What is a Tummy Tuck or Abdominoplasty?
What are the components of a tummy tuck?
There are three key steps:
1. The elimination of excess skin.
2. Repair of muscle weakness (diastasis recti).
3. Creation of an innie bellybutton.
We have great educational videos on the repair of a diastasis recti and the creation of an innie bellybutton. So make sure to check those out.
Now, for the elimination of excess skin: we have two components.
1. The vertical distance- defines as the distance from the top of your belly button to your pubic region.
2. The horizontal distance- that distance is variable. It can be as small as a few inches up to a wrap around incision. It all depends on the degree of skin redundancy that you have.
I always try to make the smallest incision possible to yield the best results.
Tummy Tuck Options
There are several options when it comes to tummy tucks!
The options really depend on the degree of midline muscle weakness (diastasis recti) present, and the location of excess skin (upper vs lower abdomen, vs both). We covered diastasis recti in a different video - so make sure you check that out!
If you have significant diastasis recti, or have excess skin of both your upper and lower abdomen, you’re a great candidate for a traditional tummy tuck (or traditional abdominoplasty). The procedure will correct the midline muscle weakness, eliminate the skin redundancy, and create a beautiful, new innie belly button.
On the other hand, if the only issue is loose skin between the lower aspect of your belly button and your pubic region, you’ll be a great candidate for a mini tummy tuck (or mini abdominoplasty)! This procedure involves the removal of excess skin of the lower abdomen!
Incision lengths were covered in a different video, so make sure to check that out as well!
What’s The Difference Between A Mini vs Full Tummy Tuck?
The word “mini” can be a little deceiving.
The incision lengths of mini and full tummy tucks are often the same- although this may vary from patient to patient.
The difference here is that a full tummy tuck addresses a midline muscle weakness, also known as a diastasis recti. In addition, a full tummy tuck also involves the creation of a new innie belly button whereas a mini tuck does not.
Recovery times are far shorter with a mini tummy tuck. The key is to determine which procedure suits you the most.
At the time of your consultation, always make sure to go over your incision length, as well as whether or not you need a midline muscle repair (diastasis recti repair, muscle plication).
What Do I Expect On The Day Of My Tummy Tuck Surgery?
And, What's The Recovery Process?
We start off by introducing you to our amazing team!
Shortly thereafter, we begin our pre-operative markings. This is one of of the most important steps to any successful surgery. It becomes a roadmap for the operation!
Once completed, we circumferentially prep your body with an antiseptic solution. This is designed to help minimize your risk of an infection, and kill off any bacteria that naturally lives on your skin. Two of the most commonly used solutions include Betadine and Chlorhexidine.
Several safety monitoring devices and tools will then be utilized, and the Anesthesiologist will administer medications for you to go to sleep. The planned procedure then ensues!
As for the recovery period: prior to your date of surgery, we would have decided on your need for an aftercare facility! The role of an aftercare is to ensure your safety post-operatively. The facility employs nurses which help monitor your hemodynamic status, make sure you are comfortable, and allow for an easy transition home. Stays are typically 24 hours, or the night of surgery.
After your surgery, I HIGHLY encourage ambulation, albeit slowly. I want you to walk around the house, as tolerated - including the day of surgery - to help prevent the development of blood clots.
All of my tummy tuck patients will have two drains placed. This is to help collect fluid that may build up and to prevent the development of a seroma. They typically stay in for 7-14 days.
Recovery Timeline After Tummy Tuck
Recovery times vary from patient to patient!
But on average, most patients are able to return to work at or around 2 weeks- without heavy lifting or strenuous activities! Remember- at the 2 week mark, your drains are also removed!
At 6 weeks, you essentially have no restrictions as 80% of your wound healing is complete.
At 3 months, you begin to see a major difference as the majority of the swelling subsides.
At 6 months, your body has 90% of healing complete.
The 1 year mark marks your new baseline!
Will I need an Incision For My Cosmetic Surgery Procedure?
One of my most frequently asked questions is, “Do I need an incision?”
I wish the answer was simple!
