About the Procedure
In most patients the skin from just above the pubic hair to the belly button can be removed. Any scars or stretchmarks below the belly button will also be removed. Although the fat beneath the loose skin of the lower abdomen is also removed, the best results are in women who are not overweight. Thin patients can expect a completely flat stomach with very firm abdominal muscles and a better waistline. I recommend that patients try to lose down to their ideal body weight to maximize the amount of skin that can be removed which results in a much flatter stomach. Many patients often find it difficult to lose weight prior to undergoing abdominoplasty. Although this does not eliminate them as candidates for the procedure, their result is not as good as in thin patients. Frequently these patients use the improvement in the contouring of their abdomen as an incentive to lose weight, making their final result even better.

Abdominoplasty or Liposuction?
Many women have both an excess of fat and skin in the lower abdomen. Liposuction alone will help decrease the amount of fat of the lower abdomen but the redundant loose skin will still be present. These patients would be better served with an abdominoplasty. Liposuction can be performed in conjunction with abdominoplasty to remove fat adjacent to the abdomen. However, liposuction of the upper abdomen should be undertaken with caution to prevent compromise in circulation to the remaining abdominal skin. Patients with minimal skin redundancy and excess fat would be better candidates for liposuction only as a slight amount of skin tightening can be expected.

Recovery
Postoperatively, patients see an immediate improvement in the contouring of their abdomen with the resolution of most swelling in 2-3 weeks. Some chronic swelling just above the scar can be expected for 3-4 months and it is recommended that a compression garment be worn during this time to eliminate all swelling. Most patients can return to normal daily activities and work in about 2 weeks. However, if muscle tightening is performed no heavy lifting or abdominal exercises are allowed for 6 weeks.

Pain Pumps
Most of the discomfort following abdominoplasty is in the first 3 or 4 days. I recommend the use of a postoperative pain pump. ON-Q pumps help control post-op pain without narcotic side effects. The pumps last for 3 days and allow patients to recover with less oral medication.

To learn more about ON-Q pain pumps visit: www.askyoursurgeon.com

Complications
Scarring – Scars are just above the pubic hair, frequently in the same location as previous C-section or hysterectomy scars, but extend from the right hip bone to the left. These scars may be asymmetric with one side being higher than the other. They typically are red, raised and sensitive for several weeks before they begin to soften and fade. Most scars continue to improve for 1-2 years and end up being flat, white scars but typically wide scars. Incisions can be placed inside the panty line so that resultant scars can be hidden.

Necrosis – Patients who smoke or who have scars on the upper abdomen from previous surgery are at increased risk for problems with circulation to the abdominal skin. This could result in skin loss and open wounds which could take several weeks to heal.

Seroma Formation – About 40% of patients will develop a collection of body fluid, or seroma, beneath the abdominal skin after the drainage tubes are removed in 4-5 days. This usually causes no discomfort and will resolve in a few weeks without the need for drainage.

Infection – Less than 1% in healthy patients. Preoperative antibiotics are routinely given.

For more information about Abdominoplasty, before and after pictures, and to view a Tummy Tuck procedure in 3D, visit the American Society of Plastic Surgeons website by clicking here.