Facelift
Blepharoplasty
Brow Lift
Rhinoplasty
Breast Augmentation
Breast Lift
Breast Reconstruction
Abdominoplasty (Tummy Tuck)
Liposuction
Thigh Lift
Body Lift
Body Contouring
Abdominoplasty
| • What is Abdominoplasty? | • Am I A Candidate? | |
| • Your Consultation | • The Procedure | |
| • Options and Alternatives | • Risks | |
| • Recovery | • Your New Look | |
| • FAQ's | • Before & Afters |
What Is Abominoplasty?
A flat and trim abdomen is one of the essential features we identify with youthful good health and physical fitness. Flabby, loose skin and a bulging abdomen may make it difficult to wear certain types of clothing items we favor, and may make us self-conscious about revealing our bodies at the beach or in the gym, or even to our spouses or partners.
Abdominoplasty, or “Tummy Tuck,” is designed to firm and smooth your abdomen. Many times, a protruding abdomen is the result of weak abdominal muscles, or repetitive cycles of weight gain followed by weight loss. Occasionally, there is an inherited familial pattern of localized abdominal obesity, while the rest of the body contours are normal. Often, the culprit is pregnancy, which may also cause the skin to lose its elasticity as well as causing the abdominal muscles to weaken and separate. This type of laxity of the abdominal wall generally will not improve solely as a result of greater attention to diet or exercise if the skin and underlying muscles have been overly stretched and weakened, and their resilience has been pushed beyond the point of recovery. Many patients are discouraged by their lack of progress or improvement in their body contours, often in spite of rigorous regimens of diet and exercise, which never seems to translate to visible improvement.
Abdominoplasty corrects the underlying conditions contributing to this problem by removing excess abdominal skin, reducing fat below the skin and tightening the muscles of the abdominal wall, if necessary. Often, old unsightly scars from C-section or appendectomy, and stretch marks of the lower abdomen can be removed as well. The result is a more youthful, firmer and flatter abdominal contour.
Realistic expectations are important. Abdominoplasty is not a substitute for weight loss. In some cases, we recommend enrollment of our patients in a medically-supervised weight management program, and often we recommend our patients to consult with a nutritionist or registered dietitian for initiation and long-term maintenance of healthy eating habits and weight stability.
Both women and men who have excess fat and loose skin of the abdomen can benefit from Abdominoplasty. Dr. Cambre carefully considers age, obesity and overall health when evaluating a candidate for this procedure. The best candidates are healthy and physically fit patients who have maintained a stable body weight near their ideal goal, with a disciplined program of diet and exercise. You may be a good candidate for Abdominoplasty if you have one or more of the following conditions:
• Excess or sagging abdominal skin
• An abdomen that protrudes and is out of proportion to the rest of your body
• Abdominal muscles that have been separated and weakened by pregnancy or weight gain
• Excess fatty tissue that is concentrated in your abdomen
Smokers, diabetics, and patients with uncontrolled obesity are poor candidates. Women should be relatively certain that they will not become pregnant in the future. For qualified patients, Abdominoplasty can provide a dramatic improvement in physical appearance and general sense of well-being. There is often an increased exercise tolerance, along with an alteration in available styles of dress and clothing, and a motivation to maintain the outward improvement in body shape, with healthier lifestyle and dietary choices.
The Abdominoplasty can sometimes be combined with other procedures, such as hysterectomy or bladder suspension.
Dr. Cambre will take a complete medical history and conduct a careful examination to evaluate your overall health. Ideally, the Abdominoplasty patient has no health problems, and wishes only to remove an excess deposit of fat or loose abdominal skin. Patients on a personal or medically-supervised weight-loss plan should be relatively close to their target weight before having the operation. Women planning future pregnancies should delay Abdominoplasty, as pregnancy may cause further abdominal stretching.
Photographs will be taken before and after surgery.
Antibiotics will be prescribed at the time of surgery to prevent infection. To minimize the possibility of excess bleeding, you should avoid taking drugs containing aspirin. You may also be advised to shower with an antiseptic soap on the night before or morning of your surgery.
Abdominoplasty is generally carried out in an accredited outpatient surgical facility, or on occasion, in a hospital setting. The procedure is done under general anesthesia. You may be given a sedative medication beforehand so you will feel relaxed. The surgery generally takes 3 to 4 hours, depending on the individual circumstance, and whether other additional procedures are planned in conjunction. Patients usually spend the night of surgery in an aftercare facility; alternatively, patients may be discharged to their own home under the care and supervision of a private-duty nurse or a responsible adult caregiver.
