Are there different types of abdominoplasty?
Yes, there are several different variations:
Full abdominoplasty is the procedure we perform most frequently. This involves a hip-to-hip incision, full fascial tightening, and removal of the skin and fat from the belly button to the pubic area. The belly button is still your original belly button, but it is sewn into a new opening. Small amounts of liposuction are used to contour the ends of the incision and the pubic area if necessary.
Modified abdominoplasty can occasionally be used when the skin above the navel does not need any correction. The fascial plication can still be performed and the only difference is that there is no scar around the belly button.
Mini-abdominoplasty involves a similar incision (sometimes slightly shorter), with removal of only some of the lower abdominal skin and no detachment of the belly button. This is a more limited operation that can benefit women who have a smaller amount of loose skin located below the belly button.
Fleur-de-lis abdominoplasty is occasionally done for women who have lost a large amount of weight and need tightening in both vertical and horizontal directions. This involves a long vertical incision in addition to the hip-to-hip incision, and ends up looking like a large “T.”
You will need a consultation in person to determine what technique is best for you.
How can I determine if I need an abdominoplasty or liposuction on my abdomen?
Liposuction is a good option for women who have good skin tone and are at or very close to their ideal body weight. There is no overhang of the lower abdominal skin, but there is a pooch in the midsection that won't respond to diet and exercise. Liposuction can thin the layer of fat under the skin, but does not offer any skin tightening benefits.
Many of our patients interested in abdominoplasty worry that they still look pregnant even after having their children. If you dislike your abdomen because of loose skin, stretch marks, and loose or separated abdominal muscles, you’re probably a better candidate for abdominoplasty. Liposuction is often used for extra contouring with an abdominoplasty, but it cannot correct loose skin or stretch marks by itself. Many of us who have had babies have some loose abdominal skin and stretch marks, and these are usually best addressed with abdominoplasty.
Why do I need to quit smoking in order to have an abdominoplasty?
Because smoking can significantly affect your ability to heal due to altered blood supply, we will not perform abdominoplasty on active smokers. You will need to quit smoking in order to be a safe candidate for this surgery.
Is abdominoplasty part of a mommy makeover?
Yes, abdominoplasty is often part of a mommy makeover. Mommy makeover refers to combinations of cosmetic breast and abdominal surgery such as abdominoplasty, liposuction, breast augmentation and lift, which aim to reverse some of the changes that happen to women’s bodies after pregnancy and childbirth. We don’t promote the use of the term mommy makeover, since the term is non-specific. However, we do offer all of the usual components of the mommy makeover, either in combination or as stand-alone procedures. We will tailor that procedure combination to each patient, to ensure the results meet her aesthetic goals.
Is it safe to combine other procedures with abdominoplasty?
In very healthy women, we commonly combine cosmetic breast and abdomen procedures. We endeavor to keep surgery times under five hours whenever possible. The risk of developing blood clots in the legs is higher in longer procedures with longer recovery times. We often prescribe a mild blood thinner for a short time after abdominoplasty in order to prevent blood clots from developing.
What other risks are associated with abdominoplasty?
Bleeding and infection are risks with any surgery, although they happen quite infrequently. If blood supply to the remaining skin and the belly button are not good, there can be healing problems with these areas. Fluid can collect under the skin (seroma), requiring drainage with a needle. Numbness on the skin of the abdomen is expected after surgery, and can be permanent in isolated areas. Scars usually fade well with time, but occasionally can be raised, red, uneven, bumpy, or itchy, even in the longer term.
Will I need a drain?
One of the advances that we have made in our abdominoplasty technique has been the elimination of drains in almost all cases. While many surgeons do use drains (and that is perfectly acceptable), we prefer instead to use quilting or progressive tension sutures. It takes a bit more time and effort in the operating room to place these extra sutures, but they allow us to fasten the abdominal skin back down to the underlying fascia without placing a drain. The result is less swelling, fewer seromas, less tension on the incision, and happier patients!
Will I need to stay in the hospital?
While it is very common for abdominoplasty patients to go home on the day of surgery, we typically perform our abdominoplasty procedures at Mineral Springs Hospital in Banff. This allows our patients to get the benefits of nursing help for 1-2 nights before heading home. By the time you are discharged, you will be more mobile and able to travel home more comfortably.
What type of pain control will I need?
We can often place a nerve (TAP) block in the abdominal wall during surgery, and this can be quite effective for pain control the first day. We also prescribe a variety of pain medications both before and after your surgery which are designed to keep you comfortable. This “multimodal” approach to pain control has made recovery from abdominoplasty much easier for patients.
What will my abdominoplasty recovery be like?
Some discomfort and overall fatigue is to be expected for several weeks after abdominoplasty. When you first go home, you may feel most comfortable bent at the waist, in a recliner, or propped up a bit in bed. We encourage getting up to stretch your legs and doing deep breathing exercises every couple of hours. You can shower right away. Pass off household chores and childcare at first - you need time to rest and recover. We provide compression garments (Spanx and a body suit) that minimize swelling. Not everyone likes wearing the garments, but compression can be very helpful once you are up and moving around because otherwise the swelling tends to collect just above the scar and this can be uncomfortable. You can go for short walks as soon as you feel up to it, but exercise which raises your heart rate and blood pressure should wait for at least two weeks. Heavy lifting should wait for six weeks to allow for full healing before placing that much strain on the abdomen.
Many women are surprised to learn how long the swelling can stick around after abdominoplasty. It can take 3-4 months for most of the swelling to go away, and a year or more for complete recovery including full reduction of swelling and fading of scars.
When can I return to work after abdominoplasty?
We generally suggest three weeks off work, and possibly longer if you have a very strenuous job. Heavy lifting should be avoided for about six weeks while the muscle tightening has time to heal. You will then find that you need to ease back into your previous activity level.
A tummy tuck offers our patients dramatic body contouring that can be permanent as long as a healthy weight is maintained after surgery. To find out whether abdominoplasty is the right option for you, contact Banff Plastic Surgery at 403-762-2055.