Tummy Tuck
Contouring procedures for your tummy can involve liposuction, mini-tucks, and full abdominoplasties. Ideally, you should be near your ideal weight and exercise regularly. Sometimes your clothing will just not fit right because of your shape. You should not have any metabolic or eating disorders, or any problems with healing. Your specific goals will often determine which procedure is best for you.
Medical reasons for a panniculectomy (removal of excess skin only) include inability to ambulate normally, chronic pains (that may have to be documented by another doctor), ulcerations under the overhanging pannus (tummy), and chronic rashes or yeast infections where there is skin to skin contact.
Liposuction is best for the individual with a strong abdominal wall, good skin tone, and simply an excess of fatty tissues. Full-term pregnancies will generally stretch your tummy muscles and skin, making liposuction less ideal. Liposuction depends on good skin tone to allow your skin to retract following removal of excess fat. Tumescent techniques, where high volumes of fluid with anesthetics are injected into the fat, are used minimizing blood loss and providing prolonged anesthesia following the procedure. Limited procedures may be done in the office under local anesthesia. However, extensive procedures or those with low pain tolerances should be done in an operating room where IV sedation or a general anesthetic is available. This does increase the cost of the procedure but is usually well worth it in terms of comfort.
Liposuction requires the use of a compression garment or girdle like garment following the procedure and this is worn 24/7 for a minimum of 3 weeks or longer, depending on your bruising. In general, you can return to work in 3-4 days but will again, continue wearing your garment. The more common risks of liposuction include contour irregularities, imperfect contours, asymmetries, numbness, and pigment changes of the skin, especially if you have excessive bruising. Any weight gains in your future will result in fat deposition in places where you have not received liposuction and can result in unusual shapes.
Mini-tucks are for those who have excessive tissues and protuberances below the belly button. This involves excising excess tissues, pulling the belly button down an inch or so, using sutures to tighten the muscles below the belly button and liposuction to thin the areas above the belly button. The scar is approximately 8-10 inches long and at the upper level of your pubic hairline. It is an outpatient procedure and requires use of a surgery center. General anesthesia is required but assures you of complete comfort. A compression garment is again necessary and should be worn 24/7, 4-6 weeks following surgery. Full activities may be resumed at 5-6 weeks following surgery. This can distort your belly button. You can maximize the tightening with an “extended” mini-tuck where the dissection goes above the belly button and muscles are tightened as high as I can reach and your belly button either dropped an inch or sacrificed and reconstructed at a later time. If you bully button already can be pulled to your pubic area, you need a full tummy tuck in Redding.
Full abdominoplasties in Redding, CA involves dissection to your ribs allowing the muscles to be tightened from your ribs down to your pubic region. Excess skin is then removed and you end up with a scar extending from hip to hip. Ideally, during your initial evaluation, the belly button can be pulled down to the pubic region indicating that the almost all of the lower abdominal skin (where most stretch marks exist) can be removed. If there is not excessive skin present but a full tummy tuck is needed to tighten the muscles, then you will eventually have a vertical scar above your pubic area. This scar will discourage you from wearing true bikini type swimsuit as the vertical scar will show. Location of the transverse scar depends on your preference for hi-cut type underwear/swimsuits or the traditional bikini which is cut lower on the thigh. A binder will be worn for 24/7 for 6 weeks with full activities resumed after 6 weeks. Recovery from this procedure takes longest compared to other methods and this is one of our most painful procedures.
A newer technique called lipoabdominoplasty combines aggressive liposuction with excision of excess skin. This is ideal for the patient who has a rather thick layer of fat on their tummy and who does not require or desire maximum tightening of the abdominal muscles. It is safer in that the risk for bleeding and seromas (fluid collections) are less and drains come out sooner, diminishing the risk for infection. This is the tummy tuck of the future and recommended if there is any significant fat layer under the skin.
Full abdominoplasties can be done either as an outpatient (with a pain infusion catheter or patient controlled analgesia IV infusion device) or in-patient where you spend the night at Patient’s Hospital in Redding. This procedure requires a general anesthetic and often requires some delayed (after several months), revisions to improve the result. It is common to have fullness in your upper abdomen after surgery that is amendable to liposuction. The tighter abdomen will require that you use more of your chest muscles (breathe like an athlete) in breathing and can aggravate heartburn if it is already a problem. Abdominoplasties (full and mini) eliminate using your tummy as an option for breast reconstruction should the need arise in the future but can give you a much improved figure. Finally, your tummy is numb below the belly button and sensation may not return to that area.
Additional costs may be incurred for revisions and are usually required to improve on the lateral scars or to flatten the upper abdominal wall even more. This may also apply to liposuction cases or mini-tuck procedures as undesirable contour irregularities may result and motivate one to pursue more procedures to improve on the results obtained from the initial procedure.
