Tummy tuck is a comprehensive plastic surgery procedure designed to remove excess skin and fatty tissue from the abdominal area. Although not a weight loss procedure, tummy tuck surgery is often pursued by people who have lost a large amount of weight and desire to remove the excess skin from the lower abdomen. The procedure is also often requested by mothers who wish to restore their pre-pregnancy body contours. Dr. Perez-Gurri has extensive experience performing abdominoplasty, and he has been recognized by his colleagues and patients as a foremost tummy tuck surgeon. If you would like to learn more about tummy tuck with Miami plastic surgeon Dr. Perez-Gurri, please explore the paragraphs listed below.
Many women find that the abdominal area tends to become more flaccid with age and after pregnancy. Most of this flaccidity occurs in the lower abdominal area between the umbilicus and pubic region. Although this condition is most frequently seen after multiple pregnancies and childbirth, it may occur simply as result of aging tissues. The age at which these changes occur varies individually among patients. Patients of varied ages, ranging from the late twenties to late fifties, frequently present with this complaint and desire correction. The correction is a surgical procedure commonly called a tummy tuck or abdominoplasty. These are all terms used to describe the same procedure and are interchangeable. The great majority of “tummy tucks” are performed on women; however, there is a rising percentage of male abdominoplasty surgeries. The overall purpose is to correct the existing flaccidity and reshape the abdominal area.
There are several variants of the tummy tuck. However, for the purpose of this discussion we will refer only to the traditional tummy tuck and mini-tummy tuck.
Dr. Perez-Gurri begins tummy tuck surgery by making a transverse incision that extends from one hip, across the area just above the pubic region and then on to the contra lateral hip. The extent of each incision varies according to each Miami tummy tuck patient’s figure, amount of excess tissues, and aesthetic goals. Accordingly, the tummy tuck surgery can range from removing just a small amount of skin and fat to removing a fairly large amount of tissue. Generally, the heavier and more pendulous the abdomen, the longer the incision will need to be.
This incision allows the elevation and dissection of the entire abdominal skin and fat, from pubic region to the costal margin or rib cage, and breastbone or xyphoid. The umbilicus does not get removed or cut off. Dissection is carefully done around the umbilicus while the rest of the skin and fat are lifted. Our plastic surgeon Dr. Perez-Gurri is then able to remove the entire portion of skin and fat that lies between the umbilicus and pubic area. Although this greatly improves the situation of the excess skin and fat it does not address the flaccidity of the underlying muscular abdominal wall.
Underneath the skin and fat of the abdominal wall lies the muscular layer of the abdomen. The main muscle of the abdomen is the rectus abdominis. This is a muscle consisting of two narrow and straight muscle strips that extend from the lower abdomen near the pubic region to the costal margin or rib cage. Usually these two strips of the muscle are very close together. As a result of pregnancy, weight gain and overall flaccidity, the muscle strips have separated. The resultant area is left very thinned out and weak. During this part of the abdominoplasty operation, Dr. Perez-Gurri will suture these muscle strips together, side-to-side from the pubic region to the breastbone. This in effect creates a “corset” like effect, thereby tightening and strengthening the abdominal wall.
Next, the skin that was originally at the level of the umbilicus is now free to be pulled down to the pubic region. It is then sutured in place. Drains will be placed underneath the skin and brought out separately. These drains are usually removed during the first post-operative week depending on the amount of drainage. The patient has sterile dressings applied followed by an abdominal binder or some other type of compressive surgical garment.
Mini tummy tuck varies from the traditional tummy tuck in the amount of tissue that is removed, the size of the incision and the extent of muscle repair that is performed. During the mini tummy tuck surgery, the amount of the skin to be removed is limited to an area just above the pubic region and below the umbilicus. Dissection of the umbilicus is not performed and muscle suturing is only done in the area below the umbilicus. Generally, Dr. Perez-Gurri performs mini tummy tuck for younger patients who are not overweight.
You will be allowed to go home after your abdominoplasty surgery. You will need to wear the abdominal binder for the following 4-6 weeks. It should be tight fitting but not uncomfortably tight. Dr. Perez-Gurri will see you the following day. If you are in the hospital, he will see you before discharge. If you went home, he will make a home-visit the following day. We want you to be comfortable at home so please wear loose fitting clothes and flat shoes. We strongly suggest the use of a recliner for the firts few days. In bed, prop pillows under your thighs and behind your head. This will allow your body to bend at the waist and therefore take some tension off your suture line. After an abdominoplasty it is absolutely normal to feel tight and experience pain and discomfort in the abdomen, rib cage and back. These symptoms will improve with each passing day. Most of our Miami abdominoplasty patients find that the discomfort can be easily managed with pain medications.
