Table of Contents
About Tummy Tuck Surgery
We Offer Drainless Tummy Tucks.
Tummy Tuck Procedure Information
An abdominoplasty is a plastic surgery technique commonly referred to as tummy tuck surgery. During an abdominoplasty, skin and tummy fat are removed from the mid and lower abdomen as upper abdominal skin is pulled downward. The muscular wall is repaired by pulling the abdominal muscles tightly back together, thereby narrowing the waistline and strengthening the abdominal wall. As the upper skin is pulled taut downward, a new opening is created for the navel which has been preserved throughout this procedure. Often times, it is necessary to place drains in the abdominal cavity which will stay in place throughout a portion of the tummy tuck recovery period. Recently, however, our surgeons have perfected a new technique that doesn’t require drains at all. Whether or not you are a candidate for our “drainless” abdominoplasty (tummy tuck) will be decided by the physician on an individual basis.
Is tummy tuck surgery right for you? Ultimately, only you can decide that. However, there are some factors that might help our plastic surgeons decide if tummy tuck surgery, or abdominoplasty, is a safe choice for you. Most of this information will be discussed during your initial consultation with us, but it is important for you to be in general good health, be within 20 pounds of your target weight, and be completely free of nicotine products. If you are a smoker, we can discuss helpful tips to “kick the habit,” but we will not consider you a candidate for this surgery if you test positive for nicotine prior to your date of surgery.
Tummy tuck, or abdominoplasty, recovery is also something you will want to consider when making your decision. You should expect to stay in the hospital for at least 23 hours following tummy tuck surgery. It is unrealistic to expect you will be able to return to work any sooner than one week after your surgery. Ideally, you would take two weeks to rest and recover. Because the skin is pulled so tight, your posture will be affected the first few days following surgery. You may walk slightly bent over for 7-10 days, but will notice with each passing day that you are able to stand up a bit straighter than the day before. A low- grade fever is not uncommon in the first few days after surgery and usually improves with deep breathing exercises. Any drains you might have will be concealed under your clothes and will be removed in our office 1-2 weeks after surgery. There will be daily progress, but you must be patient! Although results are impressive early on, they will continue to improve as swelling subsides over 12-16 weeks. After many years of performing this procedure we know that each person recovers slightly differently and at different rates of speed. Tummy tuck or abdominoplasty results usually last for years if your weight remains stable. We are committed to treating each patient as an individual and will discuss those individual concerns regarding your recovery during your consultation.
We invite and encourage you to view our before and after tummy tuck photos.
The goal most people who are anticipating abdominoplasty seek is a normal appearance. Some patients who work out frequently wish to have an appearance which matches their athletic lifestyle. People who have lost a great deal of weight and who suffer from skin loosening and excess merely want the reminder of their overweight days behind them. Some patients with chronic back pain desire relief in hopes that the muscular improvement in the front will help with the strain on the back.
Who is a Candidate
Anyone who desires an improvement in the contour of their abdomen, and who is in reasonably good health is a candidate. Disease processes by themselves rarely contraindicate abdominoplasty. However, uncontrolled diabetes, hypertension, or other chronic illnesses may delay our decision to proceed until those illnesses are adequately treated. Those with a body mass index of greater than 35 should hesitate to undergo this procedure before they lose significant weight. Greater than 40 BMI suggests dangerous or morbid obesity. Those patients should be under the care of a weight loss physician or bariatrician. A BMI of 25 is a fair body mass index to aim for if 1 wants the best result obtainable. To check your body mass index, look it up on Google. There are charts available. On-line BMI calculators are plentiful. There you enter your height and weight to obtain this information.
The decision to have elective surgery is, in 1 major way, more difficult than a decision to have surgery for an illness. Elective surgery is not immediately necessary to save life or limb. It is more of a long-term quality of life issue. Therefore, many of us will feel the weight of the decision in a special way; are we asking for trouble? Are we tempting God? There are many and varied ways that patient get through this decision. It helps greatly to talk with those whom you trust; loved ones, close friends, your plastic surgeon, and your family doctor. Not all will come off on the side of proceeding with the surgery, but all are worth listening to. Opinions from acquaintances, coworkers, or those with an agenda other than your well-being are not worth considering on the other hand. The decision process will be lonely unless you let those who truly care for you participate by being heard. Made in this way, your plastic surgeon has never seen a wrong decision. Ultimately, the decision is yours, of course.
You are a physical, emotional and spiritual being. To prepare for elective surgery, attention to each of your 3 beings is necessary.
