Tummy Tuck #101: What you should know

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Dear Dr. Lemaine, at our family picnic this past Memorial Day, my aunt announced that she was going to have “tummy tuck surgery.” What is that?

Tummy tuck surgery is a cosmetic surgery that involves removal of excess skin and fat in your abdomen, and, in most cases, tightening of weakened or separated abdominal muscles (that famous “six pack”). The medical name of the procedure is “abdominoplasty.”

After the abdomen has been stretched, it is more likely to protrude. This protrusion is caused by the loss of elasticity of the skin, excess skin, and stretching of your abdominal muscles.

With tummy tuck surgery, your abdomen will look firmer, flatter, and smoother. Tummy tuck surgery is not the same as liposuction. Liposuction removes flab or excess fat only. It does not take care of excess skin. You may choose to get liposuction along with a tummy tuck.

Who should consider surgery?

A tummy tuck is suitable for men and women who are in good health. Good candidates are those who have lost a lot of weight and still carry excess fat and loose skin around the belly. Also, women who have been pregnant may want a tummy tuck to get rid of the loose skin and to tighten their abdominal muscles.

A tummy tuck isn’t the right surgery for you if:

  • You plan to lose a lot of weight. A tummy tuck is not a substitute for weight loss and a healthy lifestyle that includes regular exercise. It should be done as a last resort after you have tried regular exercise and weight control.
  • You plan to get pregnant. It is advisable to postpone your surgery until after you’re done having children.
  • You are a smoker. Smoking increases your risk of complications and slows healing. If you smoke, your plastic surgeon will recommend that you stop smoking before your surgery and during your recovery.
  • You have major health problems. If you have health conditions, such as heart disease, irritable bowel syndrome, or diabetes, tummy tuck surgery may not be safe for you.

Also, note that health insurance generally does not cover cosmetic surgery that is performed without a medical reason.

How a tummy tuck is done

During a tummy tuck, your plastic surgeon will cut your stomach skin — from hip bone to hip bone — to remove excess skin and fat from your abdomen. If you previously had a C-section, your plastic surgeon might be able to incorporate that scar into your tummy tuck scar. If you have stretch marks below your belly button, there is a good chance that those stretch marks will be removed with surgery.

In most cases, the abdominal muscles are then tightened with sutures during surgery. The remaining skin is then repositioned to create a more toned look. Your belly button will also be moved during surgery.

After surgery, your plastic surgeon will recommend how long you will stay in the hospital. In some cases, it is possible to go home the day of surgery. You will need ice packs and to wear loose, comfortable clothing that is easy to put on and take off.

What can you expect after surgery?

Your abdomen will be swollen and tender. Your plastic surgeon will prescribe pain medication. You will also wear special dressings on your scars, and a compression garment.

You may have a surgical drain coming out of your abdomen. If your abdomen feels tight, you should sleep in a beach chair position, with pillows under your knees. You will have to limit physical activity for at least six weeks after surgery. You may need to take up to one month off work, depending on the type of work you do.

Surgery risks

In addition to the standard risks of surgery, for example, the risks associated with general anesthesia, your plastic surgeon should discuss other risks associated with tummy tuck surgery, such as:

•     Infection

•     Bleeding

•     Wound healing problems, including slow healing and loss of skin

•     Numbness

•     Fluid accumulation beneath the skin (also known as “seroma”)

•     Scarring

•     Loss or malposition of the belly button

•     Blood clots

By removing excess skin and fat, and tightening your abdominal muscles, a tummy tuck can improve the appearance of your abdomen. Results are usually long lasting as long as you maintain a stable weight after surgery.

If you are considering tummy tuck surgery to improve the appearance of your abdomen, you should meet with a skilled board-certified plastic surgeon.

Submitted photo Dr. Valerie Lemaine, M.D., M.P.H.

Dr. Valerie Lemaine, M.D., M.P.H., is a board-certified plastic surgeon in private practice in Edina, MN. She received her M.D. from the University of Montreal, Canada, and her M.P.H. from Columbia University, NY, USA. She also completed a reconstructive microsurgical fellowship at Memorial Sloan-Kettering Cancer Center in New York City. Dr. Lemaine then accepted a staff position at the prestigious Mayo Clinic, where she taught, practiced, and published clinical research until 2018 and now has a clinical practice in Edina, MN. Dr. Lemaine can be reached at PlasticSurgeryConsultants.net.