What is a Tummy Tuck or Brachioplasty?
A tummy tuck, which is referred to medically as a brachioplasty, is a surgery that cuts or removes loose skin from the belly or abdomen. Tummy tucks are one of the most commonly performed surgeries by plastic surgeons and they produce very satisfying results for patients. Women who are tired of loose sagging or wrinkled skin on their tummies have no other choice of surgeries if they want to get rid of their damaged skin, and have tight smooth skin again. Tummy tucks are the most common surgery for women that suffer from stretched damaged skin after pregnancy.
What Causes Loose Skin on the Belly
Our bellies are made to stretch and stretch they do. Whether it is pregnancy or just due to age and gravity, the lower belly is an area that just does not seem to respond to exercise and diet. And, no amount of exercise or diet will make that skin go away or those stretch marks disappear. Patients often wonder what caused my loose skin and what can I do to make it better. Sadly, whatever the condition of your skin there is not really much that can make it tighter or restore the elasticity to it. Usually, the quality of the skin, including its thickness, elasticity, or tolerance to the sun are all determined by your genetics. Some skin is just more easily damaged and looses its elasticity much earlier than others.
Tummy Tucks Help People Feel Better
A tummy tuck can improve how you look and how you feel. Wearing clothing is more comfortable without folds of skin. The upper abdomen does not roll when you sit and your bra wont rest on the upper belly roll. All of this improves your comfort. When you add muscle tightening, the benefits can be even better. Not only does it cinch the waist in, but tighter core muscles can result in better posture and decreased lower back pain for some patients. Today, people want to not only look better but feel more youthful and active. Tummy-tuck surgery can improve the appearance your abdomen by removing loose skin and excess fat and improve posture and core strength by tightening muscles in the abdominal wall. It can also remove some if not all of the stretch marks in your lower abdomen.
When to Consider a Tummy Tuck
- If you have stretch marks or excess skin in your abdomen that does not improve with diet or exercise.
- If the shape of your abdomen has been affected by pregnancy or massive weight loss.
- If your stomach muscles are weak or loose.
Pros and Cons of Tummy Tucks
- Tummy-tuck surgery will restore a flat tummy and tight skin.
- Off the rack clothing will fit better and you will have less need to cover up your “problem area.”
- Your core strength can be improved with muscle tightening which often improves lower back pain.
- You will have a scar (located in the bikini area).
- Another pregnancy may influence surgery results, so it is best to wait until you’ve finished having children before undergoing this procedure.
- The surgery is invasive and recovery takes two to four weeks
- Are you a good candidate for a tummy tuck?
- A protruding abdomen with loose muscles and excess fat is what many people consider their “problem area.”
Who is a Good Candidate for a Tummy Tuck?
Aging, heredity, pregnancy, prior surgery or weight fluctuations have left you with extra skin on your abdomen, abdominal muscle weakness, or both.
- You do not smoke. Smoking slows down the healing process and increases the risk of serious complications during and after surgery. If you smoke, you must quit eight weeks before surgery.
- Your weight is stable. Slender individuals with extra fat and loose skin in the lower tummy are the best candidates; if you are generally obese, this procedure is not appropriate for you.
- If you have a significant amount of intra-abdominal fat surrounding your internal organs, you may need to slim down before considering a tummy tuck.
- You are physically healthy. You must be in relatively good physical shape to tolerate this procedure.
- You are finished having children. The muscles that are repaired during an abdominoplasty can separate again during future pregnancy.
- Internal or external scars from any previous abdominal surgery may also affect your candidacy.
How is a tummy tuck procedure performed?
On the morning of surgery, Dr. Gruber will mark your abdomen to indicate the location of the incisions. The primary tummy tuck incision will be within the pubic hairline, from one hipbone to the other. In a full abdominoplasty, another incision is made around your navel. In a mini-tummy tuck, you may have a shorter incision.
The skin from your abdominal wall to your ribcage is freed up to allow smoothing out of the skin in the upper abdomen and removal of the skin and fat in the lower abdomen. If you are having muscle tightening, the fascia of your abdominal muscles is pulled together into a tighter position. Dr. Gruber may remove excess fat by liposuction in the areas that cannot be surgically slimmed. Your abdominal skin is then stretched down over your incision line and the excess skin is removed.
Next, the belly button will be set. Although the skin around your navel has been moved, the navel almost always stays in the same place. The belly button is set in place in a hole through the redraped skin. The incision is closed with internal sutures which do not have to be removed. The incision is then sealed with surgical skin adhesive and a bandage placed. In a full abdominoplasty, you may have drains to prevent fluid buildup, which can cause pressure on the incision. The drain is a clear plastic tube placed through a very short incision below the main incision, which leads out of the body to a small oval-shaped bulb.