Your prescriptions will be given to you prior to tummy tuck surgery, have them filled. Always have someone else administer your medication to prevent excess ingestion of medicines by self-medication. You may walk and go to the bathroom on the evening of your abdominoplasty surgery. Certainly by the next morning you should be walking short distances in your house. If you have any questions, call the office.
You will visit the office during the first week to have your drains and sutures removed. It is extremely important that you accurately record the drainage coming from your drains every twenty-four hours. These values will determine when we will pull the drains out. Don’t fret; removing the drains does not hurt.
Most tummy tuck surgery patients require two weeks of recovery time before they return to work and /or drive their car. If your work requires strong physical activity, it may be wise to plan for three to four weeks of recovery. Exercise may be continued after 6 weeks and regular household chores within three weeks. Every patient will experience some thing different. If you feel great, don’t over do it.
Complications after abdominoplasty are infrequent. However, because tummy tuck is a surgical procedure, the risk of complications cannot be eliminated altogether. Dr. Perez-Gurri will discuss all of the possible complications with you prior to your treatment, and he will also explain the precautionary steps he will take to minimize any potential risks.
Some of the complications associated with tummy tuck include: keloid scars, loss of tissue and/or umbilicus, altered sensation, collection of fluid under the skin, bleeding, contour irregularities, and blood clots. Some of these complications, if severe enough, may delay recovery time, require further surgery, and may involve other specialists. Please be aware that smokers, diabetics and overweight individuals have a higher incidence of complications when compared to those who do not smoke, have diabetes or are not overweight. You should also note that patients undergoing combined procedures (such as hysterectomy and tummy tuck) have a higher complication rate than those undergoing a single cosmetic surgery procedure.
Tummy tuck is considered a body-contouring procedure. It is not meant as substitute for weight reduction or an exercise routine. We have found that one of the key factors in achieving high patient satisfaction is appropriate patient expectations. Body image is unique and what the patient frequently sees may not be the image that is seen by the surgeon. Therefore, it is important that you become keenly aware of your expectations for the procedure, know its limitations and fully discuss any concerns with Dr. Perez-Gurri. He encourages questions and always takes the time to answer them fully. This approach helps create proper expectations and allows Dr. Perez-Gurri to consistently deliver highly satisfying results for all of his patients.
What if I get pregnant?
Although there is no definitive medical research on this issue, there have been cases of women getting pregnant without any difficulty and carrying their baby to full term. The skin is a wonderful, elastic organ capable of being stretched over time. It has been our experience that abdominoplasty patients may or may not need further surgery following pregnancy.
Will I gain weight again?
The portion of skin and fat that was removed will never come back again. However, if you do not watch what you eat and neglect to exercise it is very likely that you will gain weight in all other areas.
Are my abdominoplasty results permanent?
Although we cannot state that they are, we know of many cases that were performed more than fifteen years ago, that have remained flat.
Will I be completely flat?
Maybe yes and maybe no. Remember that if you are overweight there is always a residual amount of fat underneath the abdominal skin following surgery that will not allow you to be flat. Even patients who are within their weight limit may not be “completely” flat because their expectations exceed the possible surgical outcome. A better term that we like to use is to leave you “flatter”. Also remember that even thin persons when sitting will have some hanging skin and fat.
Will my stretch marks go away?
Very possibly. There are no permanent cures for stretch marks. Different creams and remedies exist that temporarily hydrate the skin making the stretch marks less visible but they do not remove stretch marks. Lasers have been utilized to treat stretch marks but are only effective in reducing the color intensity of red/bluish ones. If your stretch marks exist below the umbilicus the likelihood is very high that a total tummy tuck will remove them. However, if the stretch marks are above the umbilicus or on the hips they will not be removed. With a total tummy tuck the stretch marks above the umbilicus will lie near the pubic area following your surgery.
Dr. Perez-Gurri and his medical team hope that this information was helpful to you. However, they would like to remind you that definitive answers to your questions can be found only during a personal consultation with Dr. Perez-Gurri. You can schedule your one-on-one appointment by calling his cosmetic surgery offices at (305) 596-2228 or email him at email@example.com.
During your consultation, Dr. Perez-Gurri will determine whether you are a Miami tummy tuck candidate, and he will also explain other body contouring procedures, such as liposuction and mommy makeover in Miami. He will help you create a comprehensive surgical plan that will deliver aesthetically pleasing, natural-looking results.
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