Abdominoplasty ("Tummytuck")
This page gives detailed information
about abdominoplasty ("Tummytuck").
Richard V. Dowden, M.D., C.M., F.A.C.S.
Certified by the American Board of Plastic Surgery
Cosmetic and Plastic Surgery, Inc.
6770 Mayfield Road, Suite 410
(Mayfield Heights)
Cleveland, Ohio 44124
(440) 449-7470
Abdominoplasty ("Tummy-tuck")
With the passage of time, and especially after weight gain or pregnancy, the contour and other characteristics of the abdomen may become problematic. There may be loose, wrinkled skin with obvious stretch marks, the muscles may be stretched, lax, and separated in the center, and a roll of fat may accumulate in the front of the lower abdomen, all of which is made even more obvious when sitting or bending over. Many people with these problems are led to believe that diet and exercise will take care of all these problems, and then they become discouraged when they see no progress. Abdominoplasty (also known as "tummy-tuck" ) is a technique to improve some of those characteristics which diet and exercise cannot:
Correcting abdominal contour:
| Dieting: | Exercise: | Surgery: |
|---|
| Loose skin: | No - makes it worse | No effect | Yes, excess removed |
|---|
| Excess fat: | Yes - heredity limits it | Only effective with diet | Yes, much removed |
|---|
| Lax muscles: | No effect | Prior stretching limits it | Yes, tightens them |
|---|
| Internal fat: | Yes - very effective | Only effective with diet | No effect |
|---|
| Stretch marks: | No - makes them worse | No effect | Helps somewhat |
|---|
Abdominoplasty is not a substitute for weight loss, and Dr. Dowden does not consider abdominoplasty appropriate as a method of weight loss for obese people. It can be performed as an isolated procedure, but Dr. Dowden does often combine abdominoplasty with other operations. In particular, abdominoplasty combines very naturally with breast augmentation through the navel, the TUBA procedure.
Every procedure has positive aspects and negative aspects. There are advantages and disadvantages of abdominoplasty, which must be considered when deciding whether the procedure is appropriate. In addition, every operation has potential complications, which can occur in a small percentage of patients even in the best of hands, and it is therefore possible to have complications after abdominoplasty, of which patients should be aware.
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The excessive loose skin of the lower abdomen is removed, and the remaining skin is repositioned, stretched smooth, and tightened. Lower stretch marks are removed, and upper stretch marks are lowered down. Any low fat roll is removed or redistributed. The muscles are tightened and cinched together to accentuate the waistline.
In selected patients who need the muscle tightening, but do not have excessive skin needing removal, the tightening can be done endoscopically, avoiding the need for a large incision.
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The advantages of abdominoplasty in general are:
- Only method for skin tightening.
- Tightens and cinches stretched muscles.
- Removes some excess fat.
- Helps decrease stretch marks.
- Long-lasting result.
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The disadvantages of abdominoplasty in general are:
- Long horizontal scar above pubic hairline.*
- Scar around belly-button.
- Recovery time 1-3 weeks.
- Temporary bruising.
- Temporary numbness.
- Temporary swelling.
- Expenses
(* In some cases, if the skin is not excessive, muscle tightening is done
endoscopically, without the horizontal scar.)(Also, in some cases, the scar can be somewhat shorter; see next section.)
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Some patients have only a little excess skin of the abdomen. For those patients, the low horizontal scar does not need to be as long. The way to tell on yourself is to bend forward at the waist, pinch the roll of extra skin of the lower abdomen, and then follow that fold out to the side. Wherever that fold goes to, that is probably where the scar will need to go to as well.
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The fees for abdominoplasty by Dr Dowden include preoperative testing, operating room, anesthesiologist, supplies, medications, dressings, surgeon's fee, recovery room, overnight stay, and office checkups for 12 months, and the cost depends upon which surgical facility is used.
One can find surgeons offering lower fees for this surgery, and although lower fees do not necessarily mean that the surgeon is not experienced, there are several questions to which prospective patients must learn the answers:
- Is the surgeon certified by The American Board of Plastic Surgery?
- Does the surgeon have considerable experience with the surgery?
- Is the surgical facility fully accredited for general anesthesia?
- Will there be an M.D. Anesthesiologist present?
- Will the surgeon be doing the surgery himself/herself?
- Can you be sure the surgeon is not just supervising trainees?
- Does the quoted fee include everything listed above?
You want to be certain the answer is yes to all of these before deciding.
All cosmetic surgery is prepaid, but various financing options are available. It is not appropriate for health insurance to cover cosmetic surgery, and abdominoplasty is almost always cosmetic surgery. In some rare situations, such as after massive weight loss, or presence of an abdominal hernia or similar problem, health insurance assistance may be appropriate, and only in such a case would Dr. Dowden submit abdominoplasty to a patient's insurance company.
For the most current cost information, link to the cost page.
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Complications are very unlikely after cosmetic surgery, but can occur in a very small percentage of patients, even in the hands of a highly skilled and qualified plastic surgeon. Any operation carries the possibility of anesthetic risks, bleeding, infection, suboptimal scarring, and poor healing. Rarely there can be numbness, skin irregularity, fluid pockets, and discoloration after abdominoplasty. Complications are less likely if the patient is a non-smoker, is not overweight, and avoids medicines that promote bleeding, such as aspirin. Smoking, in particular, is so damaging to the skin circulation that many plastic surgeons will not perform abdominoplasty if the patient has any nicotine blood level at all, so smoking needs to be stopped wellin advance.
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It is usually advisable to stay overnight after abdominoplasty. Recovery time varies from one person to another, and depends upon the person's age and the nature of their work and activities, but most people are back to work in five to seven days. A support binder may be worn for several weeks, which may limit activities.
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Images Copyright © R.V.Dowden, MD, 1995, 1996, 1997, 1998, 1999, 2000, 2001, 2002.
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If you are interested in abdominoplasty and want to find a board-certified Plastic Surgeon in your area who is qualified to do it, call the referral service of the American Society of Plastic Surgeons at (800)-635-0635, or check
http://www.plasticsurgery.org. To find out if a surgeon whose name you have been given is truly a Board-Certified Plastic Surgeon, put the name into the search engine at http://www.abms.org to find out.
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Images Copyright © R.V. Dowden, MD, 1995, 1996, 1997, 1998, 1999, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007.
This information may not be reproduced or distributed electronically or in print without permission from Dr. Dowden.
Note that while the information given by Dr. Dowden during a consultation is completely current and up-to-date, the information of this website is only as current as the date of last update, and therefore may become out-of-date.
6770 Mayfield Road, Suite 410
Mayfield Heights, Ohio 44124
(440) 449-7470
Note: To ensure privacy for our patients, all of our outgoing phone lines have their caller ID permanently blocked; if your phone does not accept blocked ID calls you will not be able to receive any calls back from our office.
Last Update: 5:46 PM on 07/30/2007
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