Types of Tummy Tucks / Abdominoplasties
Most patients require a full abdominoplasty. This surgery addresses excess skin in the upper and lower abdomen and excess skin around the belly button. A conservative amount of liposuction can be done to shape the upper torso and love handles at the same time as an abdominoplasty. If you have a significant amount of upper abdomen and back fat, you may need to consider weight loss or liposuction prior to abdominoplasty.
Occasionally, a patient has only excess skin in the lower abdomen, right above the pubic hairline. In this case, the belly button and skin above do not need to be addressed. A mini-abdominoplasty will remove only the lower skin and allow muscle tightening if needed.
What will my tummy tuck scar look like?
The incision for a full abdominoplasty usually runs from hipbone to hipbone. Dr. Gruber will mark the incision with you on the morning of surgery. The incision height is usually 1-2 inches below the pubic hairline. This shortens the amount of pubic hair that shows and lifts and rejuvenates the pubic mons area. There is an incision around the belly button as well. These incisions usually are fairly thin and can be hidden from view in a fully sized bikini. However, there is a chance for widening of the tummy tuck scar that makes it more visible. We have special methods for keeping the scarring to a minimum. However, we cannot promise how each individuals scar will heal. Healing and scarring are a factor that is largely dependent on each patients skin type and genetics.
Your initial consultation appointment
During your initial consultation at our office in Tampa, FL, you will have the opportunity to discuss your cosmetic goals. Dr. Gruber will evaluate you as a candidate for tummy-tuck surgery and clarify what approach is best for you.
You should come to the consultation prepared to discuss your complete medical history and answer the following questions:
- Do you have any medical conditions or drug allergies? Are you being treated for any medical conditions?
- Have you had any previous surgeries?
- What are your current medications and vitamin and herbal supplements?
- What is your current use of alcohol, tobacco and recreational drugs?
- What is your history with any noninvasive cosmetic procedures?
- What outcome do you expect from the surgery? What is your chief motivation in undergoing an abdominoplasty?
Dr. Gruber may also:
- Ask you to look in a mirror and point out exactly what you would like to see improved.
- Take photos for your medical record, using imaging to show improvements you can expect.
- Evaluate your health status, including preexisting health conditions or risk factors.
- Evaluate the elasticity of your skin.
- Discuss your ideal weight, realistic weight and current weight and possibly suggest a weight loss program before surgery.
- Discuss your plans related to future pregnancies.
Your treatment plan
Based on your goals, physical characteristics, and the surgeon’s years of training and experience, Dr. Gruber will share recommendations and information with you, including:
- An approach to your surgery, including the type of procedure or combination of procedures.
- The outcomes that you can anticipate.
- Your financial investment in the procedure.
- Associated risks and complications.
- Options for anesthesia and surgery location.
- What you need to prepare for your surgery.
- What you can expect to experience after surgery.
- Show before-and-after photos of cases similar to yours and answer any questions.
How do I prepare for a tummy tuck procedure?
Dr. Gruber will provide thorough preoperative instructions, answer any questions you may have, take a detailed medical history and perform a physical exam to determine your fitness for surgery.
In advance of your procedure, we will ask you to:
- Stop smoking 8 weeks before undergoing surgery to better promote healing.
- Avoid taking aspirin, ibuprofen and certain anti-inflammatory medications and some herbal medications that can cause increased bleeding.
- Regardless of the type of surgery to be performed, hydration is very important before and after surgery for safe recovery.
- If Dr. Gruber recommends weight benchmarks or lifestyle changes, do your best to achieve them to ensure the best results and minimize the chance of complications.
Whether you stay overnight at a recovery center is based on many variables, including your medical issues, the amount of surgery you will undergo, the length of time your surgery takes, other procedures that may be performed at the same time, and the availability of your caregiver at home. Be sure to arrange for someone to drive you home after surgery and to stay with you for at least the first night following surgery.
What can I expect on the day of tummy-tuck surgery?
You will receive medications to keep you comfortable during the surgical procedure. Most patients receive general anesthesia. You will meet with the anesthesia provider on the morning of surgery.
For your safety during the surgery, various monitors will be used to check your heart, blood pressure, pulse and the amount of oxygen circulating in your blood.
The surgical dressings used will depend on the procedures you undergo. Surgical drains may also be placed.
After surgery, you will be taken into a recovery area, where you will continue to be closely monitored.
Before leaving for home, you (or someone looking after you) should feel comfortable emptying and resetting your drains.
You may go home on the day of surgery or spend one or two nights in an aftercare center with a nurse. If you have general anesthesia you will not be permitted to go home alone or stay home without another adult present.
After surgery, you and your caregiver will receive detailed instructions about your postsurgical care, including information about:
- Activity and showering
- Garments and Bandages
- Drains, if they have been placed
- Normal symptoms you will experience
- Any potential signs of complications
What to Expect for your Tummy Tuck Recovery
Immediately after your tummy tuck
You may expect the following immediately after the procedure:
As the anesthesia wears off, you may feel dizzy, disoriented, and nauseated. These sensations should pass within a few hours, although some types of oral pain medications may cause these symptoms to recur.
