Tummy Tuck Procedure

Prior to Surgery

Medical tests will have been completed well before surgery. These tests are usually done one to two weeks before surgery and cannot be older than 30 days before the day of surgery. Lab reports will check many areas of your health to make certain that you are fit for surgery.  If you are a woman, you will have to take a pregnancy test. If you smoke, you will have stopped for 6 weeks. If you regularly take aspirin, vitamin E, herbal supplements, or any kind of blood thinners, you should avoid taking those for two weeks prior to surgery. You will probably have read about every possible complication, and special instructions about what to do on surgery day, anesthesia options, and post operative care. In fact, you will have so much information about tummy tucks that you could probably write a book about your knowledge. Surgeons truly believe that informed patients are much easier to handle before, during, and after surgery.

Pre-op Day of Surgery

Before your surgery, your vitals will once again be checked as well as all your paper work.  You will be put on IV (intra venous) so that you can remain well hydrated and also because the sedation and epinephrine (to reduce bleeding during surgery) will need to be later added to your IV mixture. Any consent forms that have not already been signed will need to be signed before you go in surgery. The surgeon will mark you with a blue marker while you are standing. This is important because on the operation table, they cannot see how the skin is hanging since you will be lying on your back.  These markings will tell the surgeon where the cuts need to be made, how much tissue should be excised, etc.

Tummy Tuck Variations

As we explained in the Indications section, there are many variations to this procedure depending upon how extensive your operation is. If you have a petite figure and only require a mini tuck, the operation could last less than 2 hours. However, if you are a large person and lost a lot of weight and you require a full abdominoplasty with a muscle repair, this operation could take up to 5 hours. Rather than describing all these different procedures, we will describe only the longest operation and make notations on the steps that are not part of the smaller, limited abdominoplasty.

Surgical steps of an abdominoplasty

Incision

A horizontal incision is made just above the pubic area. The length of this incision varies depending on how much skin surface will be removed (abdominal dermal lipectomy) and how large a person you are. If little skin (mini tuck) is to be removed, the incision could only be 5-6 inches long. With lots of skin, it will extend from hip to hip. With and extensive amount of skin following a large weight loss, it will extend past the hips into the flanks, and in the case of a body lift, all around the body, meeting the incision on the other side.

Navel

A circular incision is made around the belly button (umbilicus) to free the navel from the surrounding skin (this step is usually not part of a mini tuck, where the belly button is left to "float" down the abdomen if not too much skin is removed). This navel is saved to be re-sutured at the end of the operation at a different location.

Abdominal Skin Detached

The skin is detached from the tissues below to expose the muscles and fascia (the fascia is a tough sinewy tissue that envelops a muscle). Fat is removed from this area either manually with instruments or with liposuction. The surgeon can extend the operatory field from where fat is removed by inserting the liposuction cannula between the raised skin and the underlying muscles. In this fashion, in the case of a mini tuck, they can remove fat further up the abdomen without detaching more skin.

Muscles Tightened With Sutures

If your abdominal muscles are lax, these muscles with be tightened (musculofascial plication) by suturing the center portion (around the midline of your abdomen) of these muscles together.

Opening Created for New belly Button Placement

The stalk of your belly button that was not detached, is exposed through a new opening, and the saved navel is reattached to this stalk and the surrounding skin with sutures.

Fat Sculpturing or Liposuction

Liposuction (suction-assisted lipectomy) is commonly used to sculpt the area around the abdomen so as to provide a more esthetic look after the healing period.

Last Measurements Before Stiching

After the surgeon has removed all the underlying tissue, a last measurement is made on the excessive skin (that has not already been excised), and after this is trimmed, the upper and lower edges of the skin are sutured together.

Wound Compression

In order to speed up the healing process, it's common to have compression garments placed over the wound's dressings. You should also expect to wear a drain for a day that will remove any accumulation of fluids in the initial healing period.

Recovery

After the operation is over, you will be taken to the recovery room where you will be watched until the effects of anesthesia have worn off. Once you are fully awake and your care-giver has arrived, you will be wheeled away to your car and taken home. If you chose to stay in a facility with overnight capabilities, like a hospital, you will remain one night and be taken home in the morning following an examination by the surgeon.

Home Recovery

The length of recovery will depend upon which operation you selected and could be anywhere from 1 to 4 weeks. It is recommended that for the first week at least, particularly if a muscle repair was included, that you take off from work. Any kind of heavy physical activity during the first 2 weeks is contraindicated to prevent the internal and external sutures from separating. Initially, just after the operation there will be some bruising and discomfort lying down is recommended. Compression garments will prevent some swelling and increase the rate at which you recover and are recommended to be worn as long as possible. Your full recovery will take up to 3-6 months.