What is an abdominoplasty (tummy tuck)?
One of the most satisfying procedures in plastic surgery for both men and women is an abdominoplasty, commonly known as a “tummy tuck.” This procedure addresses two specific aesthetic goals in achieving a more slim figure: 1) to remove excess fat deposits and skin of the abdomen, and 2) to tighten the internal fascia (or, “girdle”) of the abdominal wall. The abdomen has historically been the most difficult area to improve with simple diet and exercise.
In addition, certain life changes such as pregnancy and rapid weight loss may weaken the internal support of the abdominal wall or cause excessive redundancy of skin. Liposuction is usually unhelpful in these types of individuals. However, liposuction is frequently combined in order to shape and define the torso. In the correct patient, the satisfaction rate can be quite high. However, it is important to understand that the trade-off is a relatively long scar in the lower abdomen which is usually covered by underwear or a swimsuit.
There are variations of a tummy tuck that may be more amenable to different patients. A common alternative is the “mini-tummy tuck.” This is not indicated in all tummy tuck patients and typically is best used in patients who have a stubborn lower abdominal “pooch” between the belly button and the pubis. Another variation on an abdominoplasty is the panniculectomy. This usually addresses a large, overhanging section of skin and fat below the belly button and occurs most often in overweight patients or those who have experienced rapid or significant weight loss such as following gastric bypass surgery. The goal of this type of procedure Dr. Panossian performs, is to relieve the pain, weight, and infections that can result from such a large mass folding over the beltline.
An abdominoplasty may be combined with other procedures, such as breast augmentation, breast reduction, or breast lift. These combined breast and body procedures are frequently referred to as a “mommy makeover.”
During Dr. Panossian’s consultation, the various options for abdominoplasty will be reviewed, with particular focus on each individual’s best option.
How is an abdominoplasty performed?
three and four hours to complete
An abdominoplasty usually requires the patient to be under general anesthesia and typically takes between three and four hours to complete, depending on the degree of work required. A “mini–tummy tuck” may take two hours or less and can be performed under conscious sedation straight local anesthesia.
A long incision is made from hip to hip, dipping just above the pubic area. A second incision is made around the navel to allow the abdominal skin and fat to slide downward.
The skin is then separated from the tough outer lining of the abdominal wall (fascia) all the way up to the level of the ribs. This simultaneously exposes the rectus muscles and the midline of the abdominal wall around the navel. These muscles are then tightened in order to flatten the overall abdominal contour much like a girdle. This has the effect of narrowing the waistline and creating a more firm abdomen. The skin flap is then advanced and the excessive portions of both fat and skin are removed. The new position of the navel is then created and the flap is inset with sutures. Drains may or may not be used.
In a mini-tummy tuck, the process is much more simple. There is usually no muscle work required and only the skin between the navel and incision is addressed. And a panniculectomy, only the portion of excess skin and fat overhanging the beltline is addressed. This may or may not be combined with tightening of the abdominal muscles.
Recovery
What is the recovery from a tummy tuck like?
Following an abdominoplasty, to wear a compression garment or abdominal binder will be required. Use of this support garment will be required for approximately 6 weeks. Your abdomen will be swollen and feel tight. An “old lady” type posture with flexion at the hips will be required for the first week following surgery. Walking is encouraged on the first postoperative day. A short course of antibiotics may also be provided.
Stitches on the skin will be removed within 7 days, while deeper sutures will be removed in 2 to 3 weeks. Special tape may be used on the incision itself for several weeks following surgery. If drains were placed, they will be removed between 2 and 7 days following surgery.
You will start feeling like your old self 3 to 6 weeks after surgery. A minimum time off from work of 2 weeks is highly recommended. Light exercise is recommended, however, aggressive exercise, heavy lifting, or sports are to be avoided for 6 weeks.
The actual scars may appear to worsen over the initial month following surgery. However, this is normal and can be expected to improve over the course of 6 to 9 months. Scars sometimes require up to a year or more to flatten and fade, but they are typically concealed under most clothing, including bathing suits. Board certified plastic surgeon, Dr. Panossian’s unique scar management protocol will help you achieve the best possible results.
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Why choose Dr Panossian
- He received his medical education at Tufts University School of Medicine.
- Graduated at the top of his class at UCLA, receiving Phi Beta Kappa and Summa Cum Laude honors.
- Was accepted into an elite combined general surgery and plastic surgery residency at the Keck School of Medicine of USC.
- Completed subspecialty training in craniofacial surgery at the Hospital for Sick Children in Toronto and Harvard Medical School.
- Was mentored by Dr. Ron Zuker in the practice of facial paralysis reconstruction. This prestigious fellowship position was available to only one surgeon in the United States.
- Is affiliated with various charitable and educational organizations, including Operation Smile and Mending Kids.
- Is a member of the American Society of Plastic Surgeons and the highly selective American Association of Plastic Surgeons, reserved for only a select group of individuals nationally who have demonstrated excellence in academic plastic surgery.
- Holds memberships in several other professional societies including the American College of Surgeons and the American Society of Reconstructive Microsurgery.
- He serves on the Board of Directors for Mending Kids and the Gondobay Manga Foundation, a non-profit organization dedicated to the improvement of lives in Sierra Leone.
- Has been nominated by his peers annually since 2012 as a “Super Doctor.”
- Served as an expert medical consultant and appeared on The Doctors, Grey’s Anatomy, and Nip/Tuck.
- Has been featured as “Top Doctor” in US News and World Report, Pasadena Magazine, and Los Angeles Magazine.
Frequently Asked Questions About Tummy Tuck
If you live near Pasadena, CA, Dr. Panossian offers tummy tuck among its services, and is conveniently located at 39 Congress St., Suite 402 Pasadena, CA 91105
Last modified by Dr. Andre Panossian
