Tummy Tuck (Abdominoplasty)
Individuals who have changes from weight loss or pregnancy are often bothered by the appearance of their abdomen. These changes may include loose abdominal skin and stretch marks, extra lipodystrophy (fat deposits), and even rectus diastasis (a stretching out of the rectus muscles after pregnancy)—the latter of which can affect the appearance and even function of the abdomen. Even the most slender women do not escape some changes of pregnancy to their abdominal area. There are patients that may be quite thin and have very little extra skin, but their muscles might be stretched out, which can affect their posture as well as how they look in clothing. Women tend to be especially unhappy with these lax muscles when in a seated position due to their tummies having overhanging skin and fullness.
An abdominoplasty, or tummy tuck, is a surgical treatment that involves removing unwanted, loose skin utilizing a low-lying incision that can be concealed underneath most bathing suits or undergarments. During the procedure, the muscles are also tightened—or “plicated”—to restore the often-desired “flatness” that most women yearn for after having kids. This is also complemented with liposuction in the hip or flank areas to restore the feminine curve from the torso to the hip. It is the blend of using liposuction and abdominoplasty together that will recreate the waistline and restore a youthful abdomen.
For more information about tummy tuck surgery, please continue reading the detailed information we have provided throughout this page. If you have any additional questions, or if you would like to schedule a consultation with board-certified plastic surgeon James F. Boynton, MD, please feel free to contact our practice online or by phone today.
Benefits of Tummy Tuck Surgery
No matter the reason for an accumulation of diet- and exercise-resistant fat throughout the abdominal region, tummy tuck surgery can be advantageous in numerous ways. Chief benefits of abdominoplasty can include:
- Elimination of extra, hanging abdominal skin
- A reduction of excess fatty tissue (which some studies have shown to be a health benefit)
- A flattened, more toned stomach and waistline
- An improved fit for various pants, shirts, swimsuits (one or two-piece), and other types of clothing
Along with these aesthetic enhancements, one the greatest benefits of tummy tuck surgery is functional core muscle improvement. Patients who have their rectus musculature (six-pack muscles) tightened/repaired during the procedure—which is done in almost all cases—often experience better core muscle functionality when performing ab exercises, particular workout routines, and certain daily movements. In addition, Dr. Boynton has had patients who, months after their abdominoplasty, say that previous back discomfort was markedly diminished.
Candidates for Abdominoplasty
Tummy tuck surgery can be an excellent surgical solution for many individuals who wish to achieve a more toned and contoured midsection. Candidates for abdominoplasty usually include men and women who have lost a considerable quantity of weight and are bothered by:
- Loose, extra skin (with or without localized fat pockets) in the abdominal region
- Lax, torn, and/or displaced abdominal wall musculature
- Stretch marks across the abdomen
It is important to note that women and men who lose more than approximately 80 lbs (either from diet and exercise or from a bariatric surgical procedure such as LAP-BAND® or gastric bypass) may be better suited for a circumferential body lift due to the amount of loose skin about the abdomen and torso. At our practice, Dr. Boynton typically performs this as a staged procedure in two parts, approaching the abdomen first and addressing the back region three months later. The overall healing and incisions appear better when a body lift is done in two steps.
Details of the Tummy Tuck Procedure
During abdominoplasty, an incision will first be made along the lower abdomen. Compared to many traditional techniques, the incision Dr. Boynton uses is shorter in length and placed further down on the abdomen, usually eliminating any concern of “high-angled” scars that may jut out from underneath swimsuits and/or underwear. Through this low-lying incision, abdominal musculature is tightened and repaired, and extra skin is carefully excised. Dr. Boynton can also perform liposuction to remove stubborn fat buildups, and the belly button can be adjusted using an additional tiny incision made in the navel (if necessary). Once an ideal contour and overall appearance is achieved, the skin will be sewn together with great care to minimize postoperative scarring as much as possible.
Abdominoplasty generally takes about two hours to perform. While some individuals need (or desire) to stay one night in our state-of-the-art surgical facility with a private room, Dr. Boynton has quite a few patients who are completely comfortable with a true “outpatient” tummy tuck thanks to revolutionary EXPAREL®—a long-acting numbing medication that can provide 72 hours of pain relief. Ultimately, Dr. Boynton will never compromise patient safety standards, and the decision as to whether or not an overnight stay is necessary will depend on the specific wishes and medical condition of the patient after surgery.
The Aesthetics of the Belly Button (Navel)
The belly button (navel or “umbilicus”) is the central “aesthetic feature” of the abdomen. Everyone has a different belly button in terms of shape, size, and appearance. The belly button is really just a “scar” from where the umbilical cord was “connected” during pregnancy and prior to birth. In the last 10 years or more, greater aesthetic emphasis has been drawn to the belly button. Belly button “rings” have become quite popular to draw attention to this area. Most women who are considering a tummy tuck have had children and changes to the abdomen, as well as the belly button. Belly buttons can stretch out, become more of an “outie,” become a different size, or even develop a hernia after the changes of pregnancy. Also, many women who may have worn a belly button ring before having kids and are considering a tummy tuck want that “scar” from their old belly button ring to be removed, as well.
