a different color than the surrounding skin. Scar appearance may vary within the same scar, and may be asymmetrical from one side of the body to the other. Additional treatments, including surgery, may be required to treat abnormal scarring. Although very uncommon, skin discoloration around the scars may persist for long periods of time and may be permanent.

b. There may be delayed healing of the incisions. Some areas of skin may die, requiring frequent dressing changes or further surgery to remove the non-healed tissue. Fat necrosis, or death of fat tissue under skin, may cause firmness, nodules, or contour irregularities.

c. There may be bruising from blood or fluid collections (seromas) that can last for up to several weeks. These may feel like soft or hard bumps under the skin. Rarely this requires drainage with a needle or more extensive reoperation.

d. It is possible, although unusual, to experience bleeding during or after surgery. Lengthening of the initial surgical incision may be required to control the bleeding. Blood transfusion may be required. The development of a collection of blood under the skin (hematoma) may require reoperation and may delay healing and cause scarring. I understand that the risk of bleeding can be lessened by following instructions on the Medications to Avoid  page, which I have read.

e. There may be skin contour irregularities, such as depressions, wrinkling, and residual skin at the ends of the incisions (dog ears) after the procedure. Women may experience distortion of their pubic area, although it is rare. These usually resolve with time but may require surgical correction.

f. The skin of the abdomen or even the upper thigh may be numb for some period of time, and this could be permanent. Chronic pain may occur very infrequently from nerves becoming trapped in scar tissue.

g. Deeper structures, such as the bladder, intestines, nerves, blood vessels, and muscles may be damaged during the course of surgery. Injury to deeper structures may be temporary or permanent.

h. Permanent deep sutures or hardware may be used to hold tissues in position. These may spontaneously poke through the skin, become visible, or produce irritation. Surgical removal may be required.

i. Blood clots are rare, but may occur after any surgery. I understand that the risk of blood clots can be lessened by following instructions on the Risk of Blood Clots page, which I have read.

j. Rarely, there may be allergic reactions to tape, sutures, tissue glues, blood products, or injected agents that may be used during and after surgery. Serious reactions, including shock, may occur to drugs used during surgery and to the prescriptions given for drugs after surgery.

k. There may be persistent leg swelling (lymphedema), although this is rare.

l. The body is by nature asymmetrical, and therefore symmetrical results cannot be assured. Additional surgery may be required to improve symmetry.

m. The results of an abdominoplasty should last for a significant amount of time, but are not permanent. The aging process is not halted. There can be no guarantee made of the amount or percentage of improvement, the reduction in terms of apparent age, or how long the results will last. There may still be residual looseness, wrinkles or stretch marks of the abdomen.

n. If the abdominoplasty is combined with another procedure, such as a hysterectomy, hernia repair, breast augmentation, etc, the risk of complications for each procedure is slightly increased.