The presence of a relatively flat stomach is an important component of a physically fit appearance. Therefore, the development of a bulging abdominal contour or excess lax, hanging abdominal tissue can represent a considerable source of concern for many individuals (both men and women), especially where there’s no improvement despite a healthy diet and regular abdominal exercise. In these situations, an Abdominoplasty (or tummy tuck) may be the perfect solution.
By removing variable amounts of excess abdominal skin and fat as well as tightening bulging or weakened abdominal muscle, abdominoplasty is a powerful surgical technique which can restore a flatter, tighter abdominal contour.
Excellent candidates for this procedure include individuals who have developed relatively lax, redundant abdominal skin as a result of significant weight loss, weakened abdominal muscles as a result of previous pregnancy, or excess abdominal protrusion which is disproportionate to the remainder of their body. For those with an unsatisfactory abdominal contour which is restricted to the lower abdomen (ie. below the navel), a ‘mini-abdominoplasty’ procedure may provide optimal enhancement.
We’d all love to have flat tummies. But if you’ve had children or if you’ve gained and then lost a good deal of weight, your reality is likely some degree of a stomach pooch. The problem, especially due to the localized weight gain of pregnancy, is that once the skin and support tissues of your lower abdomen have been stretched for a period of time they cannot return to their former degree of tautness. In many cases, the stomach muscles that manage the center of the lower abdomen can actually become separated by the localized weight gain. No matter how many crunches your do, no matter how dietary restraint you have, those muscles cannot return to the center without surgical help.
A tummy tuck with Dr. Kimmel and our team will give you back the flat abdomen of your youth. Separated muscles are brought back to the center and sutured into place. This actually slims the patient’s waist. Excess skin is removed. Pockets of fat are usually removed with liposuction. This all works together to give you a flat, firm abdomen.
Abdominoplasty is major surgery, so there are post-operative risks such as reaction to anesthesia, infection, excessive bleeding, and poor wound healing. Specific to tummy tuck surgery, the main risk involves the incision. There will be a lengthy scar, although Dr. Kimmel does everything he can to make sure it can be hidden by underwear or a swimsuit. There is a chance the incision won’t heal evenly, but this is where Dr. Kimmel’s board certification and extensive experience make this a minimal risk. Generally, this is a low-risk procedure.
There are two differences — incision location and incision length. In a full tummy tuck, generally there are two incisions, the longer lower incision and another incision around the belly button to access the area above the navel. In full tucks, the lower incision runs from hipbone to hipbone and it can extend a little further around the flanks for an extended tummy tuck.
Mini tucks only have the lower incision, and it often doesn’t stretch from hipbone to hipbone. This depends on how much loose skin the patient has. Generally, for a mini tuck, the patient has a small pooch that doesn’t need much skin excision.
Some people think a tummy tuck is an alternative to bariatric surgery. But this is not at all the case. Dr. Kimmel wants his abdominoplasty patients to be within 10 percent of their ideal weight, preferably at their ideal weight. When a potential patient comes in who has not lost all of her baby weight yet, we advise her to come back when she has lost all of the weight. This is because weight loss will set up more sagging skin, which is what this surgery is trying to correct. This is a body-contouring procedure, not a weight-loss procedure.
Usually performed under general anesthesia, a tummy tuck is safely performed in a State Licensed, Nationally Accredited Ambulatory Surgical Facility (see ‘about Keystone Surgery Center’) on an outpatient basis requiring approximately 2 to 4 hours of operative time.
These procedures can be categorized by the placement and length of the incisions Dr. Kimmel will make. They can be full (or even extended) tummy tucks or mini tucks. During your consultation with Dr. Kimmel, you’ll discuss your options between a full or mini tummy tuck. This will depend on where you have the loose skin and weakened muscles.
In a full tummy tuck, a horizontal incision is made running from hipbone to hipbone between the pubic hairline and the belly button. Dr. Kimmel has the incision descend so that it