Physically, those who walk or exercise regularly seem to heal faster. Their bodies are used to minor injury, soreness and the necessity to rise to the occasion when presented with physical stress. We now know that activity postoperatively is far more favorable in general than inactivity. Good hydration is another key to recovery. It stabilizes heart rate and blood pressure, and helps to prevent postoperative nausea. The closer to ideal body weight one is, the better all the organs respond to the stress of healing. Wide blood sugar variations and insulin resistance due to obesity prevent the proper immune function of white blood cells. Vitamins C is the healing vitamin necessary for wound healing. It is water soluble so that any amount your body does not need is eliminated in the urine rather than stored. It is a good idea to take daily vitamins with C for at least several weeks preoperative and postoperative, if not indefinitely. Finally, protein intake should be increased in those patients with poor or erratic diets, and especially in those who have lost a great deal of weight. Liquid or tablet protein supplements should be started at least 1 month before major surgery for optimal effect.
Emotionally, those who are most certain about their decision will be best prepared to deal with occasional, but nearly inevitable misgivings and 2nd guesses postoperatively. Malcolm Gladwell’s book “Blink” shows how our intuition or gut feeling decisions are far better than our over-intellectualized 2nd guesses. Many authorities in medicine, yoga, physical training and even veterinary medicine stress the importance of slow, even and deep breathing. Not only does rapid, shallow and erratic breathing indicates stress, it actually worsens stress. Preoperative practice in breathing, as odd as it may sound, prepares you emotionally for the bumps in the road postoperatively. Allow others to help you with all other matters as you heal so that he may focus. Those who try to do everything they normally do in a day as well as try to focus on healing have a more difficult time than those who accept help as they heal.
Spiritual preparation requires a serious assessment of faith; faith in yourself, your doctor, your loved ones and in having those faith in someone or something much bigger, whether it is a belief in a Creator, God, or the wonder of the universe which makes sense, the best spiritually healers recognized themselves as a tiny part of a wonderful whole instead of a big part of something far less.
Before & After Tummy Tuck
Tummy Tuck Operation
The operating room is one of the safest places on the plant. Where else do find yourself surrounded by at least 4 or 5 professionals who’s occupation is to keep you safe? The culture in American operating rooms is one of a team. No longer is the surgeon absolute master. Every healthcare professional has a right and duty to speak up to, comment, or to question. In this way, the patient has at least 8 pairs of eyes and 4 brains with them at all times. While the room feels cold, serious attention is paid to keeping the patient warm. Circulating air blankets, warm IV fluid and body temperature monitoring allow warm tissues to function as they should. Warming the skin prevents infection in a more profound way than any known antibiotic. The initial anesthetic goes in via an intravenous line and sleep follows within seconds. While the patient is asleep, a soft plastic tube is inserted from the mouth into the throat to keep the patient’s airway open to the flow of oxygen. Safety monitoring equipment is watched by the anesthesiologist and nurses continually. The incision across the bottom of the abdomen is made down to, but not through the muscle. The skin and fat are elevated off the muscle towards the navel. The navel is left in place by cutting skin around it. Finally, the skin and fat are lifted up all the way to the bottom of the ribs. At this point, the separation of the rectus muscles that happened during pregnancy is repaired. This reduces the ability of the abdominal contents to protrude out from the lower abdomen. Long, continuous sutures synch the waist in like an internal corset. Uncomfortable for the 1st few days, this is the part of a tummy tuck patient’s appreciate most. It helps to return the abdomen to a pre-baby or pre-overweight look. The patient is then placed in a flexed position so that a maximal amount of skin can be removed. After it’s removal, it is waited and then discarded. Almost all patients are curious about the weight of what was removed. Now for a new innovation brought about by Dr. Harlan Pollock in Dallas, Texas and brought to Indianapolis by our practice; No drains! When the average tummy tuck patient is asked after she is healed what the worst thing about her experience was, she almost always says “The drains.” We now perform Dr. Pollock’s drainless technique. It involves the placement of additional sutures to stabilize the abdominal wall and skin together. This not only closes the space drains are normally placed in to, thus avoiding fluid build up, but it distributes the tension of a tight wound closure throughout the abdomen, not just on the scar. Long-term, we feel this will give a better cosmetic result. All sutures are self-dissolving underneath the skin. The last layer is what dress makers would call an invisible hem stitch. We call it a subcuticular closure, but it is the same thing. The dressing is a clear plastic Saran Wrap looking material. It is waterproof, so showering is possible anytime postoperatively.
DR’s Tip on The Drainless Abdominoplasty:
When asked what’s the worst part of having an abdominoplasty, or tummy tuck, many patients will say the drains. A tummy tuck procedure gets rid of excess fat and skin to create a well-toned abdomen. In a standard tummy tuck, your body accumulates fluid between skin and fat layer and the underlying muscles, before the layers heal together. Small tubes are used to drain this excess fluid.
