Whenever we gain a lot of weight, our tissues stretch to accommodate our new girth. When we eventually lose that weight, we end up with stretch marks and loose skin–a constant reminder of the time we were bigger. The same is true for any instance when our tissues need to stretch…like in pregnancy. After mothers give birth, their tummies (and breasts), which previously held one baby (or more), are suddenly emptied out and flattened. But they are left with an apron of skin at the belly (and oftentimes, deflated breasts). Since the body adapted to taking care of both the mother and the baby in the womb, it needed to accumulate more fat and usually, it is in areas where we didn’t have them before. Underlying muscles also become thinned out and splayed. So when the abdomen flattens out, the previous firmness also disappears. Although some of them embrace their new roles (and forms) as mothers, some can’t help but reminisce and wish for their old bodies back. This is why we have a “Mommy Makeover”.
Tummy Tuck & Mommy Makeover
Apart from breast surgery, one component of the mommy makeover is the tummy tuck (abdominoplasty). The tummy tuck addresses the trunk from below the ribcage down to the inguinal area. It is used to correct abnormalities of the soft tissues (excess skin that drapes over the pubic area) and repairs any abdominal muscles that may have frayed during pregnancy or massive weight gain. The important thing to remember is that it is meant to treat the pannus or apron of skin rather than excess fat deposits on the subcutaneous layer of the abdomen.
Ideal patients are those who are not grossly overweight, with a BMI less than 30, with stable weight for more than 6 months, those with no major, uncontrolled co-morbidities, those who are engaging in a healthy lifestyle (exercise, with no smoking or excess alcohol intake), those who are well motivated and realistic, and those without multiple abdominal scars and extreme abdominal protrusion. Surgeons are often wary about patients with previous abdominal surgeries, especially bariatric surgery, since they may encounter abdominal complications unrelated to the tummy tuck in the future.
Your Consultation with Dr. Joel Nicdao
During the initial consultation, our surgeon determines whether the patient needs a tummy tuck or liposuction or both. Some patients will get their desired results with just liposuction. Others will need just a mini tummy tuck. Some will need both tummy tuck and some liposuction. Since this is considered major surgery, the patient will need some laboratory tests and medical risk assessment prior to the surgery. Patients are also advised to stop blood thinners, diet pills and drinks, smoking, and alcohol.
The Tummy Tuck Procedure
The surgery entails fashioning a skin and subcutaneous flap that starts from hips which are dissected to the navel. The navel is freed from the surrounding skin and soft tissues. The flap is carried up to the xiphoid and laterally beneath the rib cage. The rectus fascia is inspected for any diastasis which is repaired primarily which corrects any unusual bulges, abdominal protrusions and direct hernias.
The excess skin is pulled down to the suprapubic incision to determine how much skin to remove to obtain a flat abdomen and is excised. The new skin around the navel is opened to fashion a new belly button. Drains are placed and exteriorized. The skin is closed with several layers or suturing.
Some patients benefit from some liposuction of the flanks to give them a better figure. For those patients who do not have too much excess skin, the skin and subcutaneous flap are dissected just underneath the navel. This mini tummy tuck does not create a new belly button and the incision is not as long as with a tummy tuck. Some surgeons do not place a drain for a mini tummy tuck.
After surgery, snug dressings are placed to make sure the abdomen is flat. Patients usually stay overnight to 2 nights so that they can be monitored for dehydration or other complications like bleeding. The drains are removed once the volume is below 50cc each. Stitches are removed on the 7th day after surgery. During recovery, patients are advised to keep a straight posture so that there will not be any infolding in the abdominal skin that may trap any swelling which may become permanent.
Recovery & Scars
Satisfaction with a tummy tuck is quite high not only for post-pregnancy bodies but also for those who underwent massive weight loss. For those who undergo tummy tuck after losing weight, they may also undergo other procedures for skin tightening like arm or leg lipectomy. Patients find that their clothes fit better (or are looser). They no longer have a muffin top. They feel more attractive and more confident.
The only aspect of the surgery that bothers some patients is the scars. Apart from the scars being long, sometimes they hypertrophy and darken. Because of this, patients are advised to apply a scar gel or a scarred patch to prevent the scar from becoming unsightly. If the scar starts to thicken, some measures can be done to hide them (with tattoos) or help them flatten (steroid injections).
Frequently Asked Questions
Is a tummy tuck right for me?
A tummy tuck is for patients who have loose, saggy skin in the abdomen caused by marked weight loss, previous pregnancy or lax abdominal muscles.
How is a tummy tuck done?
An incision is done underneath the panty line down to the fascial layer above the muscle. The skin flap is undermined up to the level of the xiphoid process, taking care to leave the navel in place. Muscle tightening may or may not be done depending on the condition of the muscles. The skin is then pulled down to the incision site ensuring a flat tummy. The excess skin is excised. A new hole for the navel is created. Drains are placed and the incisions are closed in layers. The drains can be removed in a day or two as long as the output is below 70cc each a day.
Will my stretch marks improve with a tummy tuck?
Only the stretch marks that are part of the skin to be excised will disappear. Vertical scars from abdominal surgeries or caesarian sections will also disappear.
What is the difference between a mini tummy tuck and a full tummy tuck?
The full tuck is the tummy tuck as described above. The minituck does not move the navel and does not do a muscle tightening. That being said, the minituck is a shorter procedure. However, both procedures are considered major surgeries that will require sedation and an epidural catheter to assist you with post-operative pain. Upon recovery, both will require you to stay with us for a day or two more while being assisted by a private duty nurse. The drains will be removed before you are sent home.
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Fees are an estimate only depending on your situation.