You will need someone to drive you. Depending on the extent of the procedure, you may be required to spend a night or two in the hospital recovering from surgery.
Immediately following an abdominoplasty, expect your abdomen to feel very sore or tender. Any pain you feel can be controlled with pain medications.
Most tummy tuck patients require several days of bed rest, even if they return home the same day as their surgery.
Your incision site will be covered with a dressing to keep the area clean and protected. You will also be wearing a wide elastic compression garment to reduce swelling and provide support to the skin as it tightens. You will wear this garment for several weeks.
Depending on the extent of your abdominoplasty, you may have drains to remove excess fluid. You will be asked to empty the drains a few times a day and keep track of how much fluid comes out. Drains are usually removed from three to fourteen days after your surgery, depending on how much fluid is coming out.
Most patients have absorbable sutures that will not have to be removed.
Dr. Gruber will provide you with detailed instructions for managing your drains, changing your bandages, and showering during recovery.
Common side effects experienced by abdominoplasty patients include redness, bruising, and swelling. These effects usually subside in one to three weeks as your body adjusts to the new contours and the incisions heal.
Recovery time frame after a tummy tuck
Recovery from a tummy tuck procedure occurs over a period of many months. In the first couple of days, managing pain and avoiding complications is your top priority. The first week will be the worst, and you will still feel like you are recovering for about two to three weeks. After a few weeks, regaining mobility and fitness becomes important. After several months, you can start evaluating the aesthetic outcome of your surgery. It is important to remember that the time it takes to recover varies greatly among individuals.
The first few days after surgery, you should rest quietly. Remember, you must not take aspirin or certain anti-inflammatory medications for 3 days after tummy tuck.
To prevent coughing and bleeding, do not smoke after your procedure. Do not drink alcohol for five days after surgery or while you are taking pain medication.
Arrange for someone to help you get around the house and help with your medication for at least the first two days after surgery.
Make sure you continue to have lots of help at home.
Follow your instructions carefully. The first two days are the most uncomfortable, so if you are instructed to take medications at certain times, stay on the schedule. Discomfort typically drops down to a lower level by five to seven days.
Your first visit is 5-7 days postop. Drains will be removed when the output has slowed down. This is usually 10-14 days postop.
You should be up and walking the day after surgery, although slowly. It is important to walk to discourage swelling and to prevent blood clots in the legs. However, avoid strenuous exercise for four to six weeks, because it can trigger unnecessary fluid retention in the treated areas.
Plan to take about two weeks off from work, depending on the physical demands of your job.
Make an effort to ease back into your normal routine gradually rather than all at once.
The recovery period is typically longest for patients undergoing a traditional abdominoplasty, rather than a mini-tummy tuck, and for those who are combining a tummy tuck with other surgical procedures.
Wearing your compression garment as directed reduces the likelihood of loose or sagging skin after an abdominoplasty. The compression garment also helps to control swelling, resulting in a shorter recovery period.
How Long Will the Results Last?
Barring another pregnancy or significant weight gain, your results should be permanent, although plastic surgery will not prevent the effects of normal aging. 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. Likewise, if you become pregnant your abdomen will loosen again. For this reason, it is best to wait until after you finish having children to undergo a tummy tuck. For safety, as well as the most beautiful and healthy outcome, it’s important to return to our office for follow-up evaluation at prescribed times and whenever you have any questions about your abdominoplasty healing and results.
Price or Cost for a Tummy Tuck
Tummy tuck costs vary for several reasons. Sometimes geographical regions may have differences. However, the most common reason for variation among different surgeons is their demand. Surgeons who are the most talented and skilled who produce the best results are often in very high demand compared to less skilled surgeons. The best surgeons will often have tummy tuck prices a bit higher than the rest. The average surgeon’s fee in the US for standard tummy tuck is $6000. When you add in the fees for the surgical facility, anesthesia, and other miscellaneous costs this price goes up another $2000 to $3000. Liposuction is also often added at an additional cost of $1500-2000 per area. This brings the total cost of most tummy tuck surgeries to the range of $8000 to $12000. Dr. Gruber’s is a very experienced surgeon in doing tummy tucks and her prices are similar to or slightly higher than the national average. We give each individual a price according to the size and extent of the tuck required, and takes into account any muscle tightening, and any additional liposuction.
Limitations and Risks
Fortunately, significant complications associated with tummy tucks are infrequent and the satisfaction rate is high. The overall complication rate is small.
All surgical procedures have some degree of risk. Some of the potential complications of all surgeries are:
- Adverse reaction to anesthesia
- Hematoma or seroma (an accumulation of blood or fluid under the skin that may require removal)
- Infection and bleeding
- Changes in skin sensation
- Allergic reactions
- Damage to underlying structures
- Unsatisfactory results that may necessitate additional procedures
- Blood clot, pulmonary embolism