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This skin redundancy is often due to child bearing or massive weight reduction (including bariatric surgery). An abdominoplasty (tummy tuck) is the removal of the excess skin and restoration of the abdominal contour.
Liposuction is an important part of the tummy tuck process and gives us the ability to fine tune the changes made in your shape. With a tummy tuck we can see the following improvements:
The main goal of a tummy tuck is to provide better contour. For some patients, a tummy tuck (abdominoplasty) can be accomplished with a standard length incision which goes from hip bone to hip bone. For other patients, an extended length incision may be required. This type of tummy tuck has a longer incision, extending past the hips. A tummy tuck with an extended incision is often recommended for patients who have excess skin beyond the abdomen going off toward the sides, but who do not need or want a 3/4 belt lipectomy or circumferential body lift. A patient with excess skin beyond the hips is a good candidate for an extended tummy tuck incision because a standard length incision would result in “dog ears” or excess skin sitting on the hips.
The tummy tuck procedure is performed at an accredited outpatient surgical center. You will be asleep under the care of a board certified anesthesiologist. A tummy tuck usually takes about 2.5 hours – 3.5 hours to complete. You are then transported to recovery, and then you are able to go home and sleep in your own bed or easy chair. You will need assistance for the first couple of days and you will need someone to drive you home.
At the beginning of the procedure, liposuction is used to thin the underlying fat and trim the waist line. The flanks (“love handles”) and area midline above the belly button are liposuctioned. An incision is then performed to remove the excess skin. The incision used goes from hip to hip, and generally falls under the underwear or panty line. In women, this scar is the same level as the horizontal c-section scar. Once the musculature is exposed, corrections of muscular separation or small hernias are repaired when necessary. The skin is tightened and re-draped, the belly button is preserved, and it may be re-shaped if necessary. Drains are placed to reduce swelling or fluid collections. These small tubes are temporary and are removed a week after surgery.
Tummy Tuck can often be combined with other procedures such as Breast Augmentation/Breast Lift (Mommy Makeover) or liposuction of additional areas
Superior Pain Management
Pain after surgery is a common concern with tummy tuck, and we have a protocol to manage this discomfort and speed recovery. We administer a long-acting numbing medication during the procedure that greatly improves the recovery process. This medicine makes the abdominal area numb for 72 hours. During this time frame, most patients rate their pain as a 2 or 3 out of 10. With this medication on board, activities of daily life are minimally restricted – walking, using the bathroom, and sleeping in bed are all possible. This injection is not an opiate, and does not cause constipation or inhibit your mental faculties.
Once the numbing medicine has dissipated, you are already three days out from surgery, and beyond the acute pain phase of recovery. Any discomfort at this point can be managed by cold compresses, ibuprofen, and if necessary, by prescription pain medications.
Scar Protocol
The main challenge in the long term recovery after tummy tuck is in dealing with the scar on your waist line. This extends from hip to hip, and can be raised and red/dark for up to a year. We have a scar protocol that works well to minimize this noticeable scar. As part of the treatment package we provide a three month supply of scar gel which is medically proven to fade scars quickly. Once the surgical adhesive comes off the incision at three weeks after surgery, we will begin treatment with scar gel. You will apply this to your incision twice daily for 3 months.
Surgical Safety
Safety is paramount in elective surgery, and as such all surgeries are performed in an accredited ambulatory surgery setting, under the care of board certified anesthesiologists and nurse anesthetists. The nursing staff have extensive knowledge regarding the care of aesthetic patients. Consequently, our patients can expect a premium experience of comfort, privacy, and top level nursing care.
The area in red is the portion of skin removed during a tummy tuck procedure. The areas in green indicate areas where subcutaneous fat can be safely removed via liposuction during abdominoplasty. A tummy tuck does not include liposuction of the back or liposuction of the bra line area. These are separate areas that can be added at your request. This entails a secondary charge due to the increase in operative time.
Liposuction of the flanks (love handles) and area midline above the belly button is included as part of the tummy tuck procedure. Liposuction can remove subcutaneous fat (just under the skin), but if you have visceral (intra-abdominal fat) below your stomach muscles and surrounding your internal organs, that cannot be removed via liposuction.
The only way to remove visceral fat is through diet and exercise. For this reason, it is recommended that patients are at their desired goal weight prior to this procedure.
For patients with excess visceral fat, the skin is tightened and abdominal contour is improved, but when viewed from the side the tummy will still appear to have some fullness due to the visceral fat.
Swelling from liposuction during a tummy tuck can last for 6 months post-op. If you have a small amount of fat in the mons pubis area, it can also be liposuctioned during a tummy tuck procedure, although it will be swollen and uncomfortable during the recovery period.
We will see you in clinic the day after your procedure for a binder and dressing change. We will give you a second abdominal compression garment so that you can wash one while wearing the other. We will also review comfort level and show you how to shower with the drains in place. Your drains will be removed between 4 and 8 days after your procedure. Most patients with a desk job can return to work a few days after drain removal. If your job includes a lot of reaching, stooping, lifting, or is in a contaminated setting such as a gym, day care, or hospital, we suggest you take 2-3 weeks off. After 6 weeks, you can expect to return to full activity without restriction. At your three week post op appointment we check your incision and initiate the scar gel protocol.
