A Tummy Tuck Explained
This surgical procedure tackles three different situations:
- Loose skin and/or sagging muscles caused by pregnancy
- Excessive skin that remains after weight loss
- A prominent (protruding) midsection following weight loss
Post-Pregnancy
A woman’s body is not the same after giving birth, and this can be most visible in the tummy. Throughout pregnancy, abdominal skin gets stretched quickly and excessively. This compromises elasticity so that after birth, the skin doesn’t always firm up. Women of all shapes and sizes experience what is commonly referred to as the “pregnancy pouch.”
Pregnancy stretches more than your skin, however. The uterus also forces abdominal muscles to stretch to accommodate the baby. After birth, the tissues surrounding those muscles can create a bulge in the stomach, bloat, and lower back pain.
Weight Loss
Just like pregnancy, weight loss can leave a person with excessive skin. The difference is that many people live overweight for years, severely compromising elasticity and collagen. For comparison, you might think of a rubber band that’s been stretched to the limit. In addition, substantial weight loss can leave sagging skin that is almost impossible to tighten.
Sometimes, weight loss also leaves a slightly protruding belly that is nothing short of confounding. This might be caused by many factors, including genetics, but pockets of fat in certain areas can be very difficult to eliminate – despite your commitment to a healthy lifestyle.
What To Expect
The goal of a tummy tuck is to eliminate excess skin and fat. It also repairs separated abdominal muscles, which, as we discussed earlier, is a common effect of pregnancy. You’ll see a stomach that is firmer, flatter, and more youthful in appearance.
The Consultation
Before surgery, we’ll conduct a thorough consultation to review your current and past medical conditions. We’ll also discuss your reasons for surgery to ensure the procedure is a good match. During this time, it’s important you tell us about your:
- Allergies
- Current medications and supplements
- Previous procedures
- Lifestyle habits and routines
We’ll use the consultation to take photographs and measurements of your body. We’ll then develop a treatment plan that is tailored to your expectations.
The Procedure
Your surgery will take between two and four hours to complete. It is performed as an outpatient procedure, so you’ll likely be able to go home the same day.
The first step in the procedure is to administer general anesthesia. We then make a horizontal incision in your abdomen, below the belly button but above the panty line. The size of this incision depends on the excess skin we need to remove. We can discuss this in greater length during your consultation.
Abdominal Muscles
After the incision, we’ll be able to lift your abdominal skin. This exposes the muscles underneath, and we can repair those if needed. It’s important to know you have eight total muscles in your abdomen. These are laid out as two sets of four, identical on either side of an imaginary horizontal line drawn down the middle of your abdomen.
The muscles are connected to each other and surrounded by a tissue known as fascia. Although muscles are designed to be elastic, fascia is not. This is why when the abdomen expands during weight gain or pregnancy, your midsection remains lax, and the fascia never returns to normal. The result can be a protruding belly, one that persists despite healthy eating and weight loss.
After the Incision
We use permanent sutures to correct muscle separation caused by pulled fascia. These sutures are stitched vertically along the edges of muscles, buried in tissue so they are never felt or seen. You will essentially forget they are there.
If the muscles remain lax after the sutures are in place, we can place additional sutures that run horizontally in the muscles. These are known as corset sutures, and the effect is to pull the muscle in from all directions.
Excess Skin
Once the abdominal muscles have been repaired, we pull your abdominal skin back down. You might think of this action as pulling a window shade. We then trim the excess skin that hangs over and/or causes your abdominal pouch. If you have extra skin in your upper abdomen, we will make another incision around the navel and then trim in that area as well.
After trimming, the taut, healthy skin that remains is sutured together. We then create your belly button opening, push it through the skin’s surface, and suture it in place. We finish the procedure by closing your skin incisions.
The Recovery Process
The recovery process is different for every patient because each body heals in its own way. You’ll need someone to drive you home after surgery, so that’s an important consideration. You may also need some additional help at home, as you’ll likely be restricted in your activities.
It’s normal to feel some tightness in the abdomen as you go through the healing process. This will ease as your body grows accustomed to the repaired muscles. To facilitate this process, you’ll need to refrain from heavy lifting and vigorous physical activity for several weeks.
Medications
You may feel some discomfort in the first days following surgery. To help with this, we’ll prescribe pain medication that should be taken as directed. Following the instructions will help you feel better more quickly and reduce swelling.
