Abdominoplasty (Tummy Tuck)
According to the statistics published by the American Society of Aesthetic Plastic Surgery, abdominoplasty is the 3rd most common operation performed by board certified plastic surgeons. In the past year, over 140,000 patients chose to have this procedure. In our practice, it is one of the most frequently performed operations.
The abdominoplasty (tummy tuck) is designed to improve the appearance of the abdomen in both male and female patients. While the vast majority of patients are women, a small percentage of patients are men, usually associated with weight loss. There are a variety of different procedures that can be used to maximize the appearance and contour of the patient’s abdomen.
The most common indication in our practice for abdominoplasty is for women who are trying to restore the abdomen after childbirth. While some women are genetically blessed with minimal damage after multiple pregnancies, women who present to the office are looking to restore their abdomen. This is part of the well-publicized “mommy makeover.”
The problem is usually corrected by restoring 2 areas. The first is the separation (diastasis) of the rectus muscle from the pressure of pregnancy. This problem is compounded by the more pregnancies a patient has, which further stretches the muscle sheath. On thin patients, this may be the only deformity that needs to be repaired. On most other patients, it is a combination of both the laxity of the muscle and the excessive amount of skin that has not retracted months after delivery. In women who have had twins, the stretching and damage to the rectus is usually pronounced.
Dr. Sherman is certified for the use of TissuGlu for a drain-free tummy tuck surgery option. Speak to Dr. Sherman to see if this procedure is right for you!
The design of the operation depends on the anatomy of the patient, the amount of skin that needs to be tightened, and the type of laxity of the abdominal wall.
Many patients are left with an umbilical hernia after pregnancy which may be repaired at the same time as the abdominoplasty. In patients who have had in vitro fertilization and laparoscopy for treatment, or any type of laparascopy through the umbilicus, an umbilical hernia is commonly found. Other patients have large defects of the entire abdominal wall which may require mesh placed behind the muscle layer. Since skin is being removed, in many patients the stretch marks (striae) are also minimized.
The abdominoplasty may be performed as an outpatient. The patient has the choice of our fully accredited office-based surgery Center or either outpatient hospital surgery or inpatient surgery. Dr. Sherman performs the tummy tuck operation at the New York Presbyterian Hospital — Weill Cornell Medical Center, or Lenox Hill Hospital in New York. In Connecticut, the operation is performed at the Greenwich Hospital.
The procedure takes about two hours to complete and is performed under general anesthesia or epidural anesthesia. Different techniques may be used depending on the needs of the patient, the presence of scars, and the contour of the abdominal wall.
Of course, patients who are contemplating additional pregnancies should wait until after all pregnancies to avoid unnecessary and repetitive surgery.
The mini-abdominoplasty is a popular alternative to the full procedure. It may be offered to patients that have a limited amount of skin below the umbilicus (bellybutton) and where the focus of repair is primarily the muscle damage with minimal skin resection.
Depending on the anatomy of the patient and the nature of the operation, this may be performed under general anesthesia or an epidural anesthesia. All our anesthesiologists are board certified and highly experienced.
Recovery after this procedure takes about 10 days to two weeks, depending upon the amount that is performed and the nature of your operation. If a hernia is repaired simultaneously, recuperation will be longer.
Complications after the surgery are well documented. While the incidence of wound healing problems and pulmonary embolism are low, they may occur. To minimize this problem, patients should stop taking birth control pills or any hormone replacement therapy for at least one month prior to surgery. We encourage all our patients to be out of bed and walking the 1st night after surgery. This will greatly reduce the possibility of a deep vein thrombosis.
It should be noted that Dr. Sherman does not perform this operation on cigarette smokers. Most of the potential complications of this operation are related to cigarette smoke including wound healing problems. If you are a smoker, you should stop at least one month prior to surgery. Nicotine patches and gum substitute are not acceptable to diminish the risk of these complications.
In certain individuals, and with several insurance carriers, insurance may apply if there is a documented hernia and repair is performed. On patients who have lost a massive amount of weight, the hanging of skin must be affecting the health of the patient, or causing local wound problems.