Tummy Tuck

A Tummy Tuck, also known as Abdominoplasty, is a surgical procedure which improves the contour and appearance of the abdomen by contouring or reshaping the underlying muscle framework, and removing excess fat and loose skin. Women and men who are in relatively good shape but have weak abdominal muscles and localized excess skin and fat make the best candidates for the tummy tuck procedure. It can be especially helpful for women who have had multiple pregnancies which stretched skin and muscles to the point that no other remedy can return them to normal. There are some other factors like age, obesity, skin tone and whether or not the patient smokes -- which can have an impact on the results of the surgery. These are just some of the topics that are discussed with the patient during the initial consultation. In some cases, these factors could have such a negative impact on the possible outcome that the patient would not be considered a good candidate for this elective procedure. The surgery, which is designed to improve the contour of the body by flattening the abdomen and narrowing the waist, is a major surgical procedure that is usually performed in our state of the art surgical facility under general anesthesia.

Consultation:

During your consultation, Dr. Brill will discuss with you each area of your abdomen which concerns you. He will explain specifically which of the components of abdominoplasty will be necessary to achieve the best contour and shape, and he will explain the type of changes you can expect. Dr. Brill takes the time during every pre-operative consultation to learn what his patients want to achieve from a tummy tuck both for their bodies and for their self-confidence. By listening to what patients have to say and closely examining them rather than performing a one-size-fits-all procedure on every person, we provide patients with completely customized treatment that takes into account their specific goals. He will evaluate your health, determine the extent of fat deposits in your abdomen, and assess your skin condition.

 

 

A Good Candidate:

 The best candidates for tummy tuck / abdominoplasty surgery are men and women in relatively good physical condition with pockets of fat or loose skin that haven’t responded well to diet and exercise. We can also help older, slightly obese people whose skin has lost some of its elasticity. Abdominoplasty can also be useful for women with stretched skin and muscles from pregnancy. Results from the tummy tuck procedure will likely diminish if women continue to bear children, so we advise patients who plan to become pregnant to delay abdominoplasty. We also encourage patients who intend to lose a lot of weight to wait before undergoing the procedure, since skin in the abdominal area typically loosens after substantial weight loss. Ideally the patient:

 

• Is close to their ideal body weight (within 30%)
• Has been at stable weight for 6 months or more
• Has good skin tone and elasticity
• Has realistic expectations and is emotionally stable
• Understands the risks of surgery
• Wants to remove specific areas of loose skin or fat that is diet and exercise-resistant

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 procedure is most suited to 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.

  

Procedure Details / Expectations:

The procedures are done on an outpatient basis. General anesthesia is usually used for safety and comfort.  Small suction tubes (cannulas) are inserted through very short incisions placed in inconspicuous locations near the fat deposits, and excess fat is removed.  The procedure takes approximately two to five hours and can be performed with general anesthesia or local anesthesia with a sedative.

Recovery time ranges from two weeks to a few months. With a balanced diet and regular exercise, results are long-lasting. Abdominoplasty will likely leave a permanent scar stretching between the hips, although it should be low enough for even a bikini to conceal it.

Abdominoplasty takes approximately two to five hours under general anesthesia. Dr. Brill will make two incisions: one from hipbone to hipbone close to the pubic area, and another around the navel. He will separate the skin from the abdominal muscles, which are then pulled together and stitched into place for a firmer abdomen and narrower waist. Dr. Brill will stretch the skin flap down and over the newly tightened muscles, remove excess skin, and reattach the navel in a natural position. Finally, he will close the incisions and apply sterile surgical dressings over the sutured areas.

The skin and fat are first lifted off the underlying musculature of the abdomen. Dr. Brill makes very precise measurements and markings before beginning any reshaping to most accurately control final shape. If the fascia is stretched (the tissues which interconnect the muscles), he will tighten it by placing multiple rows of sutures. In some cases, the muscles themselves may be repositioned for best correction. In essence, the underlying framework of the abdomen is reshaped. Dr. Brill places extra "shock-absorbing" layers of sutures to allow you to resume your normal activities much sooner without fear of disrupting the correction.

