Tummy Tuck Surgery (Abdominoplasty)
The abdominoplasty (tummy tuck) is designed to improve the appearance of the abdomen in both male and female patients. There are a variety of different procedures that can be used to maximize the appearance and contour of the patient’s abdomen.
Indications: Most of our patients who undergo abdominoplasty are recovering from either weight loss, or from the effects of pregnancies. The deformity that ensues after pregnancy is caused by two factors. 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 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.
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 is performed. In patients who have had in vitro fertilization and laparoscopy for treatment, 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.
Operation: The procedure 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 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.
Patients who are contemplating additional pregnancies should wait until they are complete, 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.
Anesthesia: 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.
Convalescence: 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: 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.
Cigarette Smoking: 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.
Insurance Reimbursement: 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.