Is This For Me?

You should consider an abdominoplasty if:

• You have loose, poorly elastic skin or excessive fat deposits with an undesirable fullness and bulging in your abdomen following pregnancy or weight loss.
• You choose your clothing styles to conceal the excess skin of your stomach.
• You notice that childbirth has stretched your abdominal muscles and tissues to an extent uncorrectable with exercise.

The Consultation

During your consultation, Dr. Forley will first ask about what concerns you most about your appearance. After discussing any relevant medical history, he will examine you to assess your skin quality and amount of skin and fat excess. Your abdominal muscles will be evaluated to look for the presence of lateral muscle displacement known as diastasis recti or any abdominal or umbilical hernias. Hernias may occur after pregnancy and can be repaired at the time of the tummy tuck. The procedure will be explained in detail and you will be given an idea of realistic expectations for improvement with examples of before and after results. Abdominoplasty cannot change the underlying skeleton and any limitations in how much actual muscles can be reshaped will be discussed during the consultation. The length of the incision placed just above the pubis depends on the amount of loose skin correction you require. Dr. Forley will discuss specific ways in which he can minimize the length of your incisions. The quality of the tummy tuck scar depends on several factors including your specific healing characteristics. Frequently, the final appearance of the scar will be a fine line.

Preparation

Achieving a stable body weight is important for the best result. A program of healthy eating and moderate exercise prior to the surgery that is resumed after the recovery period will contribute to maintaining the optimal outcome. A program of vitamins and supplements to optimize your healing and recovery will be provided to you during your pre-op visit. Instructions pertinent to reducing the risk of bleeding and bruising, minimizing discomfort, and maximizing a return to normal activities will also be discussed.

The Procedure

Dr. Forley first makes very precise measurements and markings before beginning any reshaping to enable greatest accuracy in controlling the final appearance. The anesthesiologist will then review with you the epidural and twilight/sedation technique that is utilized exclusively in the Joint Commission accredited office surgical suite. Any excess fat is first contoured with liposuction. The skin and fat are then lifted off the underlying musculature of the abdomen from an incision just above the pubis to the level just below the ribs. If the abdominal muscles are stretched away from the midline, multiple rows of sutures in the fibrous layer that surrounds them will be placed to restore the muscles to their proper position. In essence, the underlying framework of the abdomen is reshaped. Dr. Forley places extra “shock-absorbing” layers of sutures to allow you to resume your normal activities without fear of disrupting the correction. The skin is then pulled downward to tighten it and remove any excess tissue. Although your belly button will remain in the same position, it may be necessary to make a new opening for it once the skin is pulled downward. Dr. Forley will determine what is required in your individual situation during your consultation. The wound is repaired in 3 layers to best support the healing process. None of the sutures will have to be removed—they simply dissolve.

What to Expect After Your Procedure

Most patients experience mild to moderate discomfort for 2-4 days following the surgery that is treated with pain medication. Although some discomfort may linger after the first few days, it usually is well tolerated with occasional use of medication. A liquid diet (e.g. soup, protein shakes) is recommended for the first 2 days after which you can resume a normal diet. It’s important to be up and about the day following your procedure. The amount of activity will depend on the specific procedure required to reshape your abdomen. A drain is used for 5-7 days after the surgery to remove any fluid that normally will develop in the area of the surgery. You will be able to shower within a few days. Swelling diminishes over the first 2-4 weeks and continues to improve for several months. A compression garment is used after the surgery for about 4 weeks. A sense of tightness and hardening of abdominal areas may be present for a few weeks until the swelling resolves and your tissues get accustomed to their new shape. Exercise may be resumed at 6-8 weeks.

The Stages of Recovery

• Day of surgery: May be performed as an outpatient procedure in our accredited office-based surgery facility. A nurse can be booked to monitor you overnight.
• Bruising and swelling resolve: 10-14 days for the first stage with continued improvement occurring for several months and up to 1 year.
• Return to work, social activity: Average is 2 weeks.
• Aerobic or strenuous activity: 6-8 weeks.

Potential Risks and Complications

Limitations and risks associated with abdominoplasty are few. Other risks common to all surgical procedures such as bleeding, infection, thickened scar tissue formation, and blood clots occur in a very small percentage of cases. We will give you more detailed information about these and other rare risks in our written information and encourage you to discuss any which concern you during your consultation.

Minimally Invasive Options

During your consultation, Dr. Forley will discuss alternatives to a tummy tuck for you to consider should you be a candidate for a less invasive approach. This includes BodyTite™, the new minimally invasive subdermal radiofrequency energy procedure to lift and tighten skin laxity of the abdomen.