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What is tummy tuck surgery?

Tummy tuck surgery, also known as abdominoplasty, removes excess fat and skin and, in most cases, restores weakened or separated muscles creating an abdominal profile that is smoother and firmer. It can also remove some if not all of the stretch marks in your lower abdomen.

A flat and well-toned abdomen is something many of us strive for through exercise and weight control. Sometimes these methods cannot achieve our goals. Even individuals of otherwise normal body weight and proportion can develop an abdomen that protrudes or is loose and sagging. The most common causes of this include are ageing, heredity, pregnancy, prior surgery, and significant fluctuations in weight.

Other procedures that might be performed in conjunction with a tummy tuck surgery are liposuction, buttock augmentation, breast augmentation, breast lift, and body contouring. Tummy tuck surgery is often part of a mommy makeover surgery.

“Tummy tuck surgery is a highly individualized procedure. You should do it for yourself, not to fulfil someone else's desires or to try to fit any sort of ideal image, especially those coming from social media. Choosing a procedure based on “what’s new” is never a medically sound decision. Hearing about a procedure on television, through an advertisement or online does not necessarily mean it is the best procedure for you.”

Who is a good candidate for tummy tuck surgery?

In general, you may be a good candidate for tummy tuck surgery if you've got flab, stretch marks, or excess skin in your abdomen that does not improve with diet or exercise, the shape of your abdomen has been affected by a pregnancy or massive weight loss, you feel that your protruding abdomen is unattractive, your self-confidence is marred by your stomach contour, you want to look better in clothes and swimwear, you are physically fit and your weight is stable, nonsmoker or have stopped smoking recently and have realistic expectations of the outcome of your surgery.

What should I expect during a consultation for tummy tuck surgery?

During your initial consultation, you will have the opportunity to discuss your cosmetic goals. Dr Ricardo will evaluate you as a candidate for tummy tuck surgery and clarify what approach is best for you. Alternative and additional treatments may be considered, once he understands your goals and medical condition. It is important to be completely honest during the consultation and be prepared to discuss your surgical goals, medical conditions, drug allergies and medical treatments, current medications, vitamins, herbal supplements, alcohol, tobacco and drug use, and previous surgeries.

Dr Ricardo will also evaluate your general health status and any pre-existing health conditions or risk factors, evaluate the elasticity of your skin, take photographs, discuss the approach to your surgery, including the type of procedure or combination of procedures and tell you whether your expectations are in line with typical results, discuss any risks or potential complications and share before-and-after photos of cases similar to yours.

The success and safety of your tummy tuck surgery depend very much on your complete candidness during your consultation. It's very important to understand all aspects of your procedure. It's natural to feel some anxiety, whether it's excitement about your anticipated new look or a bit of preoperative stress. Don't be shy about discussing these feelings with Dr Ricardo.

How should I prepare for a tummy tuck surgery?

In preparing for tummy tuck surgery, you may be asked to get lab testing or a medical evaluation, take certain medications or adjust your current medications, stop smoking in advance of surgery and avoid taking aspirin, anti-inflammatory drugs, and herbal supplements as they can increase bleeding.

The surgery will be performed in an accredited hospital and requires you to stay overnight for observation unless you and Dr Ricardo have made other plans for your immediate postoperative recovery. You must arrange for a friend or family member to drive you to and from surgery and to stay with you the first night following the hospital’s discharge.

Dr Ricardo and the entire staff will provide thorough preoperative instructions and answer any questions you may have. The goal is to help you achieve the most beautiful and natural-looking results, as well as to make your surgical experience as easy, comfortable, and safe as possible.

What are the steps of a tummy tuck surgery?

Step 1 – Anaesthesia

Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anaesthesia. Dr Ricardo will recommend the best choice for you.

Step 2 – Surgical procedure

In a mini tummy tuck, a single shorter incision in the pubic area will be used which will be placed as low as possible and can range from a few centimetres to the entire span of your abdomen to remove excess skin, tighten slack muscles and possibly use liposuction to further refine the area. The abdominal skin that is removed is below the navel, and there are no incisions around the navel. The length of the mini-tummy tuck incision will vary based on how much skin Dr Ricardo removes. The ideal candidate for a mini-tummy tuck has laxity and protrusion below the navel. A mini-tummy tuck is usually recommended for those who have always been in fairly good shape but cannot achieve their aesthetic goals with diet and exercise.

