Tummy Tuck (Abdominoplasty)
Abdominoplasty, often called a “tummy tuck”, is a very popular cosmetic surgery performed in the United States. Tummy tucks help flatten and sculpt the abdomen, shape the waistline, and improve the three dimensional contour of the trunk by removing excess skin, thinning the fatty deposits, and tightening muscles. Pregnancy and weight loss are common precursors to an abdominoplasty. Dr. Trussler offers multiple abdominoplasty techniques which can be applied to whatever type of abdominal contouring complaint you have.
What Are My Options?
Abdominal contouring addresses areas of excess skin, deposits of fat, and central muscle laxity called a diastasis recti. Dr. Trussler will listen to your goals of the procedure and identify areas of concern on the abdomen and waistline to formulate an individualized abdominoplasty plan that suits you. There are multiple types of abdominoplasty techniques which mainly depend on the amount and region of excess skin.
Endoscopic Abdominoplasty is a minimally invasive technique using two small incisions to tighten central muscle laxity to flatten and shape the abdomen. Only a small amount of skin is removed, usually at a previous C-section scar.
Mini-Abdominoplasty is designed for the patient with only lower abdominal skin laxity. The procedure is performed through a lower abdominal incision to remove excess skin below the umbilicus (belly button) and tighten the central abdominal muscles.
Full Abdominoplasty is a contouring procedure which will address upper and lower skin excess, as well as fatty deposits along the waistline and muscle laxity. The procedure is performed through a lower abdominal incision to remove excess skin above and below the umbilicus (belly button) and tighten the central abdominal muscles. Liposuction is commonly applied to help sculpt the abdomen.
Extended Abdominoplasty is a powerful abdominal, outer thigh and buttock contouring procedure which will lift and shape the buttocks and outer thighs, as well as address upper and lower abdominal skin excess and muscle laxity. The procedure is performed through a circumferential lower waistline incision to remove excess skin and lift the buttocks, shape the outer thighs and contour the abdomen. Liposuction is commonly applied to help sculpt the abdomen and thighs. This procedure can deliver dramatic three dimensional trunk contouring.
The best candidates for all types of abdominoplasty surgery are healthy, in good physical condition with areas of fat and/or loose skin that have not responded well to diet and exercise. Abdominal contouring is common in women who have had children and those patients who have lost a significant amount of weight. Ideally women should consider abdominoplasty after they finished having children, because carrying a baby can reverse the effects of an abdominoplasty on the abdominal wall. Post-baraitric surgery patients should be at a stable weight for over 6 months prior to considering abdominal contouring procedures.
Other considerations in abdominal contouring surgery are the presence of pre-existing scars and the presence of hernias. The most common scar encountered in abdominoplasty is a C-section, which is usually removed with the procedure, however upper abdominal scars and umbilical scars may make an abdominoplasty have a higher risk of healing issues. Hernias are defects or holes in the abdominal wall which are commonly located at the belly button, or may be a complication of previous surgery. Small hernias can be repaired at the time of an abdominoplasty.
Not every patient is a candidate for every type of abdominoplasty that Dr. Trussler offers, though during the consultation process the right tummy tuck for you will hopefully meet your expectations. It is recommended that women still planning to have children postpone this procedure, as pregnancy and nursing can stretch the abdomen. A tummy tuck does not negate the need to continue with a healthy lifestyle with a good diet and regular exercise. Weight gain after abdominal contouring can effect the contour of the waistline and the long term results of the procedure. Most undergarments and swim suits will cover the abdominoplasty scar which is placed very low, and can even be marked at an expected location during your pre-operative visit.
Abdominoplasty takes approximately two to five hours under general anesthesia depending on what procedure is performed and the extent of excess skin, fat, and abdominal muscle laxity. There are numerous types of tummy tucks performed by Dr. Trussler and the choice does relate to the location and amount of the excess skin.
Endoscopic Abdominoplasty uses an endoscope which is a long narrow camera with two long instruments to tighten and repair the abdominal muscles. Dr. Trussler does this through a umbilical incision and a lower abdominal incision, usually a C-section scar if present. The diastasis is repaired with two layers of permanent stitches. A drain may be used in this procedure.
Mini-Abdominoplasty is appropriate for the woman with excess skin below the belly button only. The abdominal muscles are typically tightened with this procedure without the need for moving the belly button. The incision for this procedure is typically longer than a C-section scar.
Full Abdominoplasty is designed to recontour the entire abdomen and can tighten skin above and below the belly button. The abdominal muscle is typically tightened and the belly button is repositioned. The incision is kept in a very low position though typically extends to the hips.
Extended Abdominoplasty is designed for the patient with excess, lax skin in the abdomen and outer hip region. The incision is commonly made circumferentially in the lower waistline to lift and contour the buttocks, hips and abdomen.
In all of these procedures, the specific areas of skin laxity is corrected and the underlying abdominal muscle is tightened to help flatten the abdomen and tighten the waistline. Liposuction may be added to help decrease fat deposits to help thin and sculpt these stubborn areas. Dr. Trussler closes all incisions with deeper supporting stitches and then aligns the scars with stitches under the skin. Drains are usually placed in each of these procedures to help collect fluid that accumulates after these operations. The torso is flexed in these procedures to decrease tension on the healing skin. A compression garment is placed at the conclusion of the operation to hold the contour in place and avoid collections of fluid.
After Care & Recovery
After any type of abdominoplasty procedure, patients will likely experience mild soreness and swelling for a few days. Dr. Trussler advises at least a one night stay in the aftercare unit to encourage early ambulation and make the first night after the surgery comfortable. Mothers have two or more people to worry about at home, but in the first week after an abdominoplasty it is important to have enough help at home so moms can focus on their own healing and recovery.
- Dr. Trussler does make it easy to recover after an abdominoplasty by limiting the amount of care need on the incisions and surgical areas for the first week.
- In general, the waist is kept in a flexed position, and a compressive garment is kept on the abdomen and thighs.
- After the first week, drains and stitches are removed and the abdominal compression garments are downsized.
Most patients will be able to return to caring for their children, work and light exercise within two weeks, although vigorous exercise and other strenuous activity should be avoided for about a month. Heavy lifting greater than 30 lbs is limited for 6 weeks. Dr. Trussler will provide you with specific instructions for your individual recovery.
The results of a tummy tuck are visible immediately after surgery and will continue to improve as swelling subsides and scars fade. The body shape will evolve over a three month period. Scar treatment will be initiated at the 3 week visit and may be continued for 3 to 6 months after the operation, or until the scars soften and fade.
- Hatef, DA, Trussler, AP, Kenkel, JM. Procedural Risk for Venous Thromboembolism in Abdominal Contouring Surgery: A Systematic Review of the Literature. Plast Reconstr Surg. 2010 Jan;125(1):352-362.
- Trussler AP, Kurkjian TJ, Hatef DA, Farkas JP, Rohrich RJ. Refinements in Abdominoplasty: A Critical Outcomes Analysis over a 20-year Period. Plast Reconstr Surg. 2010 Sep; 126(3):1063-1074.
Whether you have a question or would like to setup an abdominoplasty consultation, Dr. Trussler and his staff are here to help. Please fill out our contact form, or call our office at 512-450-1077 to schedule an appointment. Start your journey to not only looking, but feeling better today!