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Updated 06/13/07
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Abdominoplasty
(Tummy Tuck)
Once
stretched by pregnancy or
weight gain, the abdomen often
fails to return to its
original shape. Stretched
beyond the capacity to return
to normal, these tissues will
also fail to respond to
exercise or diet programs. In
these cases, abdominoplasty
can provide a long-lasting
solution.
Abdominoplasty
(commonly called a tummy tuck)
is a frequently performed
procedure used to tighten
overly stretched abdominal
muscles and skin for a
smoother, flatter appearance.
If
you're considering abdominoplasty,
the following information will
provide you with a good introduction
to the procedure. For more detailed
information about how this procedure
may help you, we
recommend that you schedule a
consultation with Dr. Kremer / Dr. Zettl.
What
are some of the most common benefits
of this surgery?
Abdominoplasty can dramatically
tighten the abdominal muscles, as
well as the sagging, excess skin and
accumulated fatty tissue. Not only
will the abdomen be firmer and
flatter, but the waist will be
smaller as well.
The amount of improvement depends
upon the extent of surgery and the
patient's skin tone, body build, and
healing process. Most people are
happy with the results, and report a
better body image after the surgery.
During the consultation, you and
Dr. Kremer / Dr. Zettl will discuss the
changes that you would like to make
in your appearance. He will explain
the different options available to
you, the procedure itself, the risks
and limitations, and the type of
anesthesia that will be used. Dr. Kremer / Dr. Zettl
will also evaluate your
health, determine the extent of fat
deposits in your abdominal region,
and carefully assess your skin tone.
Be sure to ask all the questions you
have about the surgery. Learning
everything you can about your
options, risks and benefits is the
key to making an informed decision.
There are several different
abdominoplasty techniques. The most
common procedure is performed under
general anesthesia. In the full
abdominoplasty procedure, an
incision is made across the lower
abdomen, just above the pubic area
that extends laterally along the so
called bikini-line.
Another incision is made around the
belly button to free the surrounding
skin, and the all of the skin is
separated from the abdominal wall.
Then Dr. Kremer / Dr. Zettl pulls the loose
muscles from the left and the right
sides and sutures them together.
This tightens the muscles to create
a stronger abdominal wall and a
smaller waist. Excess skin is
removed, and a new opening is made
for the belly button at the right
position. After insertion of
drainage tubes, the incisions are closed
with sutures, and gauze is placed over
the incision area.
If your only problem area is below
the belly button, you may benefit
from a less complex procedure called
a partial abdominoplasty, which can
often be performed on an outpatient
basis, under local anesthetic with
light sedation.
Or,
Dr. Kremer / Dr. Zettl may recommend either a
partial or complete abdominoplasty
done in conjunction with liposuction
to remove fat deposits from the
hips, for a better body contour.
Sometimes liposuction alone offers
good results.
One overnight stay after the
surgery is most common. Depending on the
extent of the surgery and the
technique used, you may have
to remain hospitalized for two to
three days. If the area
of repair is minimal, you may be
able to go home the same day. This
is usually discussed and decided by Dr. Kremer / Dr. Zettl
during the initial
consultation.
For the first few days, your abdomen
will feel tight, and you're
likely to feel some pain and
discomfort which can be controlled
by medication. You will feel that
you abdominal wall is being
stretched when you stand up and
walk. However, there is generally no
major pain, mostly discomfort.
Bed rest for
24 hours is
recommended. While in bed, your legs
should be bent at the hips in order
to reduce the strain on the
abdominal area. You will be provided
with a firm abdominal binder to
offer support to the tightened
areas. You will have to wear
compression stockings and receive a
daily shot against thrombosis and
pulmonary embolism.
Dr. Kremer / Dr. Zettl will give you
instructions for showering and
changing your dressings. And though
you may not be able to stand
straight at first, you should start
walking as soon as possible.
Wound drains will normally be pulled about 2-3
days after surgery.
It may take you several weeks to
feel completely back to normal. If
you are in top physical condition,
recovery will be much faster. Some
people return to work after two
weeks, while others take four weeks
to recuperate.
