Tummy tucks – also known as abdominoplasties – have grown significantly in popularity over the past 15 years, and they are now one of the most common procedures performed by plastic surgeons. Part of the reason why tummy tucks have grown in popularity over the years is our increased focus on health and fitness, but another big reason is that tummy tucks can provide dramatic results. There have been recent advances in the procedure that offer better pain control and a better recovery. Now may be a good time to take a fresh look at some of the most common questions that patients ask us about abdominoplasties.
“Do I need a full tummy tuck, or can I have a smaller scar – say with a “mini” tummy tuck or just liposuction?”
There is not just one type of tummy tuck – abdominal contouring can include a variety of approaches depending on one’s individual situation. It is often helpful to think of a tummy tuck in terms of where the problem is. Is there too much loose skin, is there too much fat, or have the muscles been stretched or separated by pregnancy? If your skin is relatively tight then you may be a good candidate for a reduced scar approach, such as liposuction (tiny scars), an endoscopic abdominoplasty (1-2 inch scar), or a mini-abdominoplasty (a scar about the length of a C-section). On the other hand, if there is a lot of loose skin that you will need tightened, that will require a longer scar. If there is too much fat, then liposuction can be combined with the removal of skin – a very common situation. If the muscles are separated, then some sort of tummy tuck with muscle repair is needed, however the incision can be short or long depending on the skin.
“Do I have to have a drain after a tummy tuck?”
Historically the answer to that question was “yes”; however, new techniques have eliminated the need for drains in many cases. We now can use special stitches – known as progressive tension sutures – to seal the tissue together so that there is no need for a drain. The progressive tension technique has another advantage as well; it often allows us to remove a bit more skin than we could otherwise. Although I currently can’t prove it, I also suspect that the sutures help make the scar from the tummy tuck better because they reduce the tension on the skin during healing. Patients love it when they don’t have to have drains.
“How much pain will I have after a tummy tuck?”
Historically tummy tucks were one of the more painful operations that plastic surgeons performed, especially when repair of the muscles was required. Over the past several years, the development of some new ways of controlling pain has helped this situation a lot. First came the development of pain pumps – these are devices that push a local anesthetic through a small tube and into the area of surgery. These were very helpful and many surgeons still use them, but it requires a tube coming out of the skin. More recently there has been the development of a long lasting local anesthetic which can give significant pain control for up to 3 days, and it doesn’t require a tube. Good pain control clearly makes the recovery more pleasant. It also means that less narcotic pain medicine is required; therefore, there is less chance of a reaction to the medication. In addition, it may make the surgery even safer by allowing patients to move around more easily and to be more active.
“How long is the recovery after a tummy tuck?”
Well, the answer depends on several factors and to what level of recovery you are thinking about. If you don’t need the muscles repaired, it is likely that your recovery is going to be easier and quicker. Most patients having a full tummy tuck (with muscle repair) find that they are generally able to drive a car within a week, depending on their pain level (remember you don’t want to drive when on narcotic pain medicine). Many patients can work remotely from home, and find that they are able to log on to their computers, answer emails, or even have a conference call after only a few days, although they won’t feel like going in to work for maybe 2-3 weeks post surgery. Light exercise (e.g. walking or gently peddling on a stationary bike) can start by this time as well. By 6-8 weeks, most patients would consider themselves fully or nearly fully recovered, although it is worth remembering that the nerves will continue to heal, the scar will continue to fade, and the swelling will continue to go down for several months.
“Will the results last?”
Yes! As long as your weight remains stable over time, abdominoplasties are typically a ‘once and done’ procedure, never needing to be repeated. Of course your skin will age a bit over the decades, but it usually never gets back to the looseness that you may have experienced before surgery.
“After pregnancy, my tummy needs help, but my breasts do, too. Can you work on both at the same time?”
Not only is the answer “yes”, but combining a tummy tuck with a breast lift or breast augmentation – popularly called a “mommy makeover” – is very common. Moms love their little ones, but it is great to get their bodies back, too!
Will a tummy tuck help my stretch marks?”
That depends on where the stretch marks are located, but the answer is usually “yes”. A full tummy tuck removes most of the skin in the lower abdomen, and any stretch marks in this zone will be removed along with the loose skin. Stretch marks outside of that zone are not really going to be helped.
The board certified physicians at the Emory Aesthetic Center keep up with the latest developments in abdominoplasty. We are happy to work with you to help create a plan that is best for you.
About Dr. Eaves
Dr. Eaves recently returned to Atlanta, Georgia, to head the Emory Aesthetic Center as Medical Director, having previously completed his plastic surgery residency as well as a fellowship in endoscopic and minimally invasive plastic surgery at Emory University, The Emory Clinic, and associated hospitals. Before joining the Emory Aesthetic Center, Dr. Eaves was a partner in Charlotte Plastic Surgery for more than fifteen years and served as group president from 2010-2012.
His professional and institutional committee memberships and offices include an impressive list of national, international and local plastic surgery organizations, societies, boards, task forces, advisory councils, coalitions and foundations, including having served as President of the American Society for Aesthetic Plastic Surgery (ASAPS) from 2010-2011 and Trustee (2011-Present).
Dr. Eaves’ primary areas of academic inquiry have been in minimally-invasive and endoscopic aesthetic surgery, patient safety, system and process improvement in plastic surgery, evidence-based medicine applied to plastic surgery and recontouring surgery after massive weight loss. He has received several patents for new medical devices he developed, and has made major clinical service contributions to his field. Dr. Eaves has published more than 100 articles, book chapters and book reviews on plastic surgery in peer reviewed publications, as well as manuals, videos, computer programs and other teaching aids and has coauthored the first textbook on the topic of endoscopic plastic surgery.