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This is Dr. C. Andrew Salzberg, and I’m going to give you an overview of a procedure commonly known as a “tummy tuck.” Three main factors related to the abdomen lead people to seek a tummy tuck:  excess fat, excess skin, and/or a lack of support within the abdominal wall. A tummy tuck procedure — medically called an abdominoplasty — can flatten the lower abdomen, tighten stretched skin, strengthen abdominal muscles and reduce stretch marks.

Most people come to our practice for tummy tuck consultations because they’ve lost a lot of weight, but still carry a substantial amount of excess abdominal skin. For some women, this can be the aftermath of pregnancy and they may be unhappy with extra skin, stretch marks, and a weakened abdominal core. The strength of the abdominal core comes from both muscle and a layer of tissue called fascia, which functions to hold the internal organs in tight. This fascia gets stretched with each pregnancy or large weight gain and does not tighten up with exercise or diet. This is why someone may complain of always feeling bloated, or like they want to “suck in their stomach,” despite serious efforts at dieting and exercise.

It’s important to mention that if your situation is strictly stubborn excess abdominal fat, a more suitable procedure might be liposuction, which removes targeted areas of fat via suction and is less invasive than a tummy tuck. But liposuction cannot correct an abdomen with a great deal of excess skin or loose muscles as abdominoplasty can. A qualified plastic surgeon can help you decide which of these procedures is best for your individual needs.

Abdominoplasty surgery is performed with the patient under general anesthesia. First, we make an elliptical, or egg-shaped, incision just above the belly button, extending sideways to the hipbone. The lower portion of the incision is made low on the stomach, where a C-Section scar would be, for instance. This area of fat in-between both incisions is removed.

Next, we tighten the fascia (the strength layer of stomach tissue) with permanent stitches that restore strength and give that “tight belly” appearance. Then the top incision is pulled down to meet the lower incision like a window shade. The scar is ultimately positioned very low on the abdomen, beneath the underwear line. A new hole is made for your belly button to come through the now tighter and flatter skin. Thus, you will have a small scar around your belly button as well. The net result is less fat, less excess skin, a tight abdominal wall, and no more stretch marks below your belly button.

Abdominoplasty surgery takes about three hours. You can go home after the procedure, with drains to remove fluid from the surgical site that stay in for about two weeks. You’ll also need to wear a compression garment, or SPANX, for about four weeks to help reduce swelling and provide support for the abdominal muscle/fascial repair. You’ll be asked not to lift more than five pounds or engage in strenuous exercise until you are four weeks out from surgery. After that point, you can begin to work up to normal gym activities.

If you’re considering an abdominoplasty, it’s important to feel physically and emotionally prepared — this is a serious commitment to yourself and will take work on your part. You’ll need to be in your best physical shape — at or around your desired weight, not smoking, and with an exercise routine in place to be prepared for recovery and to help maintain your new figure afterward.

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