TUMMY TUCK

What is a tummy tuck?

There are two basic body-contouring procedures. Liposuction and tummy tuck (Abdominoplasty).  When the main problem is excess fat, liposuction is the procedure of choice. However, when the main problem is excess skin, the best procedure for the patients in a tummy tuck.

A tummy tuck will not only work over the skin by removing the excess skin and stretch marks, it will also work to improve weakness and laxity of the underlying muscle.  By tightening up the abdominal muscles, the final result will be a flatter stomach and a smaller waist.

Since most of the time, patients have both excess fat and excess skin; a tummy tuck is usually accompanied by liposuction. This procedure is called Lipoabdominoplasty, and it will definitely bring about a better result for the patient.

Am I a candidate for this procedure?

You are a great candidate for a tummy tuck if you have one or more of the following conditions:

• Excess abdominal skin
• Excess abdominal fat
• A protruding abdomen
• Abdominal muscle wall weakness (usually from previous pregnancies or massive weight loss)
• Abdominal stretch marks

What do I need to know about this procedure?

A tummy tuck can be done on its own if the main problem of the patient is excess skin and has very little fat. Or it can be done along with a liposuction if she is also overweight.  Depending on what the patient needs the procedure can take 2-4 hours. It is always done under general anesthesia and the patient stays overnight in our hospital suites.

A lipoabdominoplasty handles the fat, the skin and the muscle. So usually we start with the liposuction. It is generally done in the back, waist and abdomen and other problem areas the patient wishes to address.  After that, a horizontal line under the bikini line in made and the abdominal skin is lifted. With the skin lifted, the weak abdominal muscles are tightened with sutures. Then the abdominal skin is pulled down, the excess skin is removed and the skin is closed leaving a horizontal wound under the bikini line. In the process a new belly button in made as well.

The resulting scars will be in the belly button and a long horizontal scar that goes from side to side under the bikini line.  Dr. Mejia has a personalized technique where the scar in the belly button is minimal and practically unnoticeable.  As for the low horizontal scar, it is placed so low that any undergarment will disguise it.  It usually heals and scars very well, looking like a stretch mark after about 18 months.

When patients that have stretch marks in the abdomen, tell me that they don’t want the horizontal scar. I tell them; ¨A tummy tuck is the only thing that will remove those stretch marks.  You are changing 100 stretch marks on your abdomen that everyone sees in a bikini, for one stretch mark (scar) that is strategically placed and that nobody will see¨.

Are there risks involved?

Every patient that goes into an operating room for surgery needs to be aware that risks do exist.  However, complications in this specific procedure are extremely rare.  Dr. Mejia will go over all the possible risks of this procedure with you during the initial consultation.  It is very important that you are honest with Dr. Mejia about your medical history and habits for things to go as smooth as possible.

What is the aftercare like?

The patient always stays overnight at one of our hospital suites. The meds and the lack of activity can lead to constipation after surgery. To treat this, drink a lot of water and walk around.  If you want to take something for constipation, you can buy a laxative. Take one every 24 hrs until resolution. Avoid smoking 3 weeks before surgery and 3 weeks after surgery.

The first 2-3 nights, you should sleep with two or three pillows to keep head elevated and lower the tension on the abdominal wound.  The patient should walk around after surgery to avoid the formation of blood clots. Notify Dr. Mejia if you feel shortness of breath or pain in the lower extremities, with one extremity more swollen than the other.  Swelling of the feet, ankles and legs is normal as long as they are symmetrical and painless.

The day after surgery, the first shower should be supervised. Its normal for the patient to feel light headed or faint during the first shower.  If the patient feels light headed, make sure she sits or lies down. If the patient faints, make sure she doesn’t get hurt and lay her down flat with the legs elevated until she recovers.

The post-op garment should be worn 24-7 for the first month.  Since the skin is numb the first 2 weeks after liposuction, Dr. Mejia prefers soft, loose garments these first 15 days until the skin recovers the feeling. After 15 days post-op, tighter garments can be worn.  Special stockings to avoid blood clots should be worn for 7 days.

10 post-op massages are needed after surgery for proper drainage of the fluid. These begin the second day post-op.

Bruising is expected the first month after surgery.  These can disappear faster with special creams that will be prescribed to you. Avoid sun exposure if there is bruising to the skin.

After the tummy tuck, you will have a drain. Dr. Mejia will take the drain out on the 10th day post-op. Fluid accumulation under the skin (seroma) is very common after tummy tucks. Drainage with a syringe might be needed. This is done by Dr. Mejia in the office.

Regular activities can be started 7 days after surgery.  Exercise can be started 4-6 weeks after surgery depending on how the patient feels.

Early fibrosis is a normal finding in all lipos and tummy tucks.  Your abdominal skin will look nice and regular, but you might feel hard nodules or hard fat under your skin. You can massage them on your own and they WILL disappear in 3-6 months. No need to spend money on expensive treatments. Early fibrosis is NORMAL.

The final result of a tummy tuck can be seen after all the swelling disappears. In some patients this swelling can take 6 or even 9 months. Swelling of the lower part of the abdomen usually takes the longest to come down.

The results of a tummy tuck are better if accompanied by eating healthy and exercising. The results won’t be as good if they are not accompanied by a healthy lifestyle.

How much downtime is there?

Patients can usually go back to their regular activities 10 days after surgery.