A “tummy tuck,” or an abdominoplasty, flattens and firms your abdomen, enhancing your appearance and creating a smoother abdominal profile. This procedure is designed to tighten the abdominal muscles and remove excess skin and fat from the middle and lower abdomen.
Are you unhappy with the contour of your abdomen? Do you have a muffin top, excess skin, or stretch marks? Has your figure been affected by pregnancy or massive weight loss? Do you diet and exercise with no results? If so, you should consider a tummy tuck or abdominoplasty to restore a youthful contour and flat stomach. A tummy tuck will remove excess fat and skin from the abdomen and tighten the abdominal wall musculature, giving you a more youthful looking body.
Tummy Tuck Candidates
You are a good candidate for tummy tuck (abdominoplasty) if you are healthy, maintain a stable weight, are a nonsmoker, and don’t plan future pregnancies. Prior to tummy tuck surgery you will be asked to stop aspirin and anti-inflammatory and herbal medications which increase your post-operative bruising. Tummy tuck surgery will not address intra-abdominal fat, or the fat surrounding your internal organs.
Tummy Tuck Techniques
Tummy tuck (abdominoplasty) is an outpatient procedure done under general anesthesia. The technique and the incision length depend upon prior surgical scars and the amount of loose skin or overhang. Massive weight loss patients with a large amount of overhanging skin will need an extended incision around the hips or even a lower body lift. Liposuction is often used in addition to abdominoplasty to recreate a more youthful contour of the waist and can be performed at the same time.
Endoscopic abdominoplasty is used in patients who have severe muscle laxity or rectus diastasis with little or no loose skin and fat. This technique uses 2-3 smaller incisions with a small camera placed under the skin the visualize the fascia. The diastasis is repaired. Liposuction of the abdomen may be completed at the same time to remove excess fat. The recovery time for endoscopic abdominoplasty is like a full abdominoplasty with restricted activity for 6 weeks post-surgery.
Mini abdominoplasty is for patients who have mild skin laxity and stretch marks only below the navel. The incision is placed lower like a C-Section incision and the length is limited to include an ellipse of loose skin. A mini-abdominoplasty may be combined with liposuction. Patients usually maintain a healthy lifestyle with diet and exercise but have a stubborn overhang of skin which is sometimes causes by a previous incision, weight loss, or pregnancy.
Modified Abdominoplasty or Lipoabdominoplasty
The modified abdominoplasty is used with patients who have previous scars which interfere with the blood supply of a full abdominal flap or need a significant amount of liposuction of the abdominal flap. The modified abdominoplasty uses an abdominoplasty incision low on the abdomen and lifts the flap in the midline to preserve maximin blood flow but still allow Dr. DiFrancesco to suture the abdominal muscle to repair the laxity. The navel can be repositioned and an ellipse of loose skin below the navel is excised. The modified abdominoplasty is best for patients with a lot of loose skin, fat, and muscle laxity, but who are not candidates for a full abdominoplasty.
The full abdominoplasty is a traditional abdominoplasty that uses a low abdominal incision and an incision around the navel. An ellipse of skin is removed from the lower abdomen, the navel is repositioned on the abdominal flap, and the muscle is tightened in the midline. Your lower abdominal stretch marks are removed. Skin laxity above and below the navel can be tightened, A youthful contour to the abdomen is recreated.
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Drainless abdominoplasty is a newer technique using progressive tension sutures to avoid using drains. After abdominoplasty surgery, it is common for fluid to develop under the skin as part of the healing process. If the fluid is not removed it will form a seroma. Traditionally, drains have been used to remove the seroma fluid. However, drains are uncomfortable and can be cumbersome.
Drainless abdominoplasty uses suture to fix the skin and fat to the fascia in a pattern which eliminates the space between the skin and fascia, preventing the formation of seroma fluid. The suturing technique is called progressive tension sutures and it reduces tension on the tissues and improves scarring. Dr. DiFrancesco is known for the no drain abdominoplasty in Atlanta.
An extended abdominoplasty is used in patients who have severe skin laxity extending to the hips or love handles. This is common in patients who lose significant weight. The disadvantage of the extended abdominoplasty is the length of the scar. The extended abdominoplasty not only flattens the stomach but lifts the thighs and hips.
Tummy Tuck Recovery
During your pre-op visit, our nurse will go over your post-op instructions including your medications and signs of complications to look for. Depending on the length of your procedure it may be outpatient, or you may be required to stay overnight in the surgery center. Walking is encouraged after surgery but no strenuous exercise or heavy lifting for 6 weeks. If drains are used, you will receive instruction at your pre-op visit and again post op before discharge. The post-surgery garment is worn for 6 weeks.
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The mini version is used on patients with only mild to moderate amounts of excess fat and skin. A full tummy tuck involves removal of more significant fat and skin and tightening of the abdominal muscles from the rib cage to the pubic area. Incisions for both mini and full tummy tucks are low and well hidden in a bikini line.
Mini and full tummy tucks are two to three hour long surgical procedures performed under general anesthesia. Medication is used to control any post-operative pain. The full tummy tuck involves a slightly longer recovery period than the mini version, but all abdominoplasty patients are usually able to resume their regular work and most activities in 2 to 3 weeks. Strenuous exercise and heavy lifting should be avoided for one month, however.
Yes, most commonly liposuction is performed with abdominoplasty. Waist and back bra roll liposuction help to define the hourglass shape. Massive weight loss patients may choose to combine their abdominoplasty procedure with an arm lift or thigh lift.
At DiFrancesco Plastic Surgery, we offer drainless abdominoplasty surgery in patients who are good candidates. Good candidates for drainless abdominoplasty are patients in good health with a low BMI and moderate skin resection. Dr. DiFrancesco uses a technique called progressive tension sutures to reduce the space which allows seroma fluid to accumulate and form a seroma. This drainless abdominoplasty is more comfortable for patients after surgery and reduces scarring by eliminating tension on the flap.
Patients who are within 10 lbs. of their ideal weight will achieve the best results with the least chance of having a complication. You want to have a healthy diet and exercise before surgery and continue it after surgery to maintain your excellent results.
Dr. DiFrancesco uses ERAS – enhanced recovery after surgery – for all her surgeries, not just abdominoplasty. ERAS is a cocktail of medications to significantly improve post-operative pain control and decrease the use of opioid pain medications. Abdominoplasty patients have less downtime and a faster more comfortable recovery using ERAS. Dr. DiFrancesco is one the of first plastic surgeons in Atlanta to use ERAS and her patients love it!