Next, excess fat is removed using suction or direct removal techniques. This reduces any-excess thickness in the soft tissue to get the best re draping over your new abdominal framework. The skin is then pulled downward to tighten it, and any excess tissue is removed below. Depending on the degree of looseness of skin and the amount which has to be removed, it may be necessary to reposition the umbilicus (belly button). In the vast majority of cases, Dr. Brill is able to re contour your abdomen without repositioning the umbilicus, preventing a scar around it.

Many factors can affect the contour of your abdomen. Childbirth can stretch abdominal tissues to an extent uncorrectable with exercise, excess fat deposits can produce undesirable bulges or fullness, and loose skin following childbirth or weight loss can result in an unattractive abdomen. During pregnancy, enlargement of your uterus causes significant stretching of the tissues of your abdomen. After delivery, you can exercise to recover the tone in the muscles themselves, but the fascia tissues which interconnect the muscles may have been stretched, and fascia does not respond to exercise. Stretching or looseness of the lower abdominal tissues can allow bulging of your lower abdomen which you may not be able to correct with exercise.

 

After significant weight loss, as fatty tissue is decreased beneath the skin of your abdomen, your abdominal skin may become much looser, and sometimes actually hang downward. Skin also does not respond to any type of exercise, but excess loose skin can be removed during abdominoplasty. Even in individuals who are not overweight, localized deposits of fat can occur in areas of the abdomen, producing undesirable contours. If fat deposits are the only contour problem, they may be correctable with suction lipoplasty alone, but if stretched musculature or loose skin are present, abdominoplasty is necessary to achieve the best contour.  Abdominoplasty does three things:

• It reshapes the underlying framework of the abdomen to improve shape and contour

• It removes excess fat deposits which may be present 
• It removes excess loose skin to improve the overall contour, appearance and shape of the abdomen.

Although the new shape of your body usually begins to emerge in the first few weeks, some swelling may remain for several months. Major weight gain or loss after an abdominoplasty can produce skin surface irregularities. The final result may not be clear until 6 months after surgery. 

 

 

Recovery:

Because a tummy tuck / abdominoplasty involves removal of the extra abdominal skin and (usually) tightening of the abdominal muscles, you will experience some difficulty standing up straight for a week or two or even longer. During this period, you may find it more comfortable to place a pillow or two under your knees while in bed. The tightness will gradually disappear as you heal and progressively use your body muscles for the activities of daily living. Please make no special attempts to stretch or pull the abdomen straight during the first 2-3 weeks of healing. You must change your position and walk around the house every few hours to reduce the danger of blood clots.

We place an elastic abdominal garment that acts a binder around your tummy after surgery, in some cases to provide some gentle pressure, to give you stability, and to reduce swelling. If it feels too tight or causes pain, take it off. We do not want the garment to interfere with circulation to the skin, which could cause blistering or skin loss! You may also remove it temporarily for laundering. Many patients wear the binder for several weeks after surgery and some choose to wear it for several months. Let your own comfort and the amount of swelling you experience guide you. We want you as comfortable as possible without swelling.

 

Dr. Brill will place drains into the surgical areas at the time of surgery and will bring them out through small incisions made in the pubic area. These drains evacuate the fluid that accumulates after surgery and enable you to heal faster. When the drain is first put in place, the bulb at the end of each tube will be compressed to create gentle suction. As the fluid collects in the bulb, it will expand. Secure the bulb of the drain to your clothing or the abdominal binder with a safety pin. Whenever the bulb fills or expands 50% or more, empty the bulb by opening the plug at the top and pouring out the contents. Do not attempt to remove the bulb from the tubing. Squeeze the bulb to recompress it, and put the plug back into the hole at the top in order to maintain the vacuum. A nurse will remove the drains anywhere from 5-10 days after surgery, when the fluid begins to turn a clear straw color and/or the amount of drainage diminishes. You may shower the day after your drains are removed. 

