Tummy Tuck

Like you every woman wants a flat and firm tummy, and a beautiful shaped silhouette but pregnancies and weight gains or losses take a toll on a woman’s figure. Fat can get concentrated in the belly of both men and women. The belly becomes loose and out of shape because the abdominal muscles are weakened and stretched apart and the skin becomes flaccid.

Now you can get rid of that extra fat and skin, protruding belly and weak muscles and whatever else that bothers you. A tummy tuck can help you. If your buttock has dropped or if you have significant mobility and flaccidity of skin in your thighs the thigh and buttock lifts can help.

There are several popular approaches and since every person is different each procedure is tailored to your specific needs.

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Before and After Photos

Types of Procedures

The operation is performed in our office surgical suite or at the hospital under general anesthesia. If you smoke, you must quit at least 6 weeks before and for 6 weeks after surgery. You must also stop taking certain medications, vitamins and herbal supplements than can cause bleeding.

The following are treatment options and keep in mind that tummy tucks are sometimes combined with liposuction and lifts in single or multistage planned procedures.

Liposuction with Skin Excision of the Abdomen

Liposuction with simple removal of lower skin is indicated for those persons with excess fat especially if a previous C-section was performed.

Mini-Abdominoplasty

Mini-abdominoplasty helps those women with a problem limited to their lower belly. If you are displeased with the bulge in your lower belly especially when seating and you have moderate excess of skin and fat then you are a candidate for this procedure. The incision is much smaller and is placed horizontally over the pubic hair (“Victoria’s Secret” type) or sometimes it is shaped as an inverted U completely hidden within the pubis (“Venus” type). The scar is usually inconspicuous. The belly button (the umbilicus) remains untouched at its present location, but the abdominal muscles below it are tightened and the excess skin and fat are removed.

Abdominoplasty ( traditional or classical )

The classical abdominoplasty is reserved for those patients with significant skin and fat both above and below the belly button who also have very weak muscles which have widened and are apart. Frequently these patients have poor elasticity of the skin, which can easily be grabbed with the hand and unfortunately surgery will not correct this inelastic skin problem. The surgery is much more extensive then the mini-abdominoplasty as elevation of the skin is continued up to the rib cage and the entire rectus abdominal muscles are tightened from the sternum (center bone of the rib cage) all the way to the pubic bone. A new belly button is recreated. Currently the scar is designed as a W or bicycle handle, fashionably called a French cut, as it extends slightly above the hips. It is usually hidden easily by swimwear or other clothing.

High Lateral Tension Abdominoplasty

This procedure is designed to tighten the lateral aspects of the abdomen and outer thigh. Although the resultant scar is somewhat longer it places the highest tension laterally allowing excessive skin removal and lifting over the hip and thigh in addition to providing the results of the classical abdominoplasty. This procedure, in the ideal candidate, offers a more natural and pleasing feminine shape.

Medial Thigh Lift, Lower Body/Circumferential Lift and Upper Trunk Lift, Buttock Lift and Brachioplasty

These procedures tighten and lift the skin in the upper arms, upper trunk, medial thigh and lateral thigh or hip and buttock areas and are often combined with liposuction and tummy tucks. Candidates are patients who have either:

• generalized skin excess and flaccidity (looseness) in the upper arms, medial and lateral thighs and/or buttocks after massive weight loss or bariatric surgery or
• generous amounts of fat deposits in the upper arms, trunk, thighs and buttocks. In this case the lift procedure is often done after first liposuctioning the bulk of the fat (it generally requires two stages although occasionally it can be combined in a single procedure).

The scar in the medial thigh lift is placed in the inner thigh fold, while in (the transverse thigh and buttock lift the scar continues as a high bikini line from a tummy tuck. Sometimes only the combination of liposuction and lifting with or without a tummy tuck creates the desired body figure and achieves results superior than either technique alone; but remember these procedures are not designed to correct obesity. All these procedures are associated with longer healing times and a higher risk of complications than a tummy tuck alone. In medial thigh lifts and in brachioplasty some risks can be minimized by staging one arm or thigh a few weeks to months apart from the other. The scar in the brachioplasty is placed low in the front of the arm at the junction of the biceps and triceps muscles and starts at the armpit and then continues until stopping 2-3 inches above the elbow. Additional risks of the brachioplasty procedure are a thick and visible scar. In some cases a smaller incision can be made which is partially hidden because it is placed in the armpit (short scar or mini-brachioplasty). This mini-brachioplasty is often performed and combined with liposuction to avoid the traditional brachioplasty procedure. The ideal patient is one who has moderate skin excess in the proximal third of the arm and good skin tone. For additional information please also see the Arm Lift page.

