Abdominoplasty is commonly known as a tummy tuck
or belt lipectomy. This operation is designed to rid you of the
excess skin and fat of your abdomen, the protruding belly, love
handles, and tighten weak muscles or whatever it is that has bothered
you for years. This brief discussion is intended to serve as a reference
for the many questions you might have concerning this procedure
Planning
Since everyone is different, each operation is tailor-made and receives
individual attention and thought. This is because no two people
are exactly alike. Irregularities in fat distribution, sag, and
stretched skin are present before surgery. No one is completely
symmetrical at birth.
Because of this, your abdomen has asymmetries prior to surgery.
Symmetry is never completely achieved by surgery but you will be
more symmetrical after the operation than you were at birth. I can
improve and correct what bothers you. Since no one is exactly alike,
I personally take preoperative photographs two weeks prior to surgery
in order to be able to study your particular problem.
Surgery
The
operation is performed in the hospital or at my surgicenter under
general anesthesia. You may choose where you wish to have it performed.
If a hernia or separation of the abdominal muscles is present, insurance
will pay a portion of your surgery. If not, this operation is considered
cosmetic and is not covered by most insurance policies. A general
anesthetic is required to perform this surgery. During the operation,
a transverse incision (similar to a c-section scar) will be made
at the level of your pubic hair and the skin of your abdomen and
flanks will be freed to the level of your rib cage. All possible
skin and fat will be trimmed away. It cannot come back. In addition,
your abdominal muscles will be tightened and your waist tightened
if necessary. Where indicated, liposuction will be performed to
remove unwanted love handles, or hips.
Post Operative Period
Your tissues will resent this "turning back the clock"
and will react with swelling and a feeling of tightness which will
be responsible for some discomfort. If your abdominal muscles are
tightened there will be some discomfort due to the muscles trying
to pull apart. The undercutting and the pull to tighten the skin
occasionally are responsible for some numbness to the lower abdomen.
All areas usually regain their sensation in about three to six months.
After your operation, you will be placed in an abdominal binder.
This will create pressure upon the operative site which will discourage
bleeding and help hold your skin in place until they have had a
chance to become fixed in their new position. An additional advantage
is that the binder reduces swelling and hastens healing. You are
to wear this day and night for three weeks. Your abdomen will show
some early swelling and possible slight discoloration but you will
be able to resume normal activity in two weeks and sports in six
weeks. The greatest concern of all my patients is swelling which
occurs just above the pubic area. This is always there initially
but goes away. The rate of disappearance differs with each patient
but can be hastened by wearing the binder to create mild pressure.
Expectations
Many patients ask if their abdomen will fall again. No, it will
not fall. To safeguard the results you have gained, you are urged
to avoid excessive gain and loss of weight. The stretch will play
havoc with your surgery. Moderate sunshine, if enjoyed, is permissible.
There are a number of misconceptions concerning this operation.
The extremely obese patient who has lost a great deal of weight
will require additional incisions and is called a belt lipectomy.
Their results are universally liked because the patient has been
able to discard excess skin and weight. This allows them to wear
tighter and more attractive clothing. The operation does no remove
stretch marks but does tighten the skin and makes them less noticeable.
It takes about six to nine months before the final results are achieved.
Dr. Manchester's San Diego office is conveniently placed near:
