Abdominoplasty New York City

Abdominoplasty [Tummy Tuck]

Overview:

Patients who have protruding abdomens as a result of weak abdominal muscles, weight gain, sagging skin and an excess fat layer are the usual candidates for the ‘tummy-tuck’ procedure. These findings are frequently associated with pregnancy, weight loss or weight gain and may vary in extent. Patients experience difficulty wearing clothing, maintaining posture and can feel back discomfort because of weakness of the abdominal muscles. Occasionally, when there is excess folding of the skin, inflammation, irritation and hygiene issues are of note. These findings do not respond well to diet and exercise because the skin and underlying muscles have been stretched beyond their ability to retract. A tummy-tuck is not a substitute for weight loss.

Goals:

Abdominoplasty [tummy-tuck] is the procedure created to flatten a protruding abdomen by tightening the abdominal wall muscles and removal of excess fatty tissue and skin. When healing is complete, body contour is improved if not restored. Clothing can be fitted and worn with greater ease and confidence.

The Reverse Tummy Tuck

The classic tummy tuck (abdomenoplasty) is done through a long horizontal lower abdominal incision, just above the pubic hair line and above the groin crease, extending toward the hip on each side. The skin and fat is elevated from the muscles of the abdominal wall, the muscles tightened and the excess skin below the navel is pulled down and removed. Liposuction can also be done at the same time. This results in a low scar generally within the bikini line. However, skin above the navel if often poorly improved and many patients are left with upper abdominal skin redundance, wrinkling and sagging.

The solution to this problem is the Reverse Tummy Tuck done through two incisions – one under each breast in the natural breast fold. The redundant skin and fat is elevated, liposuction carried out if need be, and the skin tightened up to the lower chest area and excess removed. This results in a firmer, smoother upper abdominal appearance with scars well out of view in the natural inframammary breast fold.

Before Surgery:

Your medical history will be evaluated in order to determine your overall health followed by a physical examination. Dr. Simone will discuss how the surgery is performed and what you can reasonable expect with the objective of creating a natural appearance that is pleasing to you. Photographs are taken of the operative area. You will be sent a list of detailed preoperative instructions by mail which may include the restriction of certain drugs [such as those containing aspirin] alcohol, dietary supplements, caffeine and cigarettes. Medications such as antibiotics and/or analgesics may be prescribed. Dr. Simone will discuss risks and complications during your consultation.

Surgery:

Surgery is done either at Lenox Hill Hospital or at the Park Plastic SurgiCenter with anesthesia monitoring. It is done with either local anesthesia with sedation or epidural [spinal] with sedation. A low, modified horizontal incision is made along the pubic area and extends out toward the hip. A second incision outlines the navel and frees it, leaving it attached to its natural stalk. The skin and fat is freed upwards along the muscle which is then tightened to flatten the abdomen. Excess skin and fat is removed, liposuction carried out where indicated in the waste, and the incisions closed, leaving soft rubber drains in place to prevent fluid accumulation and reduce swelling. A new opening is made for the belly button to be reinserted. A moderately compressive garment is used to support the muscles and to minimize swelling. For small degrees of deformity, a “mini-tuck” may be done.

Associated procedures:

Abdominoplasty is often done with liposuction of waist and hips as well as aesthetic breast surgery.

After Surgery:

Depending on the extent of surgery, patients may either stay overnight or be discharged the same day.

An inclusive written list of specific post-op instructions will be given to you upon discharge. In addition,

• Dressings are changed in 48 hours at which time drains are removed by Dr. Simone
• Antibiotics are taken for 5-7 days
• Exercise is not permitted for 3-4 weeks, but isotonic leg exercises will be outlined
• At least 7-10 days should be taken off from work
• Pain is moderate to significant but easily controlled with good prescribed analgesics.
• Movement is often difficult but improves after the first 48-72 hours.
• Removal of sutures starts about the 7th post-op day
• You can anticipate 3-4 post-op office visits in the first 2 weeks

Abdominoplasty is an excellent option for patients with weakened abdomenal muscles, with or without excess, flaccid or redundant skin and fat. It will tighten and flatten the abdomen as well as give a better sense of posture and strength.