Bariatric Surgery or Massive Weight Loss (MWL) Surgery

Obesity has now been designated a disease. Aesthetic Surgery following a bariatric procedure or MWL is a unique field because it involves both reconstructive as well as cosmetic components. Both the bariatric surgery and subsequent cosmetic surgery for the MLW patient is challenging and is only the last stop of a long and arduous journey. Aesthetic surgery can only be contemplated after your weight has stabilized for at least the previous 3 months and a minimum of 12 months have passed following bariatric surgery, but 18 months is preferable. Generally you can divide patients in 2 categories: the first group is composed of those persons who decided to change their lifestyle and could no longer tolerate to be obese. This group is well motivated and determined, most likely will have realistic expectations from their aesthetic surgery and ultimately will continue to do well in life; the second group is composed of those persons who were pressured to undergo bariatric surgery by their doctors, coworkers or family members. This group is at a higher risk to regain their lost weight and less motivated to lead a healthy lifestyle. However, all MWL patients are to be commended because of the tremendous accomplishment they were able to achieve in transforming their body. It is worth remembering that obesity is a complex condition, and lifestyle change is very difficult. Aesthetic Surgery is associated with a higher risk of complications and to manage them successfully it is mandatory that a good support system be in place forehand as well choosing a surgeon who is compassionate and caring to enhance their surgical experience. Multiple stages are usually required with multiple procedures performed in a single stage and a lengthy informal consultation is a must to establish a successful physician-patient relationship and formulate a realistic plan.

Postoperative Period

You will experience swelling and a feeling of tightness, which will create some pain and discomfort which can be controlled with medications. You will also be fitted with an abdominal binder type garment to reduce swelling and hasten healing and you need to wear it faithfully day and night for several weeks especially if you also had at the same time liposuction. In the latter case the special garment covers your thighs and knees as well. It is very important that you limit your activities for the first few days but we encourage walking as this prevents the formation of blood clots in your lower legs. Avoid staying in bed or sitting too long and any active or strenuous activities. I have found over the years that patients a week or two after their surgery have a tendency to over do their activities at home resulting in delayed healing. It is normal for you to have prolonged swelling over the incision. This will disappear with time but at a different rate, since we are all not alike. However, in some patients this persistent swelling or a scar which appears too high may require a touch-up. Wearing the garment will definitively help in reducing this swelling. Depending on how you heal and the type of work you do you may be able to return to work after a 10 days, but it may take several weeks to feel yourself again. Again strenuous exercise should be avoided for a few weeks but very moderate exercise is helpful in healing. If you are in top physical condition with strong abdominal muscles your recovery will be much faster. Remember that to safeguard the result you have achieved, you are urged to avoid excessive weight gain or loss and begin an exercise program if you never exercised before. Dieting, Exercising and Body Contouring Surgery are all different approaches and no single modality is going to work all the time. Therefore we advocate a combination of liposuction /tummy-tuck/body lifts, sensible eating and a maintainable exercise program and if you need it we make referrals to specialists, dieticians and body trainers to address your bad habits.

Cost

Your total cost will vary a lot depending on which procedures you are interested and whether multiple procedures are combined at the same time. For a tummy tuck  the cost starts at $5,580.  If you are undergoing multiple procedures the other ones are discounted (ex.  when combined with a breast lift). Also your cost will be influenced whether the procedure is performed in our accredited in-office surgical center or in the hospital.  We can only provide an exact quote at the time of your consultation but the quote will be all inclusive of anesthesia, surgeon’s fee and operating room costs. The only exclusion is any required lab work-up. Also remember that inexpensive surgery may be unsafe and result in a substandard procedure.

Photographs

For your convenience you may view a few selected cases in our Tummy Tuck Before & After photo gallery. To see our extensive photographic catalogues of pre-operative and post-operative photographs please contact our office and schedule a complimentary consultation.