Tummy Tuck (Abdominoplasty)
Tummy Tuck, or abdominoplasty, is one of the most common cosmetic surgery procedures performed.
Dr. Roth will first listen to your concerns and goals. He will then gather a thorough medical history. Past medical events may impact your surgery, anesthesia, and recovery. Current issues such as; medications, herbal remedies, allergies, smoking, drug use, bleeding and scarring tendencies, will be reviewed. Chronic issues, (e.g. diabetes, high blood pressure, auto immune disease), are also important.
Dr. Roth will examine you and will describe not only what he sees, but also how it relates to your appearance or other issues. He will then explain what might be done to improve each area medically or surgically. You may not wish to take advantage of every treatment that is available, but at least you can know about available options and what each might offer.
Before Your Procedure
Many things can effect the success of the procedure, the subsequent healing process, and final result. Clearly, issues effecting your general health and ability to heal can impact the process, but more subtle issues and practices can also make a significant impact.. It is imperative that patients refrain from ingesting any medications or other substances that could potentially cause surgical complications. A list of medications should be reviewed and selected medications discontinued at least two weeks prior to the procedure.
Patients undergo a general physical examination prior to their surgery. This is to ensure that no underlying medical problems exist that may interfere with the safety of their surgery. The Anesthesiologist may have specific criteria to be met. Appropriate consultation, (Cardiology, Pulmonary, etc.) may be requested to address any issues. Any issues, however trivial they may seem, should be reported. For example, a seemingly innocent minor infection can result in a surgical wound infection, and so must be treated prior to surgery. Likewise, hypertension must be under control. Blood pressure medicines are typically taken right up to the time of your procedure. Cigarette smoking has a significant impact on wound healing and needs to be discontinued prior to the operation. Some procedures will not be done in those who smoke. Serious wound healing complications can occur in patients who are exposed to smoke, even passively. The risk of wound healing problems decreases after one quits. Appropriate timing of surgery after cessation of tobacco exposure can be discussed.
Preoperative photographs are taken. They assist in the planning of the procedure and in reviewing the improvement afterwards. Postoperative photographs are generally taken at 3 and 6 months after your procedure as well.You will be asked to sign a surgical consent, which enumerates the risks of the procedure in detail. Some of these risks have been reviewed here, but are also discussed at the consultation.
Appropriate prescriptions are written, (e.g. pain pills, so that you will be able to take them when you return home).
You will need to arrange for someone to drive you to and from the surgery center. Patients cannot drive after surgery, and for 10 days afterward. Recently sedated patients will not be placed into taxis for transport home. Medical transportation can be arranged in the event that you cannot find someone. It is also mandatory to have someone stay with you for at least 24 hours after surgery, for your comfort and safety. This will be less of an issue if the determination is made that you will stay in an observation unit overnight after the procedure.
After Your Procedure
After arrival at the surgicenter. The nursing staff will register you and have you change into the appropriate gown.
The choice of anesthetic will be made with input from the Patient, Surgeon and Anesthesiologist. Continuous monitoring of your vital signs is carried out throughout the operation.
There are different ways to perform the Tummy Tuck, (Abdominoplasty). These are determined by the individual's anatomy, tissues, and goals.
The procedure takes a variable amount of time, depending on the extent of your particular anatomy, tissues, and procedure. Appropriate arrangements will be made so that you'll be observed for the first night after the procedure.
Remember that any surgical procedure requires a certain period of recovery from the surgery and anesthetic. Individuals vary, but it is possible to experience soreness, swelling, and bruising.
You will need to have someone drive you home from the surgery center. Again, Less of an issue if it is decided that you will stay overnight in an observation unit. You should also have someone stay with you the first couple of days after you go home. You will also need someone to drive you to your visits to the Doctor. Remember, no driving for 10 days after the procedure. Any discomfort following abdominoplasty, is usually controlled well with the prescribed pain medication.
Since excess tissue will be taken from your abdomen, it will be difficult for you to completely "straighten up" for a few days. Tightness will progressively disappear. You must change your position and walk around the house every few hours. The post operative garment, (elastic abdominal binder), will provide gentle pressure to give you stability and support, and to reduce swelling. You may shower after removal of the dressings 2-3 days after the procedure. Many patients wear the binder for several weeks and some choose to wear it for several months. You should be able to gauge your comfort level.
Although you will be up and around in a day or two, you should plan to take it a little slower the 2-3 weeks. After the first two weeks you may resume moderate walks. We will examine you after the procedure, and the stitches will be removed from around the belly button 5-7 days after surgery, the remaining sutures in the skin 14-28 days after surgery. If your work is sedentary, you will probably return to work in 10-14 days after discussing this with the Doctor, knowing that you may be sore. Do not plan on resuming aerobic or strenuous excercise for about 5-6 weeks after surgery. Let your body be your guide. Sun exposure is discouraged for at least the first few months.
The extent of the operation may effect the length of recovery. The "Mini Tummy Tuck", (Mini-Abdominoplasty with Abdominal Wall Plication), is not as extensive an operation. Recovery is usually significantly faster.
Everyone responds differently to an operation. It may take some time for the healing process to let you accurately appreciate the operation. With proper peri-operative care, you should be able to maximize the healing process and help to achieve your goals.