We’ll prescribe antibiotics to prevent infection. Just as it’s important to follow the guidelines with your pain medication, you also need to follow the schedule provided with your antibiotics. This includes finishing the entire bottle to assist your recovery.
Bandages
We’ll bandage your abdomen once the surgery is completed. We may also recommend you wear a compression garment to help obtain the desired shape and reduce swelling. We’ll provide you with specific details on changing your bandages and cleaning the incision area. If a compression garment is recommended, we’ll also advise how long it should be worn.
Diet
Immediately after surgery, you’ll want to use caution in how often and how much movement you undertake. Foods that don’t require preparation will keep you nourished and allow you to continue resting. Opt for healthy choices like yogurt, fresh fruits, nuts, and vegetables.
It’s also important to stay hydrated. Water and herbal teas are ideal, as you’ll want to avoid excess salt and sugar consumption while healing. Salt can lead to bloat, while sugar can be hard to burn.
Walking
By the second week of recovery, we will likely recommend you start walking easily and gently. This isn’t meant to be a brisk walk, but simply gentle movement intended to get your blood flowing. The improved flow will protect against blood clots and deliver crucial nutrients to your treatment area; both will assist with healing.
Return to Work
You’ll be advised to resume your normal routine slowly. For instance, you’ll need time off from work – between one and two weeks so you can rest. Jobs that require manual labor or standing on your feet all day may require additional time. We’ll discuss this more personally during your consultation so you can plan accordingly.
Gradual Steps
Other activities will similarly need to be incorporated gradually. You can probably drive within a week, resume low-impact exercising at around six weeks, and engage in regular exercise after eight weeks.
You’ll be able to complete more tasks each day. However, it is crucial that you carefully follow post-surgery orders so your body can heal. Without adequate recovery time, you may need corrective procedures to further repair your muscles.
Smoking
Smoking before and after surgery can have serious complications, both during the procedure and in your recovery. Cigarettes have many damaging effects on the body, including restricting blood flow. We recommend you quit at least six weeks before and abstain for at least six weeks after. Ideally, this would be a good time to quit altogether.
Surgery Results
Patients often ask how quickly they will see results after surgery. You’ll likely start to see an improvement in your appearance around the two-week milestone. Substantial improvements will be visible at around four weeks, with full results showing after six months. The best news is that your wait will be well worth it; results acquired after the procedure are permanent.
We’ll be able to monitor your progress – and recovery – with regularly scheduled office visits. You’ll have between three and five follow-up appointments in the first three months following surgery. After that, we’ll continue to see you annually, but we’re always available to answer questions and help with your additional cosmetic goals.
Health Benefits
A tummy tuck yields undeniable benefits that are readily visible. A more contoured silhouette, flatter midsection, and firmer appearance. But health benefits also accompany this procedure, some of which might surprise you.
Fix a Ventral Hernia
A ventral hernia occurs when tissue or the intestines push against the abdominal wall. Common causes include a cesarean section or substantial weight loss. Because a tummy tuck repairs weak muscles in the midsection, this procedure can also repair a ventral hernia, which in and of itself may be responsible for an obvious stomach pouch.
Address Urinary Incontinence
Stress urinary incontinence (SUI) usually afflicts women, particularly after childbirth. The condition is characterized by bladder leakage caused by pressure to the urethra and bladder. A tummy tuck can relieve this pressure and therefore help reduce the severity of SUI.
Reduce Back Pain
Your core is responsible for many tasks, including supporting the upper body. When muscles in this area are compromised, other muscles have to compensate. This directly causes the back pain that people often complain about after pregnancy and weight loss – weak core muscles that don’t function optimally.
A tummy tuck tightens and restores strength to abdominal muscles. This can alleviate back pain and enable you to participate in activities you may previously have been excluded from.
Improved Posture
The core also provides body balance and ensures proper posture. Once again, by restoring abdominal muscles, a tummy tuck can improve your posture. This is beneficial from a health standpoint, yes, but it can also improve your gait and make you look younger.
Love Your Body
When asked, people often reply they are most dissatisfied with their midsections. This is the part of the body where it’s hardest to lose weight and, once you do shed excess pounds, achieve a completely flat appearance.
Fortunately, you don’t have to live with excess skin, stretched muscles, and frustrating wobbles. A tummy tuck can revive your abdomen for a shapelier and more youthful look. Call us today at Boulder Plastic Surgery in Boulder, CO to schedule your consultation.