Circumferential body lift is a tummy tuck with an excision that goes all the way around the back. This is a great option for massive weight loss patients who have extra skin around the lower back. Due to the length of the incision, the incision may take longer to heal than an abdominoplasty incision. 3/4 belt lipectomy is another type of tummy tuck where the incision extends beyond the abdomen onto the back, but does not go all the way around the back. This can also be a good option for massive weight loss patients who have rolls of excess skin going onto the back, but do not need their back midline area treated.
Anyone with excess, loose skin on the abdomen that cannot be addressed by weight loss and exercise are candidates for the procedure. You should be at or near your optimal weight because tummy tuck is not weight loss surgery. This procedure is intended for people who have already optimized their health and shape through healthy eating and exercise habits who have been left with excess skin due to pregnancy, bariatric surgery, or other weight loss. Patients who are smokers, have diabetes, or other have underlying health issues are not candidates for this procedure due to health risks and potential wound healing issues.
A tummy tuck (abdominoplasty) costs $13000. A 3/4 belt lipectomy costs $17000 and a circumferential body lift costs $23000. Some patients require a complex repair which is in addition to the tummy tuck procedure (such as significant hernia repair, extensive scar tissue from prior procedures, or other complicating factors). We offer bundled pricing so the fee includes all facility charges at an accredited surgery center, general anesthesia, an injection of a long-acting numbing medication during the procedure, two abdominal compression garments, all followup appointments in clinic, and a tube of scar gel at three weeks post op. You will not receive a separate bill for facility or anesthesia fees. Pricing does not include preop clearance visits with your primary care provider, any required labs or imaging, medications prescribed to your pharmacy, any future surgical procedures or revisions, or specialized aftercare at other health care facilities including emergency care, wound healing clinics, or optional add-ons such as post-op lymphatic massage or custom compression garments.
An extended length incision is a tummy tuck with a longer incision, extending past the hips. This type of incision is recommended for patients who have excess skin beyond the abdomen, but who do not need or want a circumferential body lift or 3/4 belt lipectomy.
Yes. It is part of our standard protocol for abdominal sculpting.
Liposuction of the flanks (love handles) and area midline above the belly button is included as part of the tummy tuck procedure. Liposuction can remove subcutaneous fat (just under the skin), but if you have visceral fat (intra-abdominal fat that surrounds the organs) below your stomach muscles, that cannot be removed via liposuction. The only way to eliminate visceral fat is through diet and exercise. Performing a tummy tuck on a patient with a significant amount of visceral fat is a similar result to tightening sheets over a basketball: the excess skin and surface fat will be removed, but fat will remain below the muscles. When a tummy tuck is performed on a patient with very little visceral fat, the tummy tuck result is similar to tightening sheets on a bed.
Many patients do not require work to be done on the mons to achieve an excellent tummy tuck result, but some patients have additional fat in the mons pubis area. If it is a small amount of fat, this can be liposuctioned during the tummy tuck procedure, although a liposuctioned mons acts as a collection pocket for body fluid. The result is swelling that can take a couple months to resolve.
Tummy tuck is not a weight loss surgery. Individuals who are significantly overweight are not candidates. The surgery is intended for people who have optimized their health and shape though healthy dietary and exercise habits, and are left with unsightly excess skin and loose tissues unresponsive to the body’s natural recovery process.
Though it is possible to have more children after a tummy tuck, Dr Camp would advise you to hold off on having the surgery until you are certain that you are done adding to your family. The stretching of the abdomen due to pregnancy will widen the scar tissue and may result in lax skin requiring additional surgery.
No. If there is a hernia or separation of muscles this will be repaired during the procedure. However, if there is no abnormality in the abdominal muscle structure, sutures are not placed to tighten the abdomen. This spares the patient the discomfort of sutures in the musculature, and reduces the chance of deep vein thrombosis and pulmonary embolism.
At Echelon Surgical Specialists, we have a protocol to manage discomfort after tummy tuck surgery and speed recovery. During your procedure, a long acting numbing medication will be injected into the surgical site that will keep the area numb for about 72 hours. During this time frame, most patients rate their pain level around a 3 out of 10. With this medication helping to ease discomfort during the immediate recovery period, patients are able to walk around inside the house, use the bathroom, and sleep in bed. The slow release pain medication provides enough pain relief that many patients do not need to use oral pain medication at all or only need it sparingly during the recovery period. Patients with muscle separation or muscle wall weakness may experience more discomfort post operatively.
During your complimentary consultation, Dr Camp will review what you do for work and make a recommendation on how much time to take off depending on the nature of your work. For patients with a typical desk job, many will return to work approximately 8 days after the procedure once the drains have been removed. If you work in an environment prone to bacteria such as a gym, daycare, or nursing home Dr Camp will recommend taking more time off before returning to work. If your position includes heavy lifting, twisting, turning, or other physical activity, Dr Camp may recommend that you return to work with restrictions after taking 2 or 3 weeks off. Most patients are ready to return to full physical activity (including working out) by 6 weeks post-op.
No, a tummy tuck only addresses excess skin and fat on the abdomen. Some patients opt to add a thigh lift and/or liposuction of thighs as an additional procedure at the same time as an abdominoplasty or small areas of liposuction from the back. For patients concerned about rolls on the back, a better option may be a 3/4 belt lipectomy or circumferential body lift.