The procedure is most commonly performed by making a gently-curving incision extending for a variable length between both hip bones and above the pubic area, hidden in the bikini line. The length of this incision depends upon the amount of excess skin requiring removal. A second (circular) incision is generally made around the navel (umbilicus). The skin is lifted from the abdominal wall and elevated up to the ribs, revealing the abdominal muscle. Loose, separated muscles are tightened with sutures, and any abdominal hernias are repaired. This results in a firmer abdominal wall and narrower waistline. The skin is re-draped and tightened over the abdomen, the excess skin and fat are trimmed and removed, and the navel is restored to its normal location through a new incision in the abdominal skin. Existing stretch marks in the lower abdomen are often removed in the process, and any remaining stretch marks tend to be flattened and improved. The incisions are then carefully closed with hidden sutures and surgical tape. Temporary suction drains are inserted to eliminate fluid buildup, and firm elastic bandages or a surgical girdle are applied to the area to limit swelling and bruising.
There are several variations of the standard technique of Abdominoplasty, which Dr. Cambre will discuss with you, if appropriate to your condition. These include “mini” or partial Abdominoplasty, in which there is no incision around the umbilicus. This more limited procedure is reserved for patients with minimal loose skin and excess fat deposits located primarily below the umbilicus. For some patients with excessive and lax skin of the flanks and hips in addition to the abdomen, a more extensive procedure such as Belt Lipectomy or Lower Body Lift may be required in order to achieve the best results. Occasionally, Liposuction alone may be used in circumstances where there is good skin elasticity and localized excess fat only. More often, Liposuction (suction lipectomy) is used in conjunction with either mini- or full Abdominoplasty procedures, to remove additional unwanted fat deposits, and to improve the overall contours of the waistline, hips, and thighs.
Anyone considering surgery should be aware of both the benefits and risks. Fortunately, significant complications from Abdominoplasty are infrequent, and patients are generally gratified with the results.
Potential risks of Abdominoplasty include bleeding, infection, and reactions to anesthesia. There may occasionally be tissue loss and delayed wound healing along portions of the horizontal incision, especially in cases where the procedure has been extensive, or in smokers and diabetic patients. Patients are encouraged to walk as much as possible in the first few days after surgery, to avoid the possibility of pneumonia or of blood clots forming in the leg veins. There may be an accumulation of serum fluid beneath the abdominal skin, requiring prolonged drainage. All scars will be permanent, although they are expected to fade over time. Rarely, the scars will require revision involving a subsequent procedure if they have healed poorly, or additional contour-correction procedures (dog-ear excision or liposuction) may be required to achieve optimal results.
It is not possible to list or anticipate every conceivable complication. However, most risks can be lessened and managed by carefully following the recommendations and instructions provided to you by Dr. Cambre during your consultation. Dr. Cambre will address any of your personal questions or concerns at that time as well.
You will awaken gently from anesthesia in the recovery room, usually free of nausea or pain. Mild discomfort is usually well-controlled with pain medication. When you are fully awake, you will be ready for transfer to the aftercare facility, or to your home with a responsible adult caregiver. You will be encouraged to get out of bed for short walks to promote circulation and to facilitate deep breathing. Although you may not be able to stand up completely straight, it is best if you do not lie in bed or sit for long periods of time during the first several days. A mild amount of swelling and bruising is normal. You will also be required to wear a support garment or girdle, to limit swelling and fluid accumulation. You may be instructed to sleep on your back with a pillow under your knees. Dr. Cambre will see you in the office 24-48 hours after surgery. You will be given special instructions for showering and changing your dressings until the drains are removed, generally 7 to 10 days after surgery. Sutures are removed in stages over the period of 5 to 14 days.
The speed of recovery depends on your physical condition prior to surgery; those with stronger abdominal muscles usually recover faster. Straining, bending, and lifting must be avoided, since these activities might cause increased swelling, bleeding, or disruption of the surgical repair. Allow yourself at least 1 to 2 weeks to recuperate before returning to non-strenuous work; sexual activity should be avoided for a minimum of two weeks. Most patients may resume light to moderate exercise 3 to 4 weeks after surgery. You may experience prolonged numbness over portions of the abdominal area, which may persist for several months. The incisions may remain red or pink for many months following surgery before they finally begin to fade. It may take several weeks for all the swelling to subside to the point that the final results of your improved abdominal contour can be appreciated.