A full tummy tuck requires a horizontally-oriented incision in the area between the pubic hairline and belly button. In women who have undergone cesarean section, the existing scars may be incorporated into the new scar. The shape and length of the incision will be determined by the amount of excess skin.

Pregnancy is a beautiful time in a woman’s life but your body goes through several transformations to embrace the growing baby inside your tummy. Excess skin, bulging belly, and stretch marks are only some of the cosmetic results of the pregnancy. One very common, yet rarely mentioned, the cosmetic problem is the diastasis recti - "diastasis" means separation. and "recti" refers to your ab muscles called the rectus abdominis. Abdominal muscle separation means your belly sticks out or has a bulge because the space between your left and right belly muscles has widened. 

Diastasis recti repair surgery is the best method to treat split abdominal muscles and it is usually done during tummy tuck surgery (abdominoplasty), which aims to tighten and rejuvenate the belly, restoring the pre-pregnancy physique.  The term "internal corset" might imply that extra effort will be made to tighten the waistline as much as possible, but this is always the goal. 

After your abdominal muscles have been sutured, Dr Ricardo will remove excess fat by liposuction or other methods. A second incision around the navel may be necessary to remove excess skin in the upper abdomen. The upper abdominal skin is pulled down like a window shade. The excess skin is trimmed and the remaining skin is sutured together. A new opening for the belly button is created. The belly button is popped through to the surface and sutured into position.

If you have excess skin in the love handles or hips, your incision can be made longer to address this problem. The high lateral tension tummy tuck was one of the first procedures developed to address skin excess after significant weight loss or pregnancy. This procedure includes a tummy tuck in the front of the abdomen and transfers the lift over the hip to the side of the thigh to improve contour in this area, suspending and improving the hip and thigh. You can simulate the effect by grabbing the skin on the sides of your waist and pulling up as if you’re putting on a pair of pants.

Step 3 – Closing the incisions

Incisions typically are closed with absorbable and non-absorbable sutures that are removed within 10-14 days. Once healed, the incision lines can be hidden in a bikini.

Step 4 – See the results

Your tummy tuck surgery will result in a flatter, firmer abdominal contour that is more proportionate with your body type and weight.

What should I expect during my tummy tuck recovery?

During your tummy tuck recovery, dressings or bandages may be applied to your incisions, and you may be wrapped in a compression garment to minimize swelling and support your abdomen as it heals following surgery. Small, thin tubes may be temporarily placed under the skin to drain any excess blood or fluid that may collect but its placement by Dr Ricardo is not common.

You will be given specific instructions on how to care for the surgical site, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in your general health, and when to follow up with Dr Ricardo. Remember to always follow his instructions to ensure the success of your surgery.

The surgical incisions mustn't be subjected to excessive force, abrasion, or motion during the time of healing. Initial wound healing may take 10 to 14 days. Sutures will be removed when it is appropriate. You should be ready to return to work and normal activity after 7-10 days. However, you must realize that the amount of time it takes for recovery varies greatly among individuals.

What results should I expect after my tummy tuck?

The final results of your tummy tuck surgery may be initially obscured by swelling and your possible inability to stand fully upright until internal healing is complete. Within a week, you should be standing tall and confident in your new slimmer profile. Your tummy tuck will result in a flatter, firmer abdominal contour that is more proportionate with your body type and weight.

A tummy tuck surgery is not a substitute for weight loss or an appropriate exercise program and cannot correct stretch marks, although these may be removed or somewhat improved if they are located on the areas of excess skin that will be excised.

Barring another pregnancy or significant weight gain, your results should be permanent, although plastic surgery will not prevent the effects of normal ageing. Once the skin is tightened, it will get a little looser as you age, but not much. However, if you gain and then lose a large amount of weight after a tummy tuck, the abdominal skin could stretch out again, negatively impacting the overall contour.

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