It all depends on 4 key factors:
1. Adiposity (or, fat) amount and its location
2. Skin redundancy and laxity
3. Age- younger versus older patient
4. Previous procedures- previous liposculpting, coolsculpting, botched surgery, etc
Patients with increased adiposity, skin redundancy and laxity, older age, and history of previous procedures are at higher likelihood of incision need.
How Do We Address The Skin?
In a different video, we went over how my liposculpting is different- the use of VASER assistance!
We left off on the two pathways that emerge after liposculpting is complete (in addressing the skin): skin removal via excision versus skin tightening using Renuvion J-Plasma or BodyTite.
The determining factor of whether you’re a candidate for an incision versus tightening is the degree of skin redundancy and laxity that you have at the start of the procedure.
For example, if you have a significant amount of loose skin and fat at the level of your belly button and below (also known as a pannus), liposuctioning the fatty tissue will result in additional loose skin, and hang. In that circumstance, you would be a great candidate for an incision to address the skin redundancy.
How long the incision will be and where the incision will be placed are both covered in different videos!
Now, if you don’t have a lot of loose skin at the start of the procedure, and we encounter skin laxity intra-operatively as a consequence of liposuctioning, you’re a great candidate for skin tightening - either through the use of Renuvion J Plasma or BodyTite.
This minimally invasive technique is performed through the same small poke holes used for the liposuctioning procedure, and will give you about 30-50% skin tightening!
What’s a Mommy Makeover?
What's a Mommy Makeover?
It’s a surgery that involves both an abdominal and breast procedure!
For the abdominal portion- this includes a mini tummy tuck, full tummy tuck (most common), or a pubic skin excision.
For the breast portion- this includes a breast augmentation (saline, silicone, or fat transfer) or breast lift (with or without an augmentation).
At the time of your consultation, we can assess your goals and determine your candidacy!
The Interplay Between Tummy Tucks and Pregnancy.
The best time to get a tummy tuck is after you are done having children. The reason is because a tummy tuck involves the plication (or tightening) of your midline muscles- and it’s best to have that done after bearing children.
Can you have children after having a tummy tuck procedure?
However, pregnancy may result in repeat weakening of your abdominal musculature, and additional loose skin.
If you’re planning to have a child after a tummy tuck procedure, be sure to let your surgeon know. I usually tell my patients to wait a year following surgery, if they can.
What’s a Daddy Makeover?
The first thing that needs to be addressed is - where’s the problem area?
Your abdominal fat can be broadly categorized into two categories:
ABOVE and BELOW the abdominal muscles.
The fat that is below your abdominal rectus muscles is termed, visceral fat. That’s the fat that surrounds your organ systems. Unfortunately, that fat, or adiposity, CANNOT be addressed with liposculpting. Instead, diet, exercise and bio-identical hormone therapy are the only methods that can address the visceral adiposity.
Now, if your abdominal adiposity is located above the abdominal rectus muscles, this is termed as subcutaneous fat- or simply put, fat under the skin (and above the muscles). This fat CAN be subjected to liposculpting and/or excision!
If you have a midline abdominal muscle weakness (known as a diastasis recti), you may be a candidate for a full tummy tuck (traditional abdominoplasty) procedure.
If not, and depending on your BMI (body mass index), you may be a great candidate for abdominal etching with VASER assisted liposuction and J Plasma skin tightening to showcase your muscles!
How Long Will My Incision Be?
The short answer is- as long as it needs to be to give you the absolute best result!
The goal is always to make the smallest surgical incision, in a place that can be well hidden. At the end of the day, we want things to be as natural as possible.
The best way to determine your incision length, and location, is to have a thorough physical examination by your surgeon.
I always try to give my patients a visual representation of their planned incision length on their body during their consultation.
What’s The Proper Placement Of An Incision?
For once, the answer is simple:
One that is well hidden!
For example, if you’re undergoing a tummy tuck, I want your incision placed within your bikini or boxer line. If you’re undergoing liposuction- I want your incisions in natural skin folds or creases. If you need drains- they should be placed in areas that will ultimately be hidden.
The key is to make you look at as natural as possible. One thing that I often do for my patients is show them where their planned incisions will be during their consultation. When you see your surgeon, make sure to ask them to map the incisions out for you!
