Abdominoplasty is one of Dr. Secretan’s most commonly requested surgical procedures – it’s not the same as liposuction, although liposuction may be done along with a tummy tuck. A tummy tuck is suitable for men and women who are in good health. Women who have had several pregnancies may find the procedure useful for tightening their abdominal muscles and reducing excess skin.
There are a number of significant advantages to undergoing a full tummy tuck. The primary benefits come from resolving the persistent components of abdominal wall deformity. A full tummy tuck leads to the permanent removal of stretch marks and excessive lower abdominal skin. Barring the patient gaining a significant amount of weight or giving birth to a child, the treatment also leads to permanent tightening of the abdominal wall, an improved waistline and improvement of the belly button’s contour.
A full tummy tuck addresses the muscles above and below the belly button, along with excessive or loose skin, but for patients who have a tight abdominal wall that doesn’t protrude significantly, and haven’t lost a significant amount of weight with resulting excessive sagging skin, a mini tummy tuck might be a better procedure.
In contrast to a full tummy tuck surgery, a mini tummy tuck only addresses the excess fat and skin just above the pubic area, and involves a smaller scar and quicker recovery. This excess fat and skin is most common in women after pregnancy and C-sections, and exercise alone won’t eliminate the problem.
Dr. Secretan will first outline the area of the body where skin and fat are to be removed. A horizontal incision, just above the pubic hairline, is then made in order to allow for the removal of unwanted tissue and skin. Consideration is paid to creating an area of skin (above the operational area) that can be pulled down and sutured closed at the end of the procedure. The shape and length of this incision is determined by the degree of correction required. A second incision, located around the navel, is made in order to be able to remove the excess skin and close the incision. Excess fat above the belly button is removed with liposuction while the skin and fat from the belly button to pubic area is removed by excision. We then place internal stitches that tighten loose fascia/muscle from the rib cage to the pubic bone. The upper abdominal skin and remaining fat from above the surgical site are then pulled down. We close the lower abdominal incisions with absorbable, internal stitches without having to place external stitches. After the procedure is complete, the patient’s belly button will be oriented vertically to give it a more youthful appearance.
Loose skin cannot be removed without leaving scars, and body contouring often means long incisions that result in long scars. Dr. Secretan will make every effort to give you the best scars possible, and to conceal them in the least visible areas. He will advise you during your consultation about the type of scar you are likely to get. Although scars will fade over time, you should know that the scars will be permanent and that their final width, height and color will not be entirely predictable.
Deciding whether or not to go forward with abdominoplasty is a very personal decision. Those who have experienced extreme weight loss or have had dramatic changes to their bodies as a result of pregnancies are often left with excess fat, weakened muscles and excess skin which cannot be helped by diet and exercise alone. This can be unsightly and shake a person’s confidence. In some cases, it can even contribute to medical issues such as back pain and hernias. Those with only minor sagging around the abdomen may decide that it is not worth undergoing major surgery to correct – however this procedure is suitable for patients with any amount of sagging should they choose it.
Your consultation, which typically lasts 45 minutes, will be your time to spend with Dr. Secretan, as well as the staff. We will discuss your goals and expectations and review with you the various options that exist in performing the procedure. Ample opportunity will be provided to ensure your personal comfort level with both the procedure and with us. Once you have decided to proceed with abdominoplasty, we will do our best to schedule your surgery as conveniently for you as possible.
Tummy tuck risks include:
These risks and others will be fully discussed prior to your consent.
An abdominoplasty surgery can cost anywhere between $7500 and $11000 dollars. While this may seem like quite a wide range, there is good reason for this, as there are a number of factors that go into the cost including the experience of the surgeon, the amount of tissue that has to be removed, scope of the procedure, etc.
A highly qualified surgeon who is in high demand will usually charge more than a less experienced doctor. Also, patients who have a lot of tissue that needs to be removed can expect to pay more than those with only minor sagging. If you are considering having multiple cosmetic procedures done, speak with Dr. Secretan about the possibility of having them all done at once.
For patients whose insurance will not cover cosmetic procedures, there are financing options available. Often patients will use a credit card or a personal line of credit, however our clinic offers financing through companies like Medicard that specialize in financing for cosmetic procedures.
These fees cover the cost of the anesthetist, whose presence is required during and immediately after your surgery, and the anesthesia administered.
These fees cover the cost of where your surgery is scheduled to take place.
In addition to your actual surgery, these fees also cover all pre-operative and post-operative follow-up appointments with your surgeon. Miscellaneous costs include the compression garment and any supplies you’ll need while you recover (such as sterile bandages).
Most plastic surgery procedures are performed as an out patient, although overnight facilities are available for patients undergoing larger procedures or for those that are form out of town or come from a distance.
