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Tummy Tuck (Abdominoplasty)

What Is It?

Tummy tuck is a procedure to remove loose skin and excess fat from the tummy region, along with a tightening of lax muscles. It can have a dramatic, slimming effect. Typically, it is done after women have worked hard to lose extra pounds following pregnancy and, despite exercising, still "look" three or four months pregnant. Many women who thought they would never again wear a two-piece bathing suit feel entirely comfortable doing so after this procedure.

However, tummy tuck surgery is not just a post-pregnancy procedure. It is also an important procedure for men and women to remove an unpleasant residual "apron" after weight loss. Some patients undergo the surgery to counteract the effect of aging on the abdominal region. Like most other parts of the body, over time the tummy begins to sag.

The operation can vary from a mini procedure, involving a scar above the pubis, to a standard tummy tuck, which extends along the entire lower abdomen, to a belt lipectomy or body lift which goes circumferentially around the trunk (see section on Post Major Weight Loss Surgery).

Patient Examples

Click on any photo for larger version and more views of that patient.

Before Surgery Consultation

In the initial consultation, Dr. Neu will take a detailed history of the patient's past health and carefully analyze the factors that contributed to the tummy profile problem. Dr. Neu will need to know if the patient’s weight is stable or if they still plan to lose more weight. At the time of surgery, patients should be within 15 to 20 lbs. of their realistic stable weight. If more than 20 lbs. is lost after surgery, there may be further loosening of abdominal tissue and a potential loss of some of the benefits of surgery.

It is also important to know whether women are considering future pregnancy. Women can certainly become pregnant after a tummy tuck, but might lose some of the benefits originally acquired through the procedure. Many of the pregnancy stretch marks in the lower tummy region can be removed through a tummy tuck; however, in the upper abdominal region, stretch marks can only be made less conspicuous by the fact that they are under some tension, and therefore less wrinkly looking.

Some patients request liposuction of the lateral flank regions (love-handles) and hips at the time of tummy tuck surgery. It is important to realize that only conservative liposuctioning of the abdominal tissue can be done at the time of a tummy tuck. Further liposuctioning of this area can decrease the blood supply to the tummy, which has already been reduced by elevating the skin and fat for the procedure. Liposuctioning of the abdomen, however, can be done safely six or more months after a tummy tuck if a patient still wishes further slimming of the tummy tissue.

The Surgery

A tummy tuck is typically done by Dr. Neu as a day surgery procedure under general anesthesia. No effort is spared in obtaining the most optimum, natural-looking aesthetic result, under the safest of conditions.

To start off, Dr. Neu uses a surgical marker to map out the surgery as previously discussed with the patient. Once the patient is asleep, the tummy skin and fat are elevated, and then the stretched muscles are brought together to maximally slim the tummy region. This effectively becomes an internal girdle. All the loose skin and fat is measured, removed
and weighed.

Dr. Neu has been at the forefront in perfecting an increasingly popular quilting technique, in which the fat is stitched down to the underlying tissue, thereby eliminating the need for postoperative drains. In the past, patients would have drains hanging from their tummy region for a week after surgery. Drains are quite unpleasant and disliked by patients; they also increase the chance of wound infection. With the quilting technique, patients are up and walking on the day of surgery without the restricting effect of drainage tubes.

With the use of precision measurements, Dr. Neu is typically able to keep the bellybutton incision small and imperceptible. To achieve the best possible result, all surgical incisions are closed with a delicate invisible mending underneath the skin, eliminating stitch marks. Staples are never used.

While there is some pain after a tummy tuck, Dr. Neu spends considerable extra time during surgery infiltrating the muscle with long-acting local anesthetics. Most patients are surprised how little discomfort they have when they wake up from the surgery. Recent studies have confirmed that patients who wake up with little or no pain end up with far less total pain, even when the local anesthetic has worn off. Subsequently, there is a much lower requirement for pain pills.

Resumption of Activity

Most patients after tummy tuck can resume sedentary work in two weeks, and more vigorous activities in three weeks.