Tummy Tuck Abdominoplasty
|Photograph before surgery (more about this patient)||Photograph 11 months after body contouring surgery|
Tummy Tuck Abdominoplasty is a family of operations that removes excess skin and fat from the middle and lower abdomen and tightens the abdominal wall. This procedure can dramatically reduce the appearance of a protruding abdomen and stomach. Tummy tuck abdominoplasty surgical sculpting addresses much more than liposuction which is only for localized fat collections. The problem dictates the length of a permanent scar where excess skin and fat are removed. Tummy tuck abdominoplasty is less extensive than a total body lift where the scar extends around the entire body. Total body lifts address sagging tissues around the entire body, front and back. In Mini-tuck abdominoplasty, the scar is the shortest. However, the amount of loose skin that can be removed is the least. In a typical tummy tuck, the scars can extend from hip to hip and another one around the belly button (umbilicus).
Let Dr. Bermant's Tumescent Tummy Tuck be an introduction to your education about this surgery and his sculpture skills. Explore the various pages and see photographs of actual results before, during and after surgery. Read the bulletin boards to see other patient's questions and Dr. Bermant's answers. This is only a start to your learning experience since each patient has a unique anatomic problem that demands a personalized approach. Then continue your education in his office to see what plastic and cosmetic surgery has to offer you.
Best candidates for tummy tuck abdominoplasty
The best candidates for tummy tuck abdominoplasty are women or men who are in relatively good shape but are bothered by a large fat deposit and or loose abdominal skin that will not respond to diet nor exercise. The surgery is particularly helpful to women who, through the stretching of multiple pregnancies, have abdominal muscles and skin that will no longer return to normal.
After massive weight loss, tummy tuck abdominoplasty can tighten loose sagging tissues. Lost skin elasticity in older patients, which frequently occurs with slight obesity, can also be improved. Women planning future pregnancies should consider waiting. The muscles tightened during abdominoplasty can separate again during pregnancy. Skin restretched may again not return to normal proportions. Previous abdominal scars need to be evaluated during an in office examination to see if they might effect possible surgery. Prominent abdominal contour scars like those sometimes seen after Caesarian delivery and other surgery can be removed or improved during this abdominal sculpting.
Before Surgery and 5 months after tummy tuck body sculpture.
Abdominoplasty can enhance your appearance and your self-confidence. It will not necessarily change your looks to match your ideal or cause other people to treat your differently. Think carefully about what this surgery has to offer. Reasonable expectations are essential to a happy outcome.
Weight loss and tummy tuck.
If you are planning to lose a lot of weight, abdominoplasty is best after the weight is stabilized. The skin and flesh are then sculpted to your new form. Massive weight loss after abdominoplasty may leave the skin loose again about the belly. One of the major fat storage areas of the body is the apron of fat around the intestines (omentum). This fat is located behind the abdominal wall and is not treatable with either liposuction or abdominoplasty. This surgery is for sculpture, not weight loss. Weight loss better done with controlled diet and improved eating exercise habits. If you maintain a positive caloric balance after surgery, you will regain your weight.
You should come to the office prepared for an extensive consultation. Dr. Bermant will need to learn about your medical history, problems, surgery and current medications. We need to know about prior cosmetic and abdominal surgery. You will need to help us understand what bothers you. Abdominal surgical sculpture needs to be individualized. Redundant skin and adherent scars are a dynamic problem. Dr. Bermant needs to see how the skin drapes, where the extra tissue is located, check for hernias, and examine your scars. Dr. Bermant will then discuss what surgery has to offer. There are several different surgeries possible depending on the anatomical defect and the nature of your tissues. Dr. Bermant then recommends what method of surgical sculpting is best suited for your problem and then discusses the risks, benefits and alternate methods of care. Understanding the benefits and limitations of surgery helps with realistic expectations.
During this consultation we will also discuss the choice of anesthesia, location of surgery, and the costs involved. In most cases insurance policies do not cover the cost of abdominoplasty, but you should check your policy to be sure. Since Dr. Bermant sees patients from around the world, some prefer to start the process with his preliminary remote package to minimize travel to Richmond.
Tummy Tuck Surgery (caution
links have graphic photographs of the actual surgery)
This surgery is designed to remove and redrape redundant lower and middle abdominal wall skin and fat. Dr. Bermant uses a minimum bruising Tumescent Tummy Tuck surgery where anesthetic fluid can permit this operation to be performed under heavy sedation or light general anesthesia.
An incision above the pubic region and extending towards the hips places the scar where it can hidden by most clothing. Skin and fat are separated from the underlying fascia (layer covering the muscles of the abdominal wall). In the standard operation this dissection continues up to the ribs exposing the vertical muscles (rectus muscles). The skin around the belly button (navel or umbilicus) is divided so the redundant tissue of the upper abdomen can be pulled down. This hole will frequently be pulled far enough down to be removed with the excess tissue. When less tissue needs to be removed, this hole may become a short vertical component of the lower scar.
In a "mini tummy tuck" there is a more limited region dissected and the bellybutton either left in place or repositioned with other techniques. When the navel is left tethered and enough tissue tightening performed, there may be distortion and an unnatural shape to the belly button.
The abdominal wall muscles are then drawn together in the midline narrowing the waistline. This stitching firms the abdominal wall and removes some bulging. The skin flap is then stretched down and the extra skin removed. A new hole is cut for the navel and contoured to create its shape. The tissues are now sewn into place. Typically, Dr. Bermant uses dissolvable sutures on the surface. This depends on your tissues and how it comes together. When superficial sutures need to be removed, Dr. Bermant removes them usually 6-10 days after surgery. Special tape strips may further align the skin. Temporary drain tube(s) may be placed to remove fluid from under the flap. If present, you will be shown how to record the output from these drains. Dressings applied usually include one around the new navel and possibly one over the main incision.
Complete abdominoplasty usually takes two to five hours, depending on the extent of work required. Partial abdominoplasty (mini tummy tuck) may take only an hour or two of operating room time. An extended body lift (back and front at the same operation can take 4 to 10 hours of surgery.
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