Abdominoplasty (Tummy Tuck)

If you've reached your ideal body weight through diet and exercise but you still have an excess of skin and fat in your abdominal area that will not reduce, we'd like to recommend lipo-abdominoplasty or as it's usually known, a "tummy tuck.

There are many ways this extra skin and fat stays around the abdominal area, and no amount of diet or exercise will eliminate it:

  • • Multiple pregnancy
  • • Loss of elasticity in the skin
  • • Sudden, extreme weight loss


After tummy tuck of the abdomen and waist to sculpt the body, a shallow incision is made in the skin. The length of the incision is dependent on the extent of the area of the damaged skin. Then, we bring your abdominal muscles closer together and affix them in place. Finally, we remove excess skin, stretch the skin back down and make a new spot for your navel. There is a single drain in place in the middle of the incision to prevent any fluid collecting under the incision. This drain is removed after 5 days. Due to the minimally invasive nature of the lipo-abdominoplasty procedure, all of our patients go home the same day. Within 2 weeks, all of your stitches will be able to be removed and you can get started on the healing process. Normal activity such as work or school can be resumed within 12-14 days. Exercise can begin after 4 weeks.

What is a Tummy Tuck?

The tummy tuck is a procedure that will remove excess fat and skin and tighten underlying muscles in the abdomen. It also gets rid of loose or wrinkled skin and stretch marks. Both women and men can benefit from this extremely effective body contouring surgery.  Pregnancy, weight gain, and weight loss have a devastating impact on a woman's abdomen. Only rarely can diet and exercise fully restore the abdominal wall to its flat desirable shape after the skin and muscles have been stretched to their limit. After losing weight, men can also have difficulties regaining their youthful flat abdomen.

Liposuction is ideal for contouring the abdomen for those who have good skin tone and excess fat that are resistant to diet and exercise, but the tummy tuck is a better procedure for women and men who have loose abdominal skin following pregnancy and weight loss.


Types of Tummy Tuck

Abdominal wall deformities have 3 components:

•  Wrinkly or loose skin with stretch marks is usually the result of pregnancy, aging or marked weight loss;

•  Excess fat tissue, usually more prominent in the lower abdomen;

•  Rectus Muscle Diastasis: the muscles of the anterior abdominal have separated. Exercise does not help in this situation (once the muscle relaxes, they separate and the tummy bulges out.)

Full Tummy Tuck

A full tummy tuck, or abdominoplasty, addresses the three defective components (skin, fat, and muscle) so it benefits most patients who want a flat stomach and skin as tight as possible. Results, especially when combined with liposuction of the flanks, are dramatic. The procedure can be done totally under local anesthesia (tumescent technique), twilight anesthesia, or general anesthesia, depending on individual patient preference and needs. A relatively long incision in the bikini line just above the pubic area is made. A second incision is made around the belly button. The skin and fat as a unit are separated from the abdominal wall and lifted up the rib cage exposing the rectus muscles’ fascia (the sheath that covers the muscles and works as an inner girdle).

The fascia is then sutured in order to tighten loose or stretched out muscles located below the fascia. This step creates a tighter abdominal all and a thinner waist. The skin is stretched down and the excess skin and fat are removed. A new opening is cut on the skin for the repositioning of the belly button. Usually drains are inserted to eliminate fluid and blood buildup. Every effort is made to hide the scars in the bikini area. The incision is then closed, and a firm dressing is then placed on the abdomen. Liposuction to remove excess fat from hips and flanks are often performed in conjunction with the tummy tuck for a better body contour.

Mini Tummy Tuck

A mini tummy tuck or partial abdominoplasty is best suited for patients who have a pouch below the belly button who do not have significant stretch marks, saggy skin, or a hooded belly button. The procedure is less invasive than a full tummy tuck. While a full tummy tuck involves an incision around the belly button and across the lower abdomen, a mini tummy tuck leaves the belly button intact and requires a smaller incision. The excess of skin and fat are removed and tightening of the muscles is performed. Liposuction is frequently employed with this procedure to remove excess fat above and below the belly button to enhance body contour.

Dermolipectomy

A dermolipectomy is a procedure that removes skin and fat from the abdomen but does not tighten the muscles. It is indicated for slender women who have wrinkly or excess skin but good muscle tone. The scar is the same as a tummy tuck.

Limitations of a Tummy Tuck

The tummy tuck procedure will not remove stretch marks of your mid or upper abdomen (but it will shift them lower on your abdomen). There will be a scar extending across the lowest part of your abdomen, just above the bikini line. Also, there will be a second scar around your belly button, if the belly button requires transposition. Underwear or a swimming suit commonly hides these scars. The scars may worsen during the first 3 to 6 months as they heal, but this is normal. It takes approximately 9 months to a year before scars flatten out and lighten in color. Regardless, you are most likely to look and feel better with a flat abdomen and scars than you are with a budging belly. Serious complications after tummy tuck surgery are uncommon. However, there are risks with any surgery and specific complications associated with this procedure.

