Abdominoplasty, known more commonly as a
'tummy tuck,' is a major surgical procedure to remove excess skin and
fat from the middle and lower abdomen and to tighten the muscles of the
abdominal wall. The procedure can dramatically reduce the appearance of
a protruding abdomen. But bear in mind, it does produce a permanent
scar, which, depending on the extent of the original problem and the
surgery required to correct it, can extend from hip to hip.
The best candidates for abdominoplasty are
men or women who are in relatively good shape but are bothered by a
large fat deposit or loose abdominal skin that won't respond to diet or
exercise. The surgery is particularly helpful to women who, through
multiple pregnancies, have stretched their abdominal muscles and skin
beyond the point where they can return to normal. Loss of skin
elasticity in older patients, which frequently occurs with slight
obesity, can also be improved.
Patients who intend
to lose a lot of weight should postpone the surgery. Also, women who
plan future pregnancies should wait, as vertical muscles in the abdomen
that are tightened during surgery can separate again during pregnancy.
If you smoke, plan to
quit at least one to two weeks before your surgery and not to resume for
at least two weeks after your surgery. Avoid overexposure to the sun
before surgery, especially to your abdomen, and do not go on a stringent
diet, as both can inhibit your ability to heal. If you develop a cold or
infection of any kind, your surgery will probably be postponed.
The surgery is performed in a
hospital and the patient stays overnight, I prefer general anesthesia.
Complete abdominoplasty usually takes two to five hours, depending on
the extent of work required. Partial abdominoplasty may take an hour or
A long incision is
made from hipbone to hipbone, just above the pubic area. A second
incision is made to free the navel from surrounding tissue. With partial
abdominoplasty, the incision is much shorter and the navel may not be
moved, although it may be pulled into an unnatural shape as the skin is
tightened and stitched.
Next, the skin is separated from the
abdominal wall all the way up to your ribs and lifts a large skin flap
to reveal the vertical muscles in your abdomen. These muscles are
tightened by pulling them close together and stitching them into their
new position. This provides a firmer abdominal wall and narrows the
The skin flap is then stretched down and the
extra skin is removed. A new hole is cut for your navel, which is then
stitched in place. Finally, the incisions will be stitched, dressings
will be applied, and a temporary tube may be inserted to drain excess
fluid from the surgical site.
For the first few days, your abdomen will
probably be swollen and you're likely to feel some pain and discomfort
which can be controlled by medication. Some people return to work after
two weeks, while others take three or four weeks to rest and recuperate.
Your scars may actually appear to worsen
during the first three to six months as they heal, but this is normal.
Expect it to take nine months to a year before your scars flatten out
and lighten in color. While they'll never disappear completely,
abdominal scars will not show under most clothing, even under a bathing
You must stay 2 weeks
after surgery in Costa Rica
. I recommend the Las Cumbres Inn
where you will receive personal attention, required medication and
transportation to and from surgery. I visit my patients at Las Cumbres
frequently following surgery to check on your recovery.
Thousands of abdominoplasties are performed
successfully each year. Nevertheless, there are always risks associated
with surgery and specific complications associated with this procedure.
Postoperative complications such as
infection and blood clots are rare, but can occur. Infection can be
treated with drainage and antibiotics, but will prolong your hospital
stay. You can minimize the risk of blood clots by moving around as soon
after the surgery as possible.
Poor healing, which results in conspicuous
scars, may necessitate a second operation. Smokers should be advised to
stop, as smoking may increase the risk of complications and delay