 

Tummy tucks are probably the most uncomfortable operation we perform. You will experience some pain for 10-20 days and will not feel like resuming sports or heavy exercise for at least 4 weeks. After the first week, you may resume moderate walks for as long as is tolerable. If your job keeps you sedentary, you may plan on returning to work in 7-14 days, with the understanding that you will still have discomfort with motion. Too much initial activity can prolong swelling. Your abdomen will feel tight for a month or longer. If you have had a muscle repair as well (the usual case), you will feel the most tightness down the center of your tummy where Dr. Brill has actually repaired your muscles. This hurts more than any other part of the procedure. Please discuss this with the nursing staff or Dr. Brill about any concerns. Here again, swelling may indicate too much activity. Do not plan on resuming aerobic or strenuous exercise for 4-6 weeks after surgery.

 

After surgery, you will wear a body-compression garment. You must wear this for several weeks. After surgery, you will need to make arrangements for a responsible adult to care for you for the first 24-48 hours. Bandages are changed in 1-2 days (drains and sutures removed within 5-10 days). Recovery from liposuction can be uncomfortable, but most people are back to work within 10-14 days. During the first few weeks most people experience varying degrees of pain, burning, swelling and temporary numbness. Pain medications can alleviate discomfort and a body-compression garment will minimize swelling. You will need to refrain from any exercise other than walking for about a week after the procedure. Slowly work your way back to your existing exercise routine giving yourself at least 2-4 weeks to regain your normal workout routine. Swelling will last from 2 weeks to 2 months or longer in some cases. Bruising will usually last 2 days to several weeks depending on procedure and healing time. Many people also experience numbness that can last only a few days to several months.

 

 Surgical scars are usually minimal and are permanent. However, usually only two small incisions (less than 1/4") are made for each area. Incisions are often placed in natural skin creases, are hidden in pubic hair, or inside the belly button so that they are not normally noticeable except on very close observation. Certain areas are easier to hide than others. To keep scar tissue soft and minimize their appearance, massage them and keep them out of the sun. Massage them with scar minimizing/reduction creams.

 

 All of your incisions will be carefully closed with stitches placed beneath the skin, so there's no chance of your having "railroad track" type marks but rather very fine line scars. You'll be able to shower or bathe within a few days. To minimize fluid collection and swelling and improve your comfort in the treated areas, we'll ask you to wear an elastic garment which we provide for two weeks or more after surgery, depending on the areas and extent of your procedure.

 

Following abdominoplasty procedures, most patients have mild to moderate discomfort the first 48-72 hours which decreases rapidly thereafter. The extent of discomfort depends largely on the extent of surgery required to reshape your abdomen. We'll pre-scribe medication for your discomfort as necessary.

 

Your abdomen will feel tighter as the result of its new, tighter shape. The feeling of tightness will decrease over 1-3 weeks as swelling decreases and the tissues become accustomed to their new shape. Bruising and swelling will resolve within 7-21 days. You can return to work in approximately 5-14 days depending on the extent of the procedure. A return to full aerobic or strenuous exercise can be achieved in 3-6 weeks.

 

It's important to be up and about the day following your procedure. How much activity we'll recommend depends on the specific procedure required to reshape your abdomen. You will be able to shower within two or three days following surgery, or sooner in some instances.

 

 

For faster Recovery:

        Drink adequate amounts of liquids to prevent dehydration.

        Avoid alcoholic beverages for 48 hours before and after surgery.

        Wear compression garments as suggested to prevent slow healing and excessive
         drainage.

        Do NOT apply hydrogen peroxide or plastic Band-Aids to incision sites.

        Do NOT soak in a bath, Jacuzzi, swimming pool, or the ocean for at least 7 days after
         surgery in order to minimize the risk of infection.

        Reduce your risk of fainting at home by: standing up slowly after urinating, remove
         compression garments slowly, have assistance for your first shower and sit down if
         you feel dizzy or lightheaded.

Other Options

Mini Tummy Tuck vs. Full Tummy Tuck:

A mini tummy tuck, or partial abdominoplasty, may be recommended by Dr. Brill for patients that are within 10% of their ideal body weight. This procedure is less invasive, has a quicker recovery time, and is performed in our Surgery Center on an outpatient basis. While a full tummy tuck involves an incision around the navel and across the lower abdomen, a mini tummy tuck leaves the navel intact and requires a smaller incision.

Liposuction is sometimes employed and the fat is removed from below the navel, tightening muscles from the navel to the pubis. If your abdominal muscles require more extensive tightening and your body weight is more than 20% above your ideal weight a full abdominoplasty may by recommended. This frequently is performed with liposuction to obtain the best results.

 

Tummy Tuck vs. Liposuction of the Abdomen:

If you have excess abdominal fat, no stretch marks and fairly good skin tone, you are a good candidate for liposuction. If you have stretch marks, loose skin and a loose inner girdle (all more likely after pregnancy), a tummy tuck is probably your best choice.

 

 

 

Cost / Insurance:

 

This procedure is considered cosmetic and therefore not covered by insurance.

Approximate Cost Range: $5,000-$20,000. This price is only an average as fees vary according to patient needs. At your consultation, you will be given exact fees, which include but are not limited to surgery, operating room, anesthesia related fees, and follow up visits.

 

** This is only an Average. Fees vary according to patient needs.**

 

 

Risks / Complications:

Though rare, post-operative complications from surgery are possible. They may include infection, blood clots, and poor healing, which may require further surgery. Patients who have had previous abdominal surgery should know that their old scars could be raised, stretched or generally more noticeable after the procedure. A scar revision procedure after abdominoplasty may minimize the appearance of an unsightly scar.

The specific risks and the suitability of this procedure for a given individual can be determined at the time of consultation. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally. Major complications are rare. Risks common to all surgical procedures such as bleeding, fluid collections, infection and scar tissue formation occur in a very small percentage of cases. We will give you more detailed information about these and other rare risks in our written information, and encourage you to discuss any which concern you during your consultation.

 

Limitations and risks associated with Abdominoplasty are very small. We want to provide you the best information so that you'll be well informed in making your decision. Current written informational material contains more details, and we'll discuss all possible risks which may concern you during your consultation.

 

How much your abdomen can be reshaped depends on several factors. The quality of your tissues is very important, and a factor over which we have little control.

 

If you are significantly overweight, you'll get a much better correction if you achieve a more ideal weight before your Abdominoplasty. There is a limit to the amount of fat which can be safely removed surgically during the procedure.

 

To reshape the underlying musculofascial framework and remove excess skin, incisions are necessary. Incisions are placed low on the abdomen, and their length depends on the amount of correction you require. In some cases, it is necessary to reposition or reshape your umbilicus (belly button). Dr. Brill will discuss the specifics of incisions during your consultation.

 

Any necessary incisions will produce scars.  The quality of these scars depends on several factors including your specific healing characteristics.  You should think of scars as a trade-off for significant improvement in the shape of your abdomen.

 

Abdominoplasty cannot change the underlying skeleton and is limited in how much actual muscles can be reshaped.  Dr. Brill will discuss any specific limitations during your consultation.

 

*Notes:*

You are at increased risk for complications from a tummy tuck if you have diabetes, poor circulation, heart, lung or liver disease, smoke, have a family history of blood clots, take certain medications, etc. You will need to discuss your medical history thoroughly with Dr. Brill before you choose to undergo surgery.

 

 

If you are ready to explore your options, please call: 

352-331-7987 or 1-800-428-8419

 

The specific risks and the suitability of this procedure for a given individual can be determined only at the time of consultation. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally. Major complications are unusual.

 

The information on this web site is only intended as an introduction to this procedure and should not be used to determine whether you will have the procedure performed nor as a guarantee of the result.  The best method of determining your options is to consult with Dr. Brill to answer specific questions related to your situation.  View our Web policy