Abdominoplasty / Tummy Tuck

Abdominoplasty, known more commonly as a “tummy tuck,” is a procedure to remove excess skin and fat from the abdomen and to tighten the muscles of the abdominal wall. This type of surgery can dramatically improve the appearance of a protruding abdomen. This procedure produces a permanent scar, which, depending on the extent of the original problem and the surgery required to correct it, can extend from hip to hip. Abdominoplasty or “Tummy Tuck” is one of the most common plastic or cosmetic surgery procedures performed in Fresno and in the California Central Valley area.

The best candidates for abdominoplasty are individuals who are in relatively good shape but are bothered by a large, localized fat deposit or loose abdominal skin that won’t respond to diet or exercise. The surgery is particularly helpful to women who, through multiple pregnancies, have stretched their abdominal muscles and skin beyond the point where they can return to normal. Loss of skin elasticity in older patients, which frequently occurs with slight obesity, can also be improved. Individuals who have undergone weight loss procedures such as gastric bypass or LapBand and have lost a significant amount of weight can also benefit from this procedure. This is not a weight loss procedure and individuals with excessive BMI’s (body mass index) should try losing weight through diet and exercise first.

  1. Am I a good candidate for abdominoplasty?
  2. How will Dr. Sian evaluate me for abdominoplasty?
  3. I understand that every surgical procedure has risks, but how will I learn more so that I can make an informed decision?
  4. How should I prepare for abdominoplasty surgery?
  5. What will the day of surgery be like?
  6. How will I look and feel initially?
  7. When can I resume my normal activities?
  8. What are the expected results of your abdominoplasty?
  9. How long will the results last?
  10. Maintaining a Relationship with Your Plastic Surgeon

Am I a good candidate for abdominoplasty?

You may be a good candidate for abdominoplasty if you have one or more of the following conditions:

  • excess or sagging abdominal skin
  • an abdomen that protrudes and is out of proportion to the rest of your body
  • abdominal muscles that have been separated and weakened
  • excess fatty tissue that is concentrated in your abdomen

If you plan to become pregnant or lose weight in the future, you should discuss this with Dr. Sian. Scarring from previous abdominal surgery may limit the results of your abdominoplasty

How will Dr. Sian evaluate me for abdominoplasty?

Dr. Sian will examine your abdomen while you are standing as well as lying down. Your skin tone and the degree of loose skin in the abdominal region will be assessed. Dr. Sian will also evaluate the amount of excess fat in your abdomen and the condition of your abdominal muscles.

You should come to the consultation prepared to discuss your medical history. This will include information about any medical conditions, drug allergies, medical treatments you have received, pregnancies, previous surgeries and medications that you currently take. It is important for you to provide complete information.

I understand that every surgical procedure has risks, but how will I learn more so that I can make an informed decision?

The subject of risks and potential complications of surgery is best discussed on a personal basis between you and Dr. Sian, or with a staff member in Dr. Sian’s office.

Some of the potential complications that may be discussed with you include bleeding, infection and reactions to anesthesia. Tissue loss along portions of the horizontal incision is a possibility when the abdominoplasty is very extensive. This complication, which delays healing and prolongs recovery, is more common in patients who smoke or have medical conditions such as diabetes. Surgical revision is sometimes helpful in certain instances where incisions may have healed poorly.

Following surgery, occasionally, fluid may accumulate under the skin. Removal of this serum is a painless process but may require several visits to Dr. Sian’s office.

You can help to lessen certain risks by following the advice and instructions of Dr. Sian, both before and after surgery.

How should I prepare for surgery?

If you are a smoker, you will be asked to stop smoking well in advance of surgery. Aspirin and certain anti-inflammatory drugs can cause increased bleeding, so you should avoid taking these medications for at least two weeks before surgery. Dr. Sian will provide you with additional preoperative instructions.

Abdominoplasty may be performed on an outpatient basis. If this is the case, be sure to arrange for someone to drive you home after surgery and to stay with you for at least the next day or two. When abdominoplasty is performed in conjunction with medically necessary procedures such as hysterectomy or hernia repair, a short hospitalization may be required.

What will the day of surgery be like?

Your abdominoplasty will be performed in the hospital (i.e. Clovis Community Hospital) by Dr. Sian.

Medications are administered for your comfort before and during the surgical procedure. A general anesthetic is administered, so that you will be asleep throughout the procedure. The abdominoplasty procedure typically requires 2 to 3 hours. Drains are usually placed under the skin flaps to help avoid accumulation of fluid. These drains are removed after a few days.

When surgery is completed, you will be taken into a recovery area where you will continue to be closely monitored. Most patients are permitted to go home after a few hours once they have fully recovered from the effects of anesthesia. In rare cases, Dr. Sian may recommend that you stay in the hospital overnight.

How will I look and feel initially?

The day after surgery, you will be encouraged to get out of bed for short walks to promote blood circulation. Although you may not be able to stand up completely straight, it is best if you do not sit for long periods of time during the first several days. Straining, bending and lifting must be avoided, since these activities might cause increased swelling or even bleeding. You may be instructed to sleep on your back with a pillow under your knees.

Surgical drains will be removed when the drainage output is less than 30 cc over a 24 hour period. You are encouraged to change your dressings after 48 hrs. Depending on the abdominoplasty technique used, you may be instructed to wear a support garment for several weeks. Dr. Sian uses mostly absorbable sutures to close the abdominal incisions, thus, there is seldom a need to remove sutures during the postoperative period.

You will notice swelling and bruising, which are to be expected. The bruising and much of the swelling will disappear over a period of weeks. However, it may be months before all swelling subsides and you may not see the final results of your abdominoplasty until then. You may also notice some numbness over portions of the abdominal area, and this may persist for several months. Incisions will initially be red or pink in color. They will remain this way for many months following surgery and may even appear to worsen before they finally begin to fade.

Recovery time is approximately 3 to 4 weeks.

When can I resume my normal activities?

It is important to realize that the amount of time it takes for recovery varies greatly among individuals. Depending on the extent of your abdominoplasty and your general physical condition, you may be able to return to non-strenuous work anywhere from one to three weeks after surgery. In many instances, you can resume most of your normal activities, including some form of mild exercise, after a few weeks. You may continue to experience some mild, periodic discomfort and swelling during this time, but such feelings are normal. Severe pain should be reported to your doctor.

Any sexual activity should be avoided for a minimum of two weeks and Dr. Sian may advise you to wait longer.

What are the expected results of your abdominoplasty?

Abdominoplasty will enhance your body contour by making your abdomen firmer and flatter. You may find that you feel more comfortable in your clothing and are more confident about your appearance.

The incisions from the procedure will heal and fade over time. It is important to realize, however, that the incision lines may be permanently visible. In some instances, they will eventually be only faint lines. Certain individuals may have incision lines that are more noticeable. Fortunately, the incisions for your abdominoplasty are usually in locations concealed by most bathing suits and undergarments.

How long will the results last?

Unless you gain or lose a significant amount of weight or become pregnant, your abdomen should remain firmer and flatter for many years. However, gravity and the effects of aging will eventually take their toll. If, after a period of years, you again become dissatisfied with the appearance of your abdomen, you may choose to undergo a second procedure to restore a more youthful body contour.

Maintaining a Relationship with Your Plastic Surgeon

You will return to Dr. Sian’s office for follow-up care at prescribed intervals, at which time your progress will be evaluated.

Please remember that the relationship with Dr. Sian does not end when you leave the operating room. If you have questions or concerns during your recovery, or need additional information at a later time, you should contact Dr. Sian’s office.