Tummy Tuck (Abdominoplasty)

Women and men who have loose abdominal skin and fat that is concentrated in the abdomen can benefit from abdominoplasty. Sometimes these conditions are inherited. In other instances, substantial weight loss may cause abdominal skin to become flaccid. Abdominoplasty also can tighten muscles that have been separated and weakened by pregnancy. The procedure may somewhat improve the appearance of stretch marks, especially those located below the navel.

Your Personal Consultation

During the consultation, you will be asked about the results you would like to achieve from abdominoplasty. This will help us to understand your expectations and determine whether they realistically can be achieved.

How Abdominoplasty Is Performed

Individual factors and personal preferences will determine the specific technique selected to smooth and flatten your abdomen.

Generally, a horizontal incision is placed just within or above the pubic area. The length of the incision, which extends laterally toward the pelvic bones, depends largely on the amount of skin to be removed. The contour of this incision will vary somewhat according to the structure of your abdomen and the style of bathing suit or undergarments that you prefer.

Generally, a horizontal incision is placed just within or above the pubic area. If there is loose skin above the navel, a second incision is made around the navel. Skin in the shaded area is separated from the abdominal wall.

Some patients have loose skin above the navel. In such cases a second incision around the navel is made so that the redundant skin above it can be pulled down. The excess abdominal skin is then removed. The position of the navel remains unchanged.

To tighten the abdominal wall, the muscles and fascia of the abdominal wall are brought together with sutures.

Skin of the lower abdomen that contains stretch marks may be removed as well. Any remaining stretch marks may be somewhat flattened and improved, but you should not expect a dramatic change in their appearance.

Abdominal skin is pulled downward, and the excess is removed. A small opening is made to bring the navel through.

The procedure always includes tightening of the underlying abdominal muscles using sutures.

Variations to the Common Abdominoplasty Technique

There are many variations both to the design of the incisions and the technique itself. In some instances, it may be possible to avoid an incision around the navel. When the amount of loose skin is minimal and the excess fat deposits are located below the navel, a short horizontal incision is all that is necessary. This procedure is called a partial, or "mini," abdominoplasty.

Sometimes liposuction may be used alone, or in conjunction with abdominoplasty, to remove abdominal fat. Endoscopic abdominoplasty is another technique for minimizing scars and may be useful when patients have only a mild degree of excess fat and muscle laxity.

Understanding the Risks

Fortunately, significant complications from abdominoplasty are infrequent. Every year, many thousands of people undergo successful aesthetic surgery of the abdomen, experience no major problems and are pleased with the results. Anyone considering surgery, however, should be aware of both the benefits and risks.

I understand that every surgical procedure has risks, but how will I learn more so that I can make an informed decision?

The subject of risks and potential complications of surgery is best discussed on a personal basis between you and Dr. Moliver, or with a staff member in our office.

Some of the potential complications that may be discussed with you include bleeding, infection and reactions to anesthesia. Tissue loss along portions of the horizontal incision is a possibility when the abdominoplasty is very extensive. This complication, which delays healing and prolongs recovery, is more common in patients who smoke or have medical conditions such as diabetes. Revision surgery is sometimes helpful in certain instances where incisions may have healed poorly. If you are a smoker you will be required to stop smoking entirely for six weeks before and after the planned procedure.

Following surgery, occasionally, fluid may accumulate under the skin. Removal of this serum is accomplished with drains placed at the time of your surgery. Dr. Moliver uses a very special type of drain that is painless to remove. It is slipped out in the office anywhere from 7-10 days after surgery.

You can help to lessen certain risks by following our written advice and instructions that we provide.

Your Surgical Experience

Dr. Moliver's goal - and that of the entire staff - is to make your surgical experience as easy and comfortable for you as possible.

Preparing for Surgery

If you are a smoker, you will be asked to stop smoking well in advance of surgery. Aspirin and certain anti-inflammatory drugs can cause increased bleeding, so you should avoid taking these medications for a period of time before surgery. We will ask you to stop some medications, supplements and certain vitamins. A complete list will be provided.

Dr. Moliver performs abdominoplasty as an outpatient procedure. In fact, he was one of the very first in the Houston area to perform outpatient abdominoplasties on a routine basis. Thus far. he has performed over 350 outpatient abdominoplasties. If this is the case, be sure to arrange for someone to drive you home after surgery and to stay with you for at least the next day or two. When abdominoplasty is performed in conjunction with medically necessary procedures such as hysterectomy or hernia repair, a short hospitalization may be required.