The ideal candidate for tummy tuck surgery should meet most of the following criteria:

• is close to their ideal body weight (within 30%)

• wants to remove specific areas of loose skin or fat that are diet and exercise resistant

• Weight has been stable for 6 months or more

• has good skin tone and elasticity

• is emotionally stable

• understands the risks of abdominoplasty surgery and scarring

If you do not meet all of these criteria, but meet some of them, you may still be a good candidate for a tummy tuck. The traditional tummy tuck procedure is most suited for those who are close to their ideal body weight, but if you have a lot of fat in an isolated area, you may still be a good candidate.

If you intend to lose a lot of weight, wait until after your weight loss to schedule abdominoplasty. If you plan on future pregnancies, you should wait to have surgery until you are done having children as pregnancy will stretch the abdomen again.

You are at increased risk for complications if you have diabetes, poor circulation, heart, lung, or liver disease, smoke, have a family history of blood clots, take certain medications, or if you are obese. If you have one or more of these conditions, you probably should not have an abdominoplasty procedure.

Additional Information

Anesthesia: Totally under Local tumescent anesthesia, twilight anesthesia, general anesthesia
Length of Surgery: 3-4 hours
Pain level: Moderate, 5-7 days of pain medication
Numbness: 3 months or more
Bandages: removed in 5-7 days
Drains: If used: removed in 5 days
Stitches: We usually close the incision with absorbable sutures placed under the skin
Work: Return to desk job often in 10 days
Exercise: May be resumed in 4 weeks
Final result: Evident after the scar heals 2-3 months

Our Technique for a Safe Office Tummy Tuck Under Local Anesthesia

The Abdominoplasty Procedure

The traditional abdominoplasty procedures (full tummy tuck, mini-tummy tuck and dermolipectomy) are associated with a relatively high complication rate because of the required large undermining of the anterior abdominal flap and subsequent extensive trauma and compromise to the blood supply of the abdominal flap. General anesthesia or heavy twilight sedation is frequently required to the complete the surgery because of the extensive tissue dissection and manipulation.

We have adopted a revolutionary minimally invasive approach to tummy tuck that can be safely and effectively perform as an office procedure totally under local tumescent anesthesia. The technique, called Abdominolipoplasty, combines two procedures: liposuction of the abdomen and the tummy tuck. By avoiding the use of general anesthesia or heavy sedation (and complications associated with this type of anesthesia) this new procedure offers an improved postoperative recovery.

In the past, traditional teaching held that performing abdominal liposuction at the same time of tummy tuck would further disrupt the blood supply, creating a significantly greater risk of necrosis of the inferior end of the flap.

Recent studies have clearly demonstrated that such a belief was erroneous. It is well established now that when one performs limited liposuction, the blood vessels remain intact and functional even though the fat is removed. The removal of the fat by liposuction leaves essentially an empty space eliminating the need to undermine. Because the skin overlying this empty space remains extremely mobile, we can remove as much skin, or more, as with standard tummy tuck without the danger of losing blood supply.

The management of the belly button is identical in both procedures. The skin incisions and the amount of skin removed are also similar. Tightening of the muscles also can be performed with either procedure. However, with the technique used by Dr. Gagliardi, the amount of fat one can remove is greater, thereby improving abdominal contour by thinning the fat layer considerably more than one can with the traditional tummy tuck.  This also decreases the risks of skin necrosis because the blood supply remains intact. Our approach doesn't require the routine use of suction drains - a standard requirement in traditional tummy tuck. Performing the procedure totally under local tumescent anesthesia adds additional benefits over the traditional tummy tuck.

•  Minimal bleeding due to the vasoconstriction created by the tumescent anesthesia. Traditional tummy tuck can be associated with profuse bleeding and even the need for blood transfusions and requires meticulous hemostasis throughout the procedure using electrocautery (which by itself creates blood vessel and tissue heat damage).

•  The operating time is significantly reduced because no bleeding is involved.

•  The technique eliminates puckers of skin on either end of the scar (dog ears) because liposuction allows the creation of similar fat thickness in the superior and inferior borders of the flap.

•  The postoperative period is similar as in the standard liposuction of the abdomen. The patient is able to stand up from the operating table, ambulate and dress herself/himself at the end of the procedure. This recovery is virtually unheard of with a standard tummy tuck under general anesthesia or heavy sedation. Due to its long lasting effects, tumescent anesthesia offers a minimum of 12 hours pain control following the surgery.

  1. • In our hands the abdominoplasty totally under local tumescent anesthesia without undermining results in a shorter a more aesthetic looking scar when compared with the scar from traditional tummy tuck.

  2. • This new approach creates a more youthful abdominal silhouette and more harmonious results while avoiding complications and the prolonged recovery time associated with the traditional tummy tuck.

 

 

Ageless Body Sculpting
1565 North Main Street
Fall River, MA 02720
Tel 877-324-3537
Tel508-646-6727
Fax508-646-7119

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