Are you self conscious of loose, sagging skin around your abdomen? When you do a plank and look down, do you see that tummy skin hanging like a curtain? Looking good in form fitting clothes can seem impossible and showing your midsection at the beach or pool can feel embarrassing. Pregnancy, weight loss, and certain genetics can bring about that stubborn loose, sagging skin.
An abdominoplasty, or tummy tuck, is a procedure aimed at tightening and removing redundant skin and restoring a flatter contour. Often, if the client desires, it is combined with liposuction if there are fat deposits on the flanks, known as love handles or “muffin tops.” For individuals who have never had a “waist,” an abdominoplasty can give considerable improvement. The abdomen can be tightened in layers, depending on each patient’s needs. For young patients, or for those who have not had children, where there is excellent muscle tone, only skin needs to be removed. For those who have had a lot of weight loss or several children, both the muscle layer and the skin usually need tightening. The scar is variable in length and depends on skin excess. There almost always is a scar around the belly button, except in those patients whose skin excess is limited to beneath the belly button (in this case a mini-abdominoplasty is done). Sometimes there may be a short vertical scar extending up from the long scar above the pubic hairline. This needs to be done in cases where there is laxity of skin but not enough to completely excise the former “hole” around the umbilicus. Please ask Dr. Pautler to explain this if it seems unclear.
The surgery usually takes up to three hours and involves general anesthesia and can be either outpatient or involve one overnight stay. Before performing the surgery, Dr. Pautler will draw the skin excision pattern on you while you are standing. She will also outline the areas where fat will be addressed with liposuction. Drains are almost always used, as is some form of compression such as a binder or a garment to wear afterwards.
After the surgery, you will need to sleep in a flexed “beach chair” position for several nights. You will also need to walk bent at the hips for the first week or so. This is because of tightness (which is good!), which will eventually loosen naturally as your skin and muscle layers relax. Pain and discomfort is controlled with a combination of light pain pills, anti-inflammatory meds, and a long lasting injected local anesthetic. The drains are most often removed 4-10 days after surgery in Dr. Pautler’s office. The compressive garment is worn for about 4-6 weeks, and afterwards most patients can return to normal activities. Smaller abdominoplasties involve a quick recovery, while more extensive ones require more healing time.
A mini abdominoplasty (mini tummy tuck) involves a shorter procedure. The correction is limited to the lower portion of the abdomen, mostly below the belly button. After making the incision, Dr. Pautler brings separated abdominal muscles back together along the midline and then sutures them in place. She removes excess fat pockets, smoothes the abdominal skin down and trims away the excess skin.
MINI VS. FULL ABDOMINOPLASTY
Often patients come asking for a mini when what they need is a full. If the skin quality above the navel is fairly smooth and free of stretch marks, while the skin below the navel is loose and saggy, then a mini tummy tuck is appropriate. Liposuction of the flanks can be done too. If the skin both above and below looks wrinkly and stretch marked, then it’s probably best to do a full, with or without the liposuction.
The best candidates for a tummy tuck are adults who are in good health, do not smoke, have a positive outlook, and desire any or all of the following improvements:
- Tightening loose, sagging abdominal skin
- Flattening a protruding belly bulge
- Removing areas of excess fat
- Reshaping a stretched or distorted belly button,
- STOP SMOKING! If you are a smoker, Dr. Pautler will strongly urge you to cease as soon as possible. It is important for you to stop smoking at least three months before and six weeks after your planned surgery. Cigarettes contain nicotine, a powerful substance that decreases blood circulation especially in the areas that need it the most: surgical wounds. Wound healing is slowed, infection risk is increased, and recovery from surgery may be prolonged. Nicotine containing chewing gums, patches, and electronic cigarettes are as harmful as cigarettes, so please try not to use them. If you absolutely cannot curb your smoking, Dr. Pautler asks that you be honest about it and let her know because she may need to alter her surgical plan for you.
The majority of tummy tuck patients that Dr. Pautler sees are mothers who are looking to get their confidence back and feel great about wearing a bikini again. She also see patients, both women and men, ranging in age from 16-70, who have lost a significant amount of weight but are left struggling with the burden of hanging skin.
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Before & After Photos
Browse our before and after gallery to gain a better understanding of the results available from Dr. Simona V. Pautler.