Most of our patients who request a tummy tuck have found that, after pregnancy or substantial weight loss, the skin around their tummy has become looser and the muscles weaker.
This can give the appearance of being overweight or flabby, and even with exercise and diet it can still be difficult to restore the abdomen to its previous firmness.
A tummy tuck is designed to remove any excess skin from the lower part of the abdomen, and to tighten the muscles at the same time.
The information on this website is intended to complement your consultation with Dr. Fred.
What exactly is a tummy tuck?
A Tummy Tuck, also called an abdominoplasty is surgery that removes excess fat and skin from around the waist, and tightens the underlying muscle to give a flatter, younger-looking abdomen. This is a major surgical procedure that removes excess fat and skin from the middle and lower abdomen and tightens the muscles of the abdominal wall underneath. The result is that you can dramatically reduce a protruding abdomen but the permanent scar left behind can be extensive. The scar length will always depend on the amount of excess skin that needs removal. This amount will vary from patient to patient – and hence the length and position of the scar will also vary. You and Dr. Fred will come to an understanding as to what is appropriate for you during your consultation.
Dr. Coville almost always combines a tummy tuck with some amount of liposuction at the same time. Liposuction done with a tummy tuck usually entails sculpting the back, waist, and buttocks to reveal a truly beautiful shape of the torso. What can and should be done in your case will depend on your consultation with Dr. Fred Coville. However, the following introductory paragraphs will, we hope, be helpful.
Am I a good candidate for an abdominoplasty?
If you are in relatively good shape but are bothered by a large fat deposit or loose abdominal skin that will not respond to diet or exercise, a tummy tuck could be right for you. The surgery is particularly helpful to women whose pregnancies have stretched their abdominal muscles and skin beyond the point where they can return to normal. It is also very appropriate for men and women who have lost a significant amount of weight and are left with hanging skin that refuses to respond to any further dieting or exercise. In older patients, a loss of skin elasticity often comes with slight obesity – this is also something that we can improve. Patients who intend to lose a lot of weight should clearly do so before the surgery. That said, you should not put off your surgery in order to get to a weight that is unrealistic for you before you can have the procedure. As Dr. Coville has spent many years overseas, he fully appreciates the varying nature of beauty around the world. Not every person can have the figure of a model, nor should they want one. Whatever your weight is when you feel most comfortable is the weight that you can have your surgical procedure. Ideal body shapes vary from person to person and culture to culture. Whatever your preference – it is your personal decision – and you should be comfortable enough to discuss this openly in your consultation.
If you are planning any further pregnancies, you should wait, as vertical abdominal muscles tightened during surgery can separate again during pregnancy; and you wouldn’t want to have to repeat the procedure down the road. Abdominoplasty can enhance your appearance and so increase your self-confidence, but it won’t necessarily achieve your dream body shape. So, before you decide on surgery, discuss everything frankly with Dr. Fred to make sure your goals are realistic and achievable – and most importantly that you both are on the same page as to your expectations.
Are there any risks?
Every year thousands of tummy tucks are performed successfully. When carried out by a qualified plastic surgeon trained in body contouring, the operation normally works well. Nevertheless, there are always risks with surgery and there are specific complications associated with this procedure. Rare though they are, infections and blood clots can occur. Infection can of course, be treated with antibiotics and, if necessary, drainage. Most often, these can be treated as an outpatient. You can minimize the risk of blood clots simply by moving around as soon after surgery as possible. It is also possible that poor healing, which is likely to leave conspicuous scars, may make a second operation necessary in order to improve your final scars. Smokers should stop, since smoking may increase the risk of complications and delay healing. Follow the post-operative directions carefully given to you by our staff and Dr. Coville, especially with regard to resuming physical activity.