What is a Diastasis Recti?
It’s a separation of the large midline abdominal muscles!
This commonly happens after pregnancy, or significant weight gain/loss.
As the abdomen stretches to accompany a baby or excessive intra-abdominal (visceral) fat, the muscles stretch thin, and weaken at the midline. Once the baby is delivered or excessive weight is lost, the muscles continue to have an inherent laxity/weakness, or central bulging.
To test whether or not you have a component of a diastasis recti, stand in front of a mirror. Now, let your belly out by relaxing the muscles. Then, suck in as hard as you can.
Do you see a significant difference?
If the answer is yes, you may have a diastasis recti.
I fix this during my signature high definition tummy tucks (abdominoplasties)- it’s permanent and helps “snatch” (pull in) the waist line. You’re new baseline will be similar to you always sucking in your belly!
At the time of your consultation, we can assess your goals and determine whether or not you have a diastasis recti!
What’s An Innie Belly Button?
Before we get into that- let’s take a step back.
What’s the telltale sign that someone has had a tummy tuck?
The belly button!
It’s an area that’s really hard to cover up if you’re wearing a two piece bikini or swimming trunks!
The key to a beautiful belly button is to make sure that’s it’s natural: an innie, proportional to your body, centered, and beautiful shape.
This is also the time where you want to be evaluated for an “umbilical hernia” (aka, belly button hernia). Should you have one, this would be the time to repair it!
Drainless Tummy Tuck
Recently, there has been a lot of buzz over drainless tummy tucks.
However, I do not recommend them!
With a tummy tuck procedure, there is significant undermining (separation) of the abdominal tissues (skin and fat) from the underlying muscles (rectus muscles). This is done so that the midline muscle weakness (diastasis recti) can be repaired.
During the immediate recovery period, your body tries to fill this potential space space with fluid, since it’s hasn’t reattached yet.
The purpose of the drains are to remove and collect this fluid!
Now, if there is no drain, what happens is that the fluid will build up and need to be drained. The drainage procedure is the insertion of a needle attached to a syringe and fluid is aspirated, on several occasions. There is also an increased risk of infection with each aspiration, capsule formation, and possibility of irregularities to the skin when healing is complete.
My recommendation is to not cut corners if you need a tummy tuck, and to get it done in a safe and effective way- with drains! I’m here to help you become the best version of you!
What Are Drains?
Surgical Drain Care
We previously discussed what drains are, and their functionality. Today, we’re going to discuss how to take care of your surgical drains!
1. Clean the drain. This is done to minimize the risk of infections! The easiest way to do this is to hold the drain in place from the exit site of the skin with your non-dominant hand, and to clean the drain with your dominant hand using alcohol. Once you reach a distance, keep your dominant hand clamped, and advance your non-dominant hand to the spot. You’ll repeat this until you reach the drainage bulb.
2. Empty the drain. As the bulbs fill, you’ll want to empty the contents and record the output.
3. Compress the drain. You want to ensure that the drain is always compressed to allow a vacuum like seal of the fluid into the collection bulb.
Voila. You’re now a surgical drain care expert.
Waistline narrowing involves the maximal removal of fat from the waist line and love handles! It’s performed differently for males and females. The proper aesthetics of a male patient is more of a “V” shape whereas the female counterpart is a “S” shape.
Depending on the degree of skin laxity, redundancy, and adiposity (or fat), we have two options:
1- VASER assisted liposculpting with Renuvion J plasma or BodyTite skin tightening
2- Lateral thigh and buttock tuck with/without VASER assisted liposculpting
Keeping proper aesthetics in mind, I am able to sculpt the abdomen, flanks and waist using the assistance of VASER. VASER allows for the adipocytes (or fat cells) to transform into a more liquified state through the use of ultrasound guided technology. After VASER, I then evacuate the fat through liposuctioning. This is then followed by Renuvion J plasma or BodyTite skin tightening.
If you have a lot of loose/redundant skin and fat, you may require a lateral thigh and buttock tuck which will remove the bulk of the tissue via an incision that will definite the shape of the buttock.
We often times will perform a concurrent BBL (Brazilian Buttock Lift) at this time as well.