Though the recovery period may be somewhat longer than that of other cosmetic procedures, Abdominoplasty provides significant and lasting rewards for a patient previously distressed by a protruding, sagging abdomen. Although the incision lines are permanent, they will fade over time. The incisions generally are well hidden in natural skin folds, and are covered by most common undergarments and swim wear. Unless you gain or lose a significant amount of weight or become pregnant, your abdomen should remain firmer and flatter for many years.
Our patients after Abdominoplasty generally feel more confident about their appearance, both in and out of clothing. As an added benefit, most patients will have a greater variety of choices as to the types and styles of clothing they feel comfortable wearing, following Abdominoplasty. Our patients who follow a proper exercise routine and healthy diet, and who dedicate themselves to maintaining the results we achieve with surgery, will benefit the most from Abdominoplasty.
Q: Why are drains necessary?
A: Suction drains are used in combination with external pressure from an elastic abdominal binder or girdle, in order to evacuate the fluid (serum and blood) that commonly accumulates between the abdominal wall and the underside of the tightened abdominal skin and fat after the procedure. By eliminating the fluid build-up, the drains help the skin to re-attach to the abdominal wall.
Q: How long will my drains remain in place?
A: Drains (usually two) will remain in place until the daily volume of drainage decreases to a minimum, generally between 5 days and two weeks.
Q: When can I shower or bathe?
A: You may shower after the first office visit / dressing change, generally within 24-48 hours after surgery. You must not bathe or immerse the incisions or drain sites under water in a bathtub, hot tub, swimming pool, etc. until all drains have been removed and the incisions are completely healed. Dr. Cambre will instruct you when bathing is permitted.
Q: How long do I need to wear the binder or girdle?
A: The binder or girdle is used to diminish the amount of swelling and bruising in the abdominal area, especially after Liposuction in combination with Abdominoplasty. It also prevents accumulation of excess fluid (serum or blood) under the abdominal skin, and helps to maintain the contour of your new abdomen. It should be worn continuously, 24 hours a day, 7 days a week (except while showering) for the first 3-4 weeks. After that time, it can generally be used for support and comfort during the daytime only, for an additional 3 weeks.
Q: When can I resume exercise?
A: Patients are encouraged to begin walking immediately after surgery. You may resume more strenuous walking on a treadmill, or mild upper extremity weight training after 7-10 days. Most patients resume full, unrestricted exercise after approximately 4 weeks.
Q: When can I resume driving?
A: Most patients may resume driving after approximately 48-72 hours. You should not drive if you are taking narcotic pain medication, sedatives, or muscle relaxants.
Q: When can I return to work or normal social activities?
A: Most patients are able to return to work or resume normal social activities after 5 to 10 days. If your work involves sitting for extended periods, you are encouraged to take frequent breaks to stand and walk, in order to promote circulation and deep breathing. You will need to wear loose-fitting clothing which will hide the presence of your drains and abdominal binder or girdle, as long as these are necessary.
Q: What would happen if I become pregnant after Abdominoplasty?
A: Your skin and abdominal wall will stretch to accommodate your pregnancy. However, you may require an additional surgery to regain the improvement, if the skin becomes lax again.
Q: Does insurance ever pay for Abdominoplasty?
A: Abdominoplasty is usually considered a cosmetic procedure; therefore it is not covered by insurance. However, if significant spreading of the abdominal wall muscles or a hernia is present, a portion of the surgicenter and professional fees may be eligible for reimbursement.
Q: Is there a greater risk if I am a smoker?
A: Abdominoplasty patients who smoke have a much higher risk for loss of skin, delayed wound healing, infection, pneumonia, and blood clots in the leg veins which may result in pulmonary embolism and death. It is absolutely essential that you refrain from smoking for three weeks before and three weeks after surgery.
Q: Is there anything that can be done to improve the appearance of the scars?
A: Generally, the scars will fade nicely as time passes, and in many cases, no additional treatments are needed. If the scars become somewhat thick or red, Dr. Cambre may recommend treatment with silicone gel strips or liquid, or possibly laser treatment of the scars to lessen the redness. For this reason, your follow-up visits are important, so that the progress of your wound healing can be monitored.
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