After you have received general anesthesia for abdominoplasty surgery, a long horizontal incision is made in the lower abdomen within the bikini line, from one hipbone to the other. In patients who have undergone a prior C-section, the incision can be made in the same location and extended to the sides. The skin and fat of the abdomen are loosened from the abdominal wall and elevated up to the xiphoid. Sutures are then placed in the fascia of the abdominal wall muscles to pull them together, creating a tight, firm abdomen. Excess fat is suctioned from the flanks with the use of liposuction. Next, the abdominal skin is pulled own over the incision line and the excess is removed.
While the umbilicus has stayed in the same place on the abdominal wall, the skin around it has moved, and therefore requires a new opening. The placement of the umbilicus is therefore then marked on the skin, and a hole is cut. The umbilicus is pulled through the skin, and sutured into place. The incisions are finally closed through the use of dissolvable sutures. Drains are generally placed to prevent the buildup of fluid, which can create pressure on the incisions and redraped skin. The drain is a clear plastic tube placed through a small incision, which leads out of the body to a small oval-shaped bulb. The drains will be removed in the office 4-5 days following surgery, depending upon the volume of drainage recorded. In select cases, drains are omitted and small sutures are used to close down the abdominal space.
In the “mini” tummy tuck or abdominoplasty procedure, lower abdominal muscle tightening with fat and skin removal are performed through a limited horizontal bikini incision only, without repositioning of the navel. The resulting scar is usually low on the abdomen, and therefore can be concealed within most bathing suits and clothing. Small drain tubes are sometimes placed with this technique as well.
Immediately following drain removal in the office, you will be placed into a special compression garment which will assist in reduction of your swelling during the early postoperative period. You are advised to wear this garment continuously for 2-3 weeks following surgery.
Liposuction is sometimes performed in conjunction with tummy tuck surgery to contour the flanks and inner thighs. Some patients wish to undergo simultaneous breast surgery to lift, add volume, or both. The combination of tummy tuck surgery and breast augmentation or breast lift surgery is commonly referred to as a “mommy makeover” procedure. Some patients have hernias, which are defects in the abdominal wall. A hernia can be repaired at the same time as a tummy tuck, and this is usually done in conjunction with a general surgeon.