Posts

What is a Tummy Tuck, Exactly?

A tummy tuck isn't like tucking in a shirt.

If you are considering a tummy tuck, you might be wondering exactly what a tummy tuck is. When you “tuck” in your shirt, it’s not like your shirt tail disappears, is it? It’s still there, just hidden. Is that what happens with a tummy tuck? Is that extra pooch simply tucked in so it is hidden, like a good pair of Spanx?

Not really. Many people say tummy tuck in place of the technical term, abdominoplasty. Abdomino- refers to the abdomen, and –plasty refers to “molding, grafting, or formation of a specified part, especially a part of the body.” You see it in “rhinoplasty,” rhino- meaning nose, and in “angioplasty,” -angio meaning vessels.

So in a tummy tuck, the tummy isn’t just “tucked” in. The surgeon molds and forms the abdomen surgically to obtain a pleasing result for the patient. While the exact surgery an individual will require may vary, you can understand the basics about the procedure by considering a full tummy tuck.

Tummy Tuck Incision

First, your plastic surgeon will need to make an incision. Typically this will be oriented in a horizontal fashion above the pubic bone. It won’t necessarily be a straight line. The curvature and length of the incision will be determined by your specific anatomy, the amount of loose skin, and the location of any stretch marks you want removed.

Since the belly button doesn’t move and you want to keep it in the center of your abdomen even if it could, another incision is made around it. This frees the skin that surrounds the belly button so the excess skin can be removed in the next step. Modified or mini tummy tucks do not require an incision around the belly button; however, full tummy tucks do.

Tummy Tuck Modification

Next, excess skin and fat are cut away so that the abdomen is flat and tight when the upper of incision is pulled down to meet the lower incision. Another incision is made to allow your belly button to peek through the skin that is now covering it.

Tummy Tuck Closure

Once the excess removes excess skin and fat and puts everything is in its new, proper location, he sutures the two sides of the incision together.

Anytime an incision is made, the body’s natural response is to produce fluid to fill it. When the skin is repositioned as it is during a full tummy tuck, a space is created under that skin where fluid can accumulate. Traditionally a drain would be placed in that space. The patient would wear the drain for about a week until the natural healing process closed the space. But this is uncomfortable and increases the opportunity for infection.

With progressive tension sutures, the skin is sewn in place as it is pulled down, closing off the space where fluid might accumulate. This eliminates the need for a drain and speeds recovery.

Tummy Tuck Healing

A tummy tuck is major surgery. You will probably need to take about two weeks off of work and avoid physical exertion for four to six weeks.

There are things you can do to ease the process such as quit smoking, eat a well-balanced diet of whole foods, stay hydrated, and exercise regularly before surgery. These actions will go a long way toward easing your recovery. And after recovery they will help you maintain excellent surgical results.

Tummy Tuck “Extras”

Some patients will also benefit from tightening of their abdominal muscles because their “six-pack” has separated down the middle over time. Others will get the best results if liposuction is performed in conjunction with the tummy tuck. We will discuss these “extras” in later posts to give the full picture of what your surgery might include.

So, yes, there is a little more to a tummy tuck than just a “tuck.” But if you are unhappy with the appearance of your abdomen and exercise and diet aren’t getting the results you want, it may be a good choice for you.

Dr. Slack would like to consult with you in his Collin County office to discuss whether a tummy tuck can help you achieve your goals.

3 Things You Should Know about a Tummy Tuck

A tummy tuck can build your confidence.

Just like our bodies, tummy tucks come in different shapes and sizes. Knowing the differences will help you choose the right doctor and make you a good partner in your own care. All of which means a better outcome.

A tummy tuck, or abdominoplasty, can successfully flatten out your abdomen for a more youthful appearance by removing excess skin and fat. People who most benefit from tummy tucks include women who have had children, and people who have lost a significant amount of weight. It can also be a good solution for more slender people who have been unable to get rid of excess belly fat despite diet and exercise.

It is important to note here that a tummy tuck is not a weight-loss tool. You should only consider one if you are at a stable weight and preferably don’t plan on any further pregnancies.

1.There are different kinds of tummy tucks

When you start researching any kind of tummy tuck, you will soon discover there are three or four different levels of this type of surgery. The procedure that is best for you depends on the answers to three main questions:

How much skin and fat need to be removed?
Will your belly button need to be repositioned?
Will your abdominal muscles need to be repaired?

Understanding each procedure will also help you predict things like how big your scar will be and how long you will need to fully recover. Here are the four main types of tummy tuck and their most salient features:

Mini or Modified

  • Small amount of skin and fat removed from the lower abdomen
  • No repositioning of the belly button
  • Horizontal scar just above the pubic area
  • Sometimes includes muscle repair and liposuction

Full

  • Skin removed from lower abdomen to just above the belly button
  • Fat beneath the skin is removed
  • Repositioning of the belly button
  • Scar runs across the lower abdomen from hip to hip
  • Typically will include muscle repair
  • May or may not include liposuction

Extended

  • Full tummy tuck (as described above)
  • Fat and skin additionally removed from the flanks toward the lower back
  • Scar runs across the lower abdomen and around toward the lower back

Circumferential

  • Full tummy tuck (as described above)
  • Fat and skin additionally removed from the flanks as well as the lower back
  • Scar runs completely around the lower abdomen and the lower back

An experienced board-certified plastic surgeon can help you understand which procedure is right for you by assessing things like your anatomy, amount of excess skin, and past surgical history.

2.Tummy tucks can be done with or without drains

Drains have long been used after a tummy tuck to help with recovery. This is because of a necessary space created during surgery between the abdominal wall and the overlying skin and fatty tissue. The space has the potential to fill up with fluid leaked from the raw tissue surfaces in the early phases of healing. This then causes the formation of a seroma, or a build-up of fluid. Without the use of drains, this fluid would have no place to go, causing swelling, discomfort, a prolonged recovery, and a less than optimal outcome.

Drains do, however, come with some risk of infection and they can be uncomfortable. That is why some specially trained plastic surgeons, like Dr. Slack, have begun using what are called progressive tension sutures to get rid of that fluid-producing space.

They do this by stitching the abdominal layers together in a specific way that limits the amount of space for fluid to accumulate. This occurs to such a degree that the drains are no longer necessary. In one study of 450 tummy tuck procedures, done over the course of seven years, the seroma rate (rate of fluid build-up) was cut down from 9% to just 2%, when the progressive tension sutures were used.

Make sure to ask your surgeon if he or she is trained in the use of this procedure, and find out if you are a candidate for the drainless tummy tuck.

3. You play a big role in your outcome

The last, but certainly not the least important, thing you should know about having a tummy tuck is that you play a crucial role in its success. Choosing the right plastic surgeon for you is critical to your outcome. And the best way to do that is to do your homework first (Learn more in our article on How to Choose a Plastic Surgeon).

After you’ve done your research, make sure to do all the things your doctor tells you to prepare for the surgery. This might include getting enough rest, eating well and quitting tobacco–especially that last one (read more here).

After surgery you will be responsible for following doctor’s orders regarding your recovery. This will initially include continuing to avoid tobacco, caring for the incision site, taking your medications, modifying your activity, and getting plenty of rest. Later, following your surgeon’s instructions for scar care, abdominal binding, and maintaining a healthy weight can greatly improve your cosmetic results.

———————-
To learn more about the different types of tummy tucks and which one might be right for you, schedule a consultation with Dr. Slack to develop a specific plan.