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Is a Tummy Tuck for Me?

Posted 4/18/2013

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Now that the warm weather is here we are finally being released from the frozen bonds of winter.  It's time to get outside to run, bike, and swim.  It’s also time to shed our winter clothes and their wonderful ability to disguise our winter dietary indiscretions.  The transition from the warm cozy confines of long johns and winter parkas to the revealing snugness of a bikini or spandex can be a shock.  Not surprisingly this is a common time of the year for me to see patients interested in changes in their body contour.  The term ‘body contouring’ is a very general term applied to a set of cosmetic and reconstructive surgical procedures.  These include, but are not limited to, tummy tucks, breast lifts, thigh and arm lifts and liposuction. 

Every consultation for body contouring begins with an assessment of the patient’s general health, their expectations and of course an assessment of the anatomy.  I always focus on steps that the patient can take that may solve the problem with little or no surgical intervention.  Though not always welcome advice, diet and exercise can fix many of the problems that I am presented with.   The decision to move ahead with body contouring surgery should be a last resort not a starting place.  Cultivating good dietary and exercise habits may not only eliminate the need for surgery they will contribute to lasting results and improved health if and when surgery is performed.

Despite a patient's best efforts to shed pounds and tighten muscle, circumstances do exist that may require surgery if correction is desired.  For the purposes of this article I will focus on abdominal contouring.  The two key factors associated with the appearance of the abdomen are the amount of fat present and the amount and quality of the skin present.  To a lesser extent, the integrity of the underlying abdominal wall musculature is relevant.  Due to the endless cycle of weight gain and loss or due to pregnancy, the abdominal region is subject to incredible force.  This often results in stretching of the skin in this region.  Skin stretching may simply increase the amount of skin present or cause tearing of the dermal layers underneath the skin with resulting stretch mark formation.  This excessive skin with or without stretch marks may persist after maximum dietary and exercise efforts to eliminate it.  In these circumstances a tummy tuck may be indicated. 

Abdominoplasty, or 'tummy tuck' is extremely successful in shaping the abdomen and eliminated unwanted skin and stretch marks.  To a lesser extent, tummy tucks can remove excess fat in the abdominal region.  Occasionally performed in conjunction with liposuction in the flank region, tummy tuck remains one of the most commonly performed abdominal contouring procedures. 

There are two main types of tummy tucks the 'full abdominoplasty' and the 'mini-abdominoplasty'.  The first is by far the most common.  This procedure involves removing tissue from above the belly button all the way to the lower abdominal region.  Most women fall into this category because of the pattern of stretch marks or the location of the excess skin/fat.  The mini tuck is reserved for those special cases where the skin excess, stretch marks or fat excess exists beneath the belly button and in the central, lower abdomen.  The benefit of the mini tuck is a shorter scar and less surgical time.  During either procedure, if widening of the abdominal wall musculature exists (rectus diastasis), sutures can be used to tighten these.

Surgical procedure times are quite short, in the 1-1.5 hour range.  Typically this is performed under general anesthesia in a hospital or a surgery center.  Overnight stays are recommended but not necessary.  The recovery time is about 4-6 weeks during which time some type of abdominal binder is necessary to keep compression on the abdomen.  The risks of this surgery are generally very few but do include anesthesia risks and blood clots.  The resulting scar is usually well tolerated and low enough to be concealed by most swimsuits and underwear.

Tummy tucks are reserved for those cases where despite maximum effort, excess skin or unsightly stretch marks remain on the abdomen.  It is a short, safe, well tolerated procedure with minimal downtime.  It remains one of the most common plastic surgery procedures performed for these reasons and due to the high level of patient satisfaction.  Additional details regarding cost, and the specifics of surgery based on specific anatomic considerations, can be given at the time of consultation.  

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