Initially, Dr. Fred Coville will evaluate your health and assess both your abdominal fat deposits and your skin tone. Tell him if you smoke, and if you’re taking any medications, vitamins, or other drugs. Discuss your expectations frankly and he, in turn, will describe your alternatives and the risks and limitations of each. If, for example, the fat and laxity is all below the navel, a partial abdominoplasty or mini-tummy tuck may be enough. You may on the other hand, benefit more from a partial or complete abdominoplasty done in conjunction with liposuction. This is a combination that Dr. Fred frequently employs to remove fat deposits from the hips, waist, back and buttocks for a much better body shape. Sometimes liposuction alone will create the best result. Dr. Fred will work with you to come as close as possible to achieving your desired body contour. He will also cover anesthesia, the location for your surgery, the recovery schedule, and the costs.
We will be give you specific instructions on how to prepare for your surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins, and medications. If you smoke, stop at least four to six weeks before your surgery and do not resume for at least two weeks afterwards. Avoid overexposure to the sun before surgery, especially to your abdomen, and do not diet excessively. Both can inhibit your ability to heal. If you develop a cold or infection of any kind, Dr. Coville will probably postpone your surgery. Always arrange for someone to drive you home afterwards. Someone should also be available to help you out for a day or two if needed. If you would like, we can arrange a health aide to stay with you to help you during this period. If you are visiting us from out of town or from abroad for your surgery, we will help make all the arrangements to make your recovery as comfortable as possible. Be sure to ask about our Seaside Recovery options.
Complete abdominoplasty can take from two to four hours depending on the amount of work that Dr. Fred has decided with you to perform. If he will be sculpting your back and buttocks at the same time as contouring your abdomen, then that will require much more time than a tummy tuck done alone. Mini tummy tucks need take only an hour or two. Most commonly, your Dr. Coville will make an incision just above the pubic area. A second, optional incision may be made to free the navel from surrounding tissue. With partial abdominoplasty, the incision is much shorter and the navel may not need to be moved, although it may be pulled into a lower position as the skin is tightened and sutured. Next, your surgeon separates the skin from the abdominal wall and lifts the skin to reveal the vertical muscles in your abdomen. These muscles are then pulled together and stitched into a new position so that they are tighter. This provides a firmer abdominal wall and narrows the waistline. The skin is then pulled down and any surplus is removed. A new opening may be made for your navel, which is then sutured into place. Finally, the incisions are closed and dressings applied. Usually, one or two temporary drainage tubes may be inserted to drain excess fluid. These are generally removed after 72 hours, but in some cases will be left in longer.
Your abdomen will naturally be swollen for the first few days, but we will have given you any medication necessary to control your pain. Please let Dr. Coville know immediately if you feel you need anything to make you more comfortable. Our staff will have given you instructions on how to contact Dr. Fred Coville twenty-four hours a day for anything. He would rather you call him to ask what you may consider a silly question than for you to be uncomfortable with something that he could help you with. The Cornerstone staff will give you instructions for showering and caring for your dressings and any temporary drains that may be in place. Though you may not be able to stand up straight immediately, you should start walking as soon as possible.
It may be weeks or months before you feel completely like yourself again. Those who start out in top physical condition with strong abdominal muscles will recover much faster. Some return to work after only two weeks, while others take three or four weeks to recuperate. Exercise will help you heal more quickly. Even people who never normally exercise should begin an exercise program to reduce swelling, tone muscles, and lower the chance of blood clots. Vigorous exercise, however, should be avoided until you can do it comfortably. This especially includes abdominal exercises, such as “crunches.” If in doubt, as to what you may or may not do, please as us. Your scars may actually appear to worsen during the first two to three months. This is normal. Expect it to take from nine months to a year before the scars flatten out and lighten in color. Dr. Coville is a leading authority on hyperpigmented scars and skin. He will very often recommend treatments while you are healing to minimize any poor scarring. Please be sure to ask him if you feel your scars are not healing appropriately, or if they are thickening or darkening abnormally. It is much easier for him to prevent a poor scar than to treat one that is already mature. Scars will never disappear completely but they can be helped to be as inconspicuous as possible. Keep in mind also that abdominal scars will not show under most clothing, even under bathing suits.
Will I be satisfied?
Abdominoplasty produces excellent slimming and shaping results. You must, however, be realistic in your expectations, accept the permanent scar, and take some time off to recover. The results are normally long lasting, provided you follow a balanced diet and exercise regularly.