Do not eat after midnight the night prior to surgery. You may drink clear fluids only, up to 6 hours prior to your scheduled surgery time. We will see you at the clinic before your surgery. We will usually do a few measurements and make several standardized markings before going in to the operating room. Surgery is usually carried out under general anaesthesia, but for some patients, and depending upon the procedure, local anaesthesia with intravenous sedation is used. Our highly skilled anaesthesia and nursing staff are there with you at all times to provide you with a safe experience in as caring and compassionate manner as possible.
The length of surgery depends upon the procedure that you are undergoing. At the conclusion of the surgery, a very light bandage will be applied over the incision site. The anaesthetist will have given you pain medication prior to the end of the surgery to minimize postoperative discomfort. From the operating room, you will be taken to our recovery area where you will stay until you are ready to go home. A recovery room nurse will be attending to you at all times to monitor your recovery and to ensure that you are comfortable.
Once you are ready to be discharged home, we will see you to review your postoperative instructions. You will be given a number to contact us or one of our staff 24 hours a day should you need any advice after leaving the clinic. Because you will have been under an anesthetic, your judgment and coordination may be affected for up to 24 hours. It is important to have a responsible adult pick you up from the clinic and stay with you the first night following surgery.
Following your surgery, there are several things that you should be aware of. Most important, if there is anything at all that you are uncertain about, please make sure to contact our office.
After surgery some discomfort should be expected, however this can be controlled with prescribed medication. It is important to slowly walk around within the first two to three days, slightly bent forward to prevent any tension on the incision. You’ll be required to wear a compression garment for 4-6 weeks after the surgery. This controls swelling and helps the skin in the area conform to its new sleeker contour. It also helps with proper healing of tummy tuck scars. The return to work after your initial mini tummy tuck recovery can be as early as two weeks and 4 weeks for a full tummy tuck, depending on your comfort level.
The mini tummy tuck may not be as strenuous a procedure as the full tuck, and the resulting scar is less visible, however the focus on rest and recovery should be the same to promote successful healing. It can take 6-12 months to see the final result of body contouring surgery.
When you awake from your surgery you will be in the recovery room. Your incision will be well hidden in the low bikini line and groin. You will have your support garment on, and you will most likely not have any drains. If drains are present, there will be one or two soft drains exiting from the pubic area. You may feel some incisional pain and discomfort, but this is generally well controlled by pain medications. If you are not staying overnight, you will be able to go home when you have fully recovered from the sedation.
Immediately after surgery, the skin will feel tight. For the first 2-3 days, you are encouraged to walk slightly bent forward to avoid pulling on the incision line, and to put pillows under your knees and your head when you’re reclining so you’re bent at the waist. You can also sleep on your side in a slight ‘fetal’ position (i.e. bent at the waist). You may find it difficult to rise from a lying position and it will be easier to turn on your side, allow your legs to hang over the side and slowly use your arms to raise yourself to a sitting position before rising. Avoid sitting up in a chair for the first week. You should plan to be off work for 2-3 weeks. During that time, you should take it easy – a little stroll is okay but not much more. We encourage you not to spend all your time in bed. This will minimize the risk of deep clots in your leg veins. Avoid straining, lifting, and bending completely over. You may be able to begin cardio type physical activity at 3-4 weeks. Strenuous physical activity (like lifting weights, abdominal crunches) is not permitted until 6 weeks after surgery.
On the first day after your surgery, you can take a shower. Do not sit in a bath. When taking a shower, remove the support garment and underlying dressing. The small white tapes (called steri-strips) over your incision should be left on. You will need to hold the drains in your hand while you shower. You can wet and soap the tapes and your incision. Use mild soap such as Dove or Ivory. Pat yourself dry using a towel (do not rub) and put the dressing pad and support garment back on. This daily routine will help keep the incision and drain sites clean and will promote wound healing. Taking a bath will only be possible once the drains are out, the sutures around your belly-button are out and the incisions are well on their way to being healed (approximately 2-3 weeks). Avoid swimming pools or whirlpools for at least 1 month.
Drains are used to remove any excess fluid or blood, preventing accumulations under the skin that would promote swelling after tummy tuck surgery. Both drains are usually removed within 2 weeks. Occasionally, they need to be left in longer. Before you are discharged home, the nurse will show you how to empty your drains, but here are a few reminders:
The garment is necessary to support the tightening of your abdominal muscles. It will help to decrease swelling, prevent the accumulation of fluid under the skin, and to conform the skin to its new position, maximizing the cosmetic outcome. Failure to comply with garment instructions will increase the risk of seroma formation and suboptimal results. The garment should be worn day and night for 6 weeks, removing it only to shower or wash the garment. The support garment should cover the incision – if you notice it has slid upwards, you can slide it back down by pulling down at the sides.
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