The perfect time to reshape and improve the appearance of the belly button is concurrently with a tummy tuck. The belly button can be “sized down,” and the same belly button is brought out through a new “hole.” Dr. Boynton prefers a vertical oval, which has been found to be the most desirable aesthetic shape to the belly button. He has developed a specialized technique to hide the incision inside the belly button and give patients a nice, sexy, well-shadowed belly button with the proper “hooding” on the upper half. This technique is natural in appearance.
In some cases, if patients have a large belly button hernia, the hernia and the tummy tuck / belly button surgery are done together. Other times it is better to do them as separate procedures. Each case is really individualized by Dr. Boynton in order to provide the most optimal results possible.
Recovery from Abdominoplasty
The majority of individuals will experience some temporary bruising, swelling, and/or soreness immediately following abdominoplasty, but these symptoms should resolve with the passage of time. A significant degree of pain is extremely rare, though any discomfort that might occur can often be effectively relieved with medication.
Patients are able to shower the day after surgery, and Dr. Boynton recommends getting up intermittently to walk around and keep blood flowing during the initial stages of recovery. Most men and women feel well enough to return to normal daily routines—such as office jobs, school, etc.—after approximately two weeks, but strenuous activities like sports, vigorous exercise, and heavy lifting should be avoided for at least four weeks to six weeks, particularly if actions place strain on abdominal musculature.
"In addition to the surgical care he gives his patients, he cares very much about their nutrition and whats going on with them."
Tummy Tuck FAQs
What is the recovery time? Back to work? Working out?
Patients generally need to plan to be off work for two weeks. As far as cardio, working out can often be started at two weeks. Light weights can typically commence at four weeks, and situps or crunches need to wait about six weeks.
How long will I be in the surgery center or hospital?
Patients simply stay overnight and go home usually by 7 or 8 am the morning after the procedure.
Will I have drains?
Yes. Drains help remove the fluid that the body creates after the surgical “undermining” of the abdomen during the procedure. They are not a big deal and are well concealed within clothing. My patients are usually able to shower the next day with drains, and they are generally removed six to seven days after surgery.
What will my belly button look like?
The belly button will look a little funny for a few weeks as it heals. Often, it is the slowest part to heal and requires a simple gauze to be placed “in the hole” for few weeks. The incision heals “inside” the belly button, leaving a natural-appearing belly button after the procedure.
How long will the incision be?
Dr. Boynton utilizes a shorter and lower scar for his tummy tucks than most traditional techniques. Patients that have had tummy tucks complain most about the scars on the sides. Some techniques involve a “high angled” scar that juts out from a swimsuit. Dr. Boynton keeps his low. Some patients with massive weight loss (greater than 80 lbs) might require an “extended” tummy tuck, which may extend a bit farther around if there is loose skin that needs to be addressed on the “side.”
What about a mini-tummy tuck?
Mini tummy tucks are “mini” with their results. This technique only removes a small amount of skin. The lower abdomen is plicated, leaving the upper abdomen loose and often creating a noticeable bulge. It also pulls the belly button down. There are very few “true” candidates for this procedure. Most patients that think they need a “mini” abdominoplasty actually need a full tummy tuck and are not happy with a mini. The recovery is not that much faster, and patients are not often happy with the overall results.
When you tighten up the muscles will they still function normally?
Absolutely. The covering, or “fascia,” of the muscles is tightened in order to centralize the rectus abdominis (six pack muscles). They actually function better from a physics standpoint since they are back “in place” where they were prior to the weight gain or pregnancy.
When can I resume eating?
Most patients have liquids the day of surgery and resume low salt, non-spicy or non-greasy solid foods the day after surgery.
Will I need a two stage procedure ever? With extra liposuction on the top?
Some patients have quite a bit of “fullness” at the top part of the abdominal area. This area cannot be liposuctioned much at the time of a tummy tuck because it can jeopardize the blood supply to the skin and affect healing. So, for safety reasons when this area needs more correction than can be done with a tummy tuck, a second outpatient procedure is performed to focally address this area at three months after the tummy tuck with liposuction as a one-hour outpatient procedure.
What is a dog ear deformity?
This is a small area of fullness at the corner or end of the incision. If one arises and needs correction, it can usually be done as a minor procedure in the office.
Do you use pain pumps?
Yes. Our practice was of the first to conduct research with pain pumps after tummy tuck and found it to be helpful in lessening pain and discomfort.
Schedule a Tummy Tuck Surgery Consultation
If you would like to know more about tummy tuck surgery, or if you are interested in combining the procedure with other cosmetic surgeries as part of a Mommy Makeover, please contact Dr. James F. Boynton today. Our plastic surgeon can meet with you for an initial consultation to talk about your goals and answer all of your questions.