What is an 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 in Austin, Texas, which can be applied to whatever type of abdominal contouring complaint you have.
What Are My Tummy Tuck 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.
What To Consider Before A Tummy Tuck
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-bariatric 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 maybe a complication of previous surgery. Small hernias can be repaired at the time of an abdominoplasty.
What Can I Expect From 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 affect the contour of the waistline and the long-term results of the procedure. Most undergarments and swimsuits 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 durable 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 are 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.
What Is Recovery From A Tummy Tuck Like?
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.
*Disclaimer: Results and individual patient experience may vary.
Frequently Asked Tummy Tuck Questions
Some of Dr. Trussler’s patients wonder if a tummy tuck or liposuction would be the better procedure. The deciding factor is skin laxity and sagging. If only lower fat deposits are present, liposuction would be an acceptable choice. Once the skin has been stretched to a degree of damage caused by pregnancy or serious weight gain, it often cannot tighten back down to its former contour when the weight is gone. And this can’t be rectified with exercises.
A tummy tuck or abdominoplasty addresses multiple common complaints of the trunk including excess or lax skin, muscle separation or a Diastasis Recti, and localized fatty deposits. Liposuction alone, no matter what technology applied cannot replace the effects of a tummy tuck for skin laxity and muscle separation. Dr. Trussler has championed a more modern abdominoplasty technique utilizing liposuction as a tool in all abdominoplasty called a lipo-abdominoplasty which safely helps to contour the abdomen while discontinuously releasing the skin while maintaining nerves and blood supply. Dr. Trussler does perform multiple different tummy tuck techniques depending on the extent and distribution of skin laxity.
Abdominoplasty with Dr. Trussler is performed with general anesthesia and is major surgery, there are inherent risks of surgery including bleeding under the skin called a hematoma, fluid collections called seromas and infections. DVT and PE (blood clots) are the most serious and can happen in less than one percent that is why early ambulation after surgery, risk stratification, and the selective use of blood thinners are all recommended. Scar care, compression and radial pulse sound wave treatments are all used to optimize results and limit hypertrophic scarring and contour irregularities.
The cost of a tummy tuck varies depending on your unique situation. That is because, while one patient may only need a mini tummy tuck, another may need an extended tuck to fully address the sagging skin. During your consultation, once Dr. Trussler can ascertain your needs, we can give you a good idea of what your surgery will cost.
Stretch marks are signs of permanent skin damage and commonly occur in the areas addressed with a tummy tuck. This damaged skin is removed and or repositioned though flank and thigh stretch marks may not be completely removed.
These are lengthy incisions, and there will be some pain during recovery. Dr. Trussler will provide prescription pain medication and you’ll need it at least for the first week. After your first week, things should improve quickly. It will be important for you not to push your recovery by lifting heavier objects than you should or exercising harder than we’ve discussed. These can impact your incision and slow your healing
You won’t be able to stand up straight for a while. That’s because Dr. Trussler has created multiple layers of sutures holding your tightened abdomen in its new configuration. Because your skin is pulled taut, it will feel tight. You’ll be bent over for the first week or two until the skin begins to relax.
You’ll prepare as you would for any surgery by stopping taking any blood thinners, anti-inflammatory medications, and most supplements for one week prior to your surgery. If you smoke, you’ll need to stop for at least two weeks prior to and after your surgery, as smoking impedes wound healing.
Most of your preparation should really be aimed at your recovery. Due to the long incision Dr. Trussler makes in these surgeries, patients have an involved recovery where they need to really lay low. These are major surgeries on the abdominal area, and the odds are Dr. Trussler will need to bring your separated abdominal muscles back to the center and re-anchor them.
Bottom line? You will need to rest for at least two weeks. For extended tummy tucks this may even be longer. To prepare, you’ll want to create a comfy recovery nest, filled with pillows, blankets, and lots of entertainment options. You’ll need to arrange help around the house, as you won’t be able to lift more than just a couple pounds. Any lifting of more weight or strenuous exercise will need to wait for at least six weeks, so you need to plan for that.
You’ll be able to see the changes made with this procedure immediately, although they will be somewhat masked initially with your bandages and then with compression garments. You will have swelling, but you’ll see the difference in your stomach immediately. As your recovery progresses, your skin and support tissues will continue to tighten down over your slimmer contour.
Tummy tucks create a long incision scar — it’s unavoidable. But Dr. Trussler descends the incision running from hipbone to hipbone so that it can be hidden beneath a bikini bottom or underwear. Dr. Trussler is a double board-certified plastic surgery (in General Surgery and Plastic Surgery). He works to ensure your incision heals as cleanly and evenly as possible. If you don’t place stress on your incision during your recovery, the scar will begin to quickly fade. It will be there, but its appearance will diminish with time.
Tummy tucks do not need to be stand-alone procedures. Dr. Trussler performs tummy tucks as part of his mommy makeover procedures, along with a breast lift (with or without augmentation) and liposuction. Mommy makeovers group the three surgeries into a single surgical session. Our patients like the combination of procedures, as they address the issues that have changed in their bodies as the result of pregnancy, childbirth, and breastfeeding.
Liposuction is often a part of most tummy tuck procedures, but it can be extended to the thighs and buttocks when combined with a tummy tuck. Thigh lifts and butt lifts can extend the contour improvements to these areas, as well.
If you’re interested in combining procedures into a single surgical session, discuss your goals with Dr. Trussler during your consultation. He can give you a good idea of what is possible and what could be too much.
These changes made by Dr. Trussler are permanent. The excess skin he removes will not be back if a patient maintains their healthy lifestyle. When the separated stomach muscles are re-aligned back together with a diastasis repair, it’s not likely they will ever separate again. It is important to note that core strengthening is a vital part of the abdominoplasty which begins at 6 weeks. Your contour will be slimmer and defined after 3 months of core work. If you maintain a healthy weight and incorporate exercise into your life, you’ll be pleased with your tummy tuck for the rest of your life. You may develop some slight sagging as you age, but it will be nothing like you had before your surgery.
Whether you have a question or would like to set up a abdominoplasty consultation in Austin, Texas, 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 better, but feeling better today!
- 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.