An abdominoplasty, also called a tummy tuck, is a cosmetic surgery procedure which removes excess skin and fat from the abdomen, and tightens the abdominal muscles. During the procedure sutures are used to tighten the abdominal muscles that have separated due to pregnancy or weight gain. The skin from the belly button to the top of the pubic hairline is removed and the incision is closed with dissolvable sutures.
An abdominoplasty is best for people that are young, healthy and close to their ideal body weight. People that have the best results from an abdominoplasty are usually women who have excess skin and fat from having children or patients with excess skin and fat from weight loss. Patients who want to use an abdominoplasty as a weight reduction operation are not typically good candidates. Also, patients who have not had children and have good skin with no stretch marks may be better candidates for liposuction. Often liposuction of the flanks (the sides) and/or thighs is added to the abdominoplasty procedure to improve the contour of the body.
When you come in for your initial consultation, you will meet with both Dr. Maloney one of our clinical coordinators. Dr. Maloney will examine you to determine if you are a good candidate for the procedure. He will discuss details of the operation, show you before and after photos and take some measurements of your breasts. A member of our team will review surgical fees, financing options and answer any other additional questions you may have. If you choose to have surgery with Dr. Maloney, you will return for a pre-operative consultation about three weeks prior to your operation. At this pre-operative appointment, Dr. Maloney will review the surgical plan with you as well as go through consent forms, and give you your prescriptions. One of our team members will take pre-operative photos, review all of your surgical instructions and give you a packet of information so when you leave this appointment you will have everything you need for surgery.
Once you have met with Dr. Maloney and have chosen a surgical date for your abdominoplasty, you should plan for your care and recovery after the operation. You will need to arrange a ride to and from the surgery center as well as arrange for someone to stay with you for the first twenty-four hours. You should take seven days to three weeks off of work for this operation depending on the type of work you perform. Please speak to one of our team members for specific questions related to taking time off of work. If paperwork is required by your employer for your time off, please obtain it ahead of time and bring it to our office. If you smoke, you must quit a minimum of three weeks before surgery. We suggest six to eight weeks, but three weeks is the minimum. Smokers heal more slowly and can have wound healing problems. Smoking may require modifications to the surgical plan. If you take aspirin or another medication that causes bleeding, you should stop taking it three weeks before surgery. If you are taking any diet pills (prescription or over-the-counter) or if you are taking Metformin (a common diabetes medication), you should stop one week prior to surgery because of anesthesia risks. All medications, herbs, vitamins and dietary supplements you are taking should be carefully reviewed with Dr. Maloney prior to surgery. If you are under the care of a physician for any health issues, we may require surgical clearance from your physician and/or cardiologist.
At your pre-operative consultation with Dr. Maloney you will be given a map to the surgery center and your prescriptions. Get these prescriptions filled before surgery. Bags of frozen peas or corn work well as icepacks after your procedure. You need to stay hydrated. Have plenty of water or sports drinks around the house. We suggest you begin a stool softener as narcotic pain medication and anesthesia can make you constipated.
If you are having surgery before 10:00am, you cannot have anything to eat or drink after midnight, this includes water. If your procedure is scheduled for after 10:00am, we suggest drinking 16-24 ounces of Gatorade or other “sports drink” (the full sugar version, not diet) four hours before your operation. Studies have shown this will decrease dehydration and nausea post-surgery. You should not have anything to eat or drink other than the Gatorade. Do not put any lotions, deodorant or make-up on the day of surgery. Please do not wear any jewelry to the surgery center. You should wear comfortable clothes that are easy to get on and off. A shirt that zips or buttons up the front is preferable, as are loose workout type pants or sweat pants. Bring your picture ID when you check into the surgery center. You will check in and then be taken back to the pre-operating area where Dr. Maloney will come and discuss the surgical plan, answer any additional questions you have and mark the surgical site. At this time you will meet the anesthesiologist and ask him/her any questions you may have.
An abdominoplasty takes two to six hours depending on how much extra tissue you have that needs to be removed. The anesthesiologist will put you to sleep for this operation for safety and comfort. Dr. Maloney will make an incision from roughly hip bone to hip bone across your abdomen just above your pubic hairline. This incision is similar to a c-section incision, only longer. The excess fatty tissue will be removed and your abdominal muscles are tightened. A new hole is made for your bellybutton. The excess skin will be pulled tight and sutured into place. Dr. Maloney will inject Experal into the abdominal muscles at the end of the procedure. Experal is a long acting medication which will keep the abdominal muscles numb for the first 72 hours. Because the tightening of the abdominal muscles is the most uncomfortable part of the procedure, the Experal helps significantly with post-operative discomfort. Drains and a compression garment will be placed and you will wake up in the recovery room ready to go home in about an hour.
You will wear a compression garment to minimize swelling and bruising. You may have some drainage of fluid from the incisions especially if liposuction is performed at the same time. You should rest and eat a healthy diet high in protein to assist your body with healing. We recommend early and frequent ambulation after surgery to reduce the risk of blood clot formation in the legs and to speed up your recovery. You may be stiff and sore when you first get up and walk around. You may be swollen after surgery and you may walk hunched over for a few days. It takes about six to ten weeks to see your results, so be patient during the healing process. You will need to record the amount of fluid your drains are collecting. The nurses at the surgery center will show you how to do this before you are discharged home. You will return to the office for your first post-operative exam one to three days after surgery. After this appointment, you may shower and wash your incisions with soap and water. A low grade fever is not uncommon after any operation. If you have any questions during the recovery phase, please do not hesitate to call the office any time, day or night.
After an abdominoplasty procedure your abdomen will be flat with the extra lose skin and fat removed.
An abdominoplasty has both aesthetic and health risks, and it is the patient’s personal decision whether the benefits outweigh those risks. Most patients have discomfort for a few weeks and otherwise heal uneventfully. Some patients may develop minor infections or healing problems that require antibiotics by mouth for a short period of time. There is a risk of blood clot formation in the leg with any operation and thus early and frequent ambulation is important. For a full list of risks, go to www.plasticsurgery.org.
Dr. Maloney is a Harvard trained, board certified plastic surgeon who returned to his home town of Tucson, AZ to open Maloney Plastic Surgery in 2002.