The Day of Surgery

Your abdominoplasty may be performed in a hospital or at our AAAASF fully accredited surgical outpatient facility. A general anesthetic is administered, so that you will be asleep throughout the procedure. When surgery is completed, you will be taken into a recovery area where you will continue to be closely monitored. Small drain tubes will have been placed within the abdominal tissues to help avoid accumulation of fluids. Gauze or other dressings may be applied to your abdomen and covered with tape or an elastic bandage.

You may be permitted to go home after a few hours unless you and Dr. Moliver have determined that you will stay in the hospital or our surgical facility overnight.

Frequently Asked Questions

Am I a good candidate for abdominoplasty?

You may be a good candidate for abdominoplasty if you have one or more of the following conditions:

• Excess or sagging abdominal skin.
• An abdomen that protrudes and is out of proportion to the rest of your body.
• Abdominal muscles that have been separated and weakened.
• Excess fatty tissue that is concentrated in your abdomen.

If you plan to become pregnant or lose significant weight in the future, these may be mitigating reasons to possibly postpone abdominoplasty. Scarring from previous abdominal surgery may limit the results of your abdominoplasty.

How will I be evaluated for abdominoplasty?

Dr. Moliver will examine your abdomen while you are standing as well as lying down. Your skin tone and the degree of loose skin in the abdominal region will be assessed. The amount of excess fat in your abdomen and the condition of your abdominal muscles will be assessed as well. You should come to the consultation prepared to discuss your medical history. This will include information about any medical conditions, drug allergies, medical treatments you have received, pregnancies, previous surgeries and medications that you currently take. It is important for you to provide complete information.

Will my insurance help cover the cost of surgery?

Although in rare circumstances we have seen insurance companies cover a portion of this surgery, we have not had that occur in the past several years. For this reason, Dr. Moliver is not accepting insurance reimbursement at this time.

How will I look and feel initially?

The evening of surgery, you will be encouraged to get out of bed for short walks to promote blood circulation. Although you may not be able to stand up completely straight, it is best if you do not sit for long periods of time during the first several days. Straining, bending and lifting must be avoided, since these activities might cause increased swelling or even bleeding. You may be instructed to sleep on your back with a pillow under your knees.

Any surgical drains probably will be removed within a week following surgery, at which time your dressings may also be changed or removed. For the most part, Dr. Moliver does not feel that abdominal binders are beneficial and in many cases may hinder wound healing. The reason for this is that the pressure caused by abdominal binders probably inhibits blood flow to the abdominal skin flap. Generally, stitches will be removed at two weeks after surgery.

You will notice swelling, which is to be expected. Although bruising is uncommon even if concomitant lipoplasty is performed, it occasionally occurs. The bruising and much of the swelling will disappear over a period of weeks. However, it may be months before all swelling subsides and you see the final result of your abdominoplasty. You may also notice some numbness over portions of the abdominal area, and this may persist for several months. Incisions will initially be red or pink in color. They will remain this way for many months following surgery and may even appear to worsen before they finally begin to fade.

When can I resume my normal activities?

It is important to realize that the amount of time it takes for recovery varies greatly among individuals. Depending on the extent of your abdominoplasty and your general physical condition, you may be able to return to non-strenuous work anywhere from one to three weeks after surgery. In many instances, you can resume most of your normal activities, including some form of mild exercise, after a few weeks. You may continue to experience some mild, periodic discomfort and swelling during this time, but such feelings are normal.

Any sexual activity should be avoided for a minimum of two weeks.

How long will the results last?

Abdominoplasty will enhance your body contour by making your abdomen firmer and flatter. You may find that you feel more comfortable in your clothing and are more confident about your appearance.

The incisions from the procedure will heal and fade over time. It is important to realize, however, that the incision lines will be permanently visible. In some instances, they will eventually be only faint lines. Certain individuals may have incision lines that are more noticeable. Fortunately, the incisions for your abdominoplasty are usually in locations concealed by most bathing suits and undergarments.

Unless you gain or lose a significant amount of weight or become pregnant, your abdomen should remain firmer and flatter for many years. However, gravity and the effects of aging will eventually take their toll. If, after a period of years, you again become dissatisfied with the appearance of your abdomen, you may choose to undergo a second procedure to restore a more youthful body contour.

Maintaining a Relationship with Your Plastic Surgeon

You will return to our office for follow-up care at prescribed intervals, at which time your progress will be evaluated.

Please remember that our relationship with you does not end when you leave the operating room. If you have questions or concerns during your recovery, or need additional information at a later time, you should contact us by phone or email.

See examples of tummy tuck surgeries in our Photo Gallery.

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