Tummy Tuck / Abdominoplasty After WLS
The abdominoplasty, also known as a tummy tuck, is one of the most trusted and effective plastic surgery procedures available for creating a countered abdomen. A tummy tuck is not a weight loss surgery, and ideal candidates are happy with their weight and have reached weight stability for at least six months and in some cases 12 months. A tummy tuck addresses the overlying tissue of the abdomen. This procedures removes excess skin and fat tissue from the abdomen by surgically removing the redundant portion of the lower abdomen and pulling the overlying skin taught after restoring a tight center line to the abdominal muscles. This procedure is considered to be cosmetic, not medically necessary.
How it Works
When a basic tummy tuck is performed, the skin and tissue is carefully cut along the lower abdomen, generally just above the pubic bone in the cross the hips. Then the tissue is then lifted to expose the abdominal muscles. During an abdominoplasty, the entire abdomen will be addressed, unlike with a panniculectomy. Some surgeons will also offer modified procedures for patients who want to address skin only, or combination procedures where other areas of the body are also addressed. Some people with extreme amount of weight loss, a fleur de lis abdominoplasty will have to improve the contour of the waist. The downside is a vertical incision is needed, but the benefit is improved skin tightening. Infrequently, entire circumference of skin needs to be excise, aka belt lipectomy, to eliminate the excess skin and fat from both the front and back of one’s trunk.
Often times when weight is gained or life events like pregnancy occur, the abdominal muscles experience a separation. This separation, known as diastasis recti, is repaired during abdominoplasty. The plastic surgeon will carefully sew the abdominal muscles together in a vertical line up the “six pack” of abdominal muscles creating the effect of an internal corset. This eliminates the pouches appearance of the abdomen and emphasizes the counter of the waist. This also helps to reset the muscle to the initial length and can help improve one’s ability to have better muscle definition.
Once this work is completed underneath, the overlying tissue is pulled down to smooth the line of the abdomen and a new opening is created for the belly button. The tissue is manipulated to show where excess falls and is then tacked into place at the incision line. At this point your surgeon is able to evaluate exactly how much tissue is truly excess and can be removed. Once this redundant tissue is gone, the surgeon can carefully stitch the overlying tissue along the base line, leaving a scar that can typically be hidden by a bikini bottom.
What Should You Expect
The operating time for a tummy tuck varies based on the complexity of the individual procedure, but is generally performed in about two hours. A tummy tuck will be performed under general anesthesia or with IV sedation, but without any major complications, patients most often are discharged and go home the same day of surgery to begin recovery. Most patients will have 1-2 drains which will be removed at the surgeon’s discretion. Patients will have restrictions on activity after surgery to ensure proper healing and safety. Recovery time will vary for each patient.
It is important to note, a tummy tuck is considered to be a cosmetic procedure and is therefore never covered by health insurance. When pursuing plastic surgery, it is ideal that you are within the range of your ideal weight and that your weight has stabilized. Gaining or losing weight can impact the results of your procedure. We are aiming to tailor your skin to fit your body. For bariatric patients, waiting until you have reached your goal weight and have maintained it for at least 6 months is a good rule of thumb. You will often see guidelines recommending you are at least 18 months out from your bariatric surgery.