New developments and research show that quilting technique not only eliminates the need for a drain but also gradually tightens the skin al the way down to the tummy. In 2002, Drs. Harlan and Todd Pollock published their technique for a drainless tummy tuck, demonstrating how additional suturing of the abdomen obliterates the space where drains are normally placed. This concept immediately clicked for us.
Many patients had been holding off on the surgery because they were afraid of the drains. Others now say this drainless technique has made recovery easier. Most of all, they’re sending their friends and that’s the best recommendation we can get.
Physical healing involves pain resolution, mobility, and return to normal activities. Swelling is as much or more of an impediment to this process as is pain. Most patients do take narcotic pain medication such as hydrocodone in the 1st week postoperatively. Most patients say they dealt with swelling tissues for several more weeks postoperatively. Those patients who physically heal fastest are those who work diligently at increasing their activity level every day and who get professional or family member massages regularly as well.
Emotional healing seems to take less time than physical healing for most patients. It seems to involve a mental acceptance that discomfort in contour irregularities are normal parts of the healing process. Focusing on things and people outside of the physical healing process seem to help. Concentration on slow, regular breathing is helpful as well. When you are breathing in a slow, deliberate fashion, your mind tends to understand the body’s needs for oxygen and calm in good measured doses. Long walks seem to help not only with mobility, but tend to resolve swelling more rapidly and are meditative in nature. Many of us believe walking is as good for the mind as it is for the body.
Finally, spiritual healing is the process of accepting one’s importance in the world. To be a healed and happy tiny part of a gigantic everything is a good spiritual goal. Even if the result is imperfect (and we plastic surgeons do not think that we have ever gotten a perfect result) that acceptance of the outcome as improvement or elimination of what was once a major distraction, is true healing. Believing that the decision was justified helps one move forward. This does not mean that any outcome should be excepted as rapidly as possible. Sometimes complications happen or revision is desired for an improved shape or contour by the patient. True spiritual healing, therefore, takes the longest, but is the most rewarding.
Aker Aesthetics has done upwards of 1,000 abdominoplasty or tummy tuck surgeries in Indianapolis and Carmel over the past 10 years and find it’s one of the most rewarding surgeries to perform because patient satisfaction is overwhelming. We look forward to meeting and helping you on this journey.
Frequently Asked Questions
Is abdominoplasty (tummy tuck) surgery safe?
Although any surgery has risks, abdominoplasty is a commonly performed procedure. The complications from tummy tuck surgery are very similar to other procedures we do and will be discussed thoroughly at your consultation.
Is the patient satisfaction rate very high after tummy tuck surgery?
Yes, it is one of the highest. The results are impressive and long lasting.
I’ve heard my posture will improve once I’ve had a tummy tuck. Is this true?
Posture can improve if there is substantial tummy muscle laxity producing a forward tilt to the hips prior to the surgery. Tightening the tummy muscles frequently reduces the tilt to a more normal position, and by default, improves one´s posture.
Isn’t tummy tuck surgery basically weight loss surgery?
No. Certainly the tissue that is removed does weigh something, typically only a few pounds, but abdominoplasty is a contour procedure that improves shape.
I hate the thought of having drains after my tummy tuck surgery. What are my options?
For certain people, depending upon their history and some other factors, drains may not be necessary. This simplifies the recovery considerably. You should discuss this possibility with your surgeon during your consultation.
Is a mini-tummy tuck the same thing as a standard tummy tuck?
A “mini tummy tuck” involves limited tightening of the skin, with optional muscle repair. Recovery is much quicker and may not require an overnight stay at the hospital unless combined with other procedures.
I won’t have to exercise anymore to keep my tight stomach after tummy tuck surgery, right?
Exercise is always beneficial for overall health. This surgery creates results that exceed those obtained with exercise alone. However, exercise can enhance and extend the results of surgery.
I’m a smoker. Will I have to cut back before my tummy tuck surgery?
Absolutely! Smoking and nicotine inhibit skin circulation and wound healing. They also make anesthesia riskier. Smoking, nicotine use, chewing tobacco and nicotine gum must be stopped at least 8 weeks prior to surgery to avoid serious, unnecessary complications.
What if there is still too much fatty tissue in my stomach area after my tummy tuck surgery?
This is unlikely after tummy tuck surgery. More commonly, it is fat in the hip/flank area that you might notice more now that your tummy is much flatter and more contoured. The doctor will address these concerns with you during your consultation.
Will my scar be big? Can I hide it in my underwear or bathing suit?
Typically it runs from hip to hip, but is designed to fit within a two-piece bathing suit, underwear or briefs.
Meet the Doctor
Dr. Aker, an Indianapolis plastic surgeon affiliated with several area hospitals, has lectured and is published widely on a variety of plastic surgery topics. Dr. Aker brought several new techniques in cosmetic surgery to Indianapolis and Carmel including the endoscopic breast augmentation (“endo aug”) and Asian eyelid surgery.