What is Abdominoplasty?
Abdominoplasty, also known as a tummy tuck, removes excess skin and fat, as well as restore weakened or separated abdominal muscles. Factors that often contribute to these issues include aging, pregnancy, genetics, prior surgeries, and significant weight fluctuations. A tummy tuck results in a flatter abdomen that is proportionate with your body type.
Am I a good candidate for abdominoplasty?
Candidates for abdominoplasty surgery in Boston and Worcester, Massachusetts are healthy men or women who are unhappy with the appearance of their abdomen. It is important that patients are at a stable weight, are non-smokers, and have realistic expectations for the outcome of their surgery. Furthermore, patients should be aware that a tummy tuck should not be used as a primary weight loss solution. A consultation with Dr. Hall can help you decide if a tummy tuck is right for you or if you might benefit from a different procedure.
Abdominoplasty – Patient 169
A mother of 2 in her late 40’s who lost 40 lbs following her pregnancies and is bothered by excess skin and bulging of her abdomen. She is shown just before and again, 5 months after an extended abdominoplasty. Her umbilicus is brought back to the midline while repairing her diastasis and bulging of the abdominal muscles by means of a “plumbline” suture. EXPAREL was used to limit her need for narcotics after surgery. She is just back from a cruise, where she was able to wear a bikini, and loves the new appearance of her stomach.
Abdominoplasty – Patient 168
A mother of 3 in her early 50’s who is bothered by bulging and rolls of the abdomen> She has had previous laparoscopic gallbladder surgery. She is 5’6 and 146 lbs. Her photos are shown before and again, 11 months after surgery. Her case is made more challenging by a higher position of her umbilicus. In a normal abdominoplasty when the skin is elevated up to the rib cage and then pulled down like a window-shade and removed, the skin that was around the umbilicus is completed removed and falls below the abdominoplasty scar. But in this case, when the abdominal skin is elevated and pulled down like a window shade, the slit of the scar from around the umbilicus sits higher and is closed as a small vertical ( up and down) scar, allowing the abdominoplasty scar to stay low, in a “thong” position where it is hidden by most clothing styles. An alternative procedure when the umbilicus is high is an umbilical “float” where the umbilicus is detached at its base and pulled down slightly lower-but this does not work as well when the upper abdominal skin is also loose because the “sheet” of skin is not able to be pulled as tight.
In cases such as here, it is better to keep the abdominoplasty scar in the “thong” position where it is low enough to be hidden by yoga pants and bikini bottoms, and accept a small vertical slit scar that shows, rather than putting the entire scar higher where it cannot be hidden.
Abdominoplasty – Patient 167
A mother of 3 ( including twins) in her early 40’s who is bothered by bulging and loose skin of her abdomen. She would like to be comfortable wearing fitted clothing. She is 4’10” and 124 lbs and is shown before and again, 11 months after an extended abdominoplasty. She has severe stretching of the abdominal wall from her pregnancies and her umbilicus is deviated to her right. An attempt was made to bring it closer to the midline with differential tightening of the muscle wall. She has had an excellent correction of her abdominal contour and loves being able to wear fitted clothes and t shirts now. The fat has been sculpted in the abdomen to give her a midline groove and a hollow around the umbilicus. Her scar has been placed in a thong position.
Abdominoplasty – Patient 166
A mother of 2 in her early 40’s who is bothered by the appearance of her stomach. She was especially concerned about the scar placement and wanted to make sure that it would be placed in a thong position where it would be hidden by most clothing styles. She is shown before and again, 1 year after an extended abdominoplasty. EXPAREL was used during surgery to decrease her need for narcotics after surgery. Progressive Tension Sutures were placed at the time of surgery to decrease the risk of seroma. Her scar placement is 6.5 cm from the vaginal fornix to keep the scar low, in a “ thong” position. Tattoos have been blurred for her privacy. Nearly 5 lbs of skin were removed with the extended abdominoplasty.
Abdominoplasty – Patient 165
A mother of 2 in her late 50’s who is bothered by bulging of her abdomen in clothing. She felt that her left side bulged more and on exam was noted to had an inguinal hernia on that side. She has had 2 C-sections. Her umbilicus is relatively high and in her case we “floated” the umbilicus by pulling it down lower, avoiding a scar around the umbilicus and a midline scar from the umbilical slit in the lower abdomen. She is shown before and again, more than 3 years after her extended abdominoplasty with floating of the umbilicus. Her inguinal hernia was repaired by General Surgery at the same time. Her scar is placed low in a “thong” position where it is hidden by most clothing styles.
Discussion: Floating of the umbilicus is a technique that I find useful in patients with a relatively high umbilicus that do not have much looseness in the upper stomach and wish to avoid a scar around the umbilicus and a vertical slit scar in the lower abdomen. The umbilicus is detached at its base and brought down lower, instead of cutting around the top of the umbilicus and popping it back up through in the new position. It does not “pull the sheet tight” in the upper abdomen as much as with a traditional technique but can work well in some cases as shown here. Liposuction was used to form a midline groove above the umbilicus. The abdominal muscles are still tightened and bring in the waist and correct the muscle bulge. Her incision is “extended” to allow better tightening of the sides and has higher tension placed on the sides to better shape the stomach.
How is an abdominoplasty performed?
How your abdominoplasty procedure is performed will depend on your specific needs and body concerns. Patients choosing to undergo abdominoplasty surgery have the choice of intravenous sedation and general anesthesia, and Dr. Hall will recommend which choice is best for you. During the surgery, Dr. Hall creates a horizontal incision between the belly button and the public hairline, where a bikini can easily cover. The skin is then lifted, and the weakened abdominal muscles will be tightened. Depending on how much excess skin is being removed, a second incision around the naval may be necessary. Skin on the upper abdomen is pulled down, and a new opening for the belly button is created. Incisions will be closed with sutures, tapes, or skin adhesives.
What should I expect during recovery?
During abdominoplasty recovery, dressings are applied to incision sites and a compression garment may be worn to minimize swelling and provide support. Small tubes may also be inserted to drain any excess blood or fluids. You can expect to be assisted with walking as soon as the next day to prevent the formation of blood clots, however, you should be resting for the first week or two after surgery. After your procedure, you will likely experience some swelling and discomfort. Dr. Hall can provide you with prescription medication to manage your pain and make your recovery more comfortable. You will also have some activity restrictions in the first few months. You should avoid strenuous activity or movement such as bending at the waist, that might strain the incision site. Dr. Hall will provide you with specific instructions about your recovery and activity restrictions.
The result of your abdominoplasty can be distorted due to swelling in the first few weeks, however as swelling diminishes you will begin to notice your results and can enjoy a toned abdominal area. Abdominoplasty results are permanent, although substantial fluctuations in weight can greatly diminish these results. Patients who are planning on losing a substantial amount of weight or future pregnancies are advised to delay tummy tuck surgery.
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