After about three days, you may
begin light activities. Even if you’ve never exercised
before, you should begin a light
exercise program to reduce swelling,
lower the chance of blood clots, and
improve muscle tone. However,
vigorous exercise, especially
lifting, should wait until you can
do it comfortably and Dr. Kremer / Dr. Zettl
gives you permission.
Your scars may appear to worsen
during the first few months, but
this is normal. It may take up to a
year before your scars flatten out
and lighten in color. While they'll
never disappear completely, these
scars will be placed so that
they’ll be covered by your
clothes, including most bathing
suits.
What
is the long-term outcome like for
most people?
As long as you keep your weight
relatively constant, eat a healthy
diet, exercise regularly, and follow
Dr. Kremer / Dr. Zettl’s instructions about
how to resume physical activity, the
long-term results from this
procedure are generally excellent.
In
general, the best candidates for
abdominoplasty are:
18
years of age or older
In
relatively good shape, except
for the abdominal area
Not
pregnant or planning to become
pregnant
Not
severely overweight
Not
smoking.
Not
planning to lose a considerable
amount of weight
In
good health
Wanting
to improve their appearance
and/or comfort
Realistic
in their expectations
The
above is only a partial list of the
criteria that Dr. Kremer / Dr. Zettl
will
consider in determining whether or
not this procedure is appropriate
for you.
Note: If you have scarring from
previous abdominal surgery, Dr. Kremer / Dr. Zettl
may recommend against
abdominoplasty or may caution you
that scars could be unusually
prominent.
In some patient old scars can be
used for the abdominoplasty incision
and may thereby be improved.
Strenuous exercise and weight loss
alone will reduce the bulk of the
abdominal wall and tighten the
muscle tone; however, the stretched
skin may not be able to contract
without surgery. Liposuction has been touted as
causing contraction of excess skin,
but most often will not be effective
enough to achieve results in
patients who consider abdominoplasty
as liposuction can also not tighten
the abdominal wall muscles.
All surgery has some potential
risks, including the risks of
bleeding, reaction to the
anesthetic, and infection. Scars are
to be expected, but they will become
lighter and flatter with time.
Smoking may increase the risk of
complications and delay healing.
This could result in larger scars,
and a second surgery. You can reduce
your risk of complications by
closely following Dr. Kremer / Dr. Zettl's
instructions before and after the
surgery, especially with regard to
when and how to resume physical
activity.
Abdominoplasty
bears a chance of thrombosis and its
possible complications even though
preventive measures will be
undertaken during and after surgery.
Tell
Dr. Kremer / Dr. Zettl about any allergies
you have (to foods, drugs,
environmental elements)
Tell
Dr. Kremer / Dr. Zettl if you have a history
of bad scarring, such as keloids.
Tell
Dr. Kremer / Dr. Zettl about all
medications, herbal supplements
or natural supplements you are
taking (both prescription and
non-prescription)
Carefully
follow any instructions Dr. Kremer / Dr. Zettl
gives you regarding
eating and drinking and smoking.
Avoid
aspirin and aspirin-containing
medicines for
two weeks prior to surgery.
Arrange
for someone to drive you home
after surgery or after discharge
from the day surgery center or
the hospital.
Please
inform Dr. Kremer / Dr. Zettl immediately in
case you should experience fever
or symptoms of an infection
after surgery.
Tell
Dr. Kremer / Dr. Zettl if you have any of the
following pre-existing conditions:
thyroid
problems such as hypothyroidism
elevated
blood pressure or other
circulatory disorders
cardiovascular
disease
history
of deep venous thrombosis
diabetes
any
other serious medical
condition(s)
The
information on this web site is only
intended as an introduction to this
procedure and should not be used to
determine whether you will have the
procedure performed nor as a
guarantee of the result.
The
best method of determining your
personal options is to schedule a
personal consultation with Dr. Kremer / Dr. Zettl. He will be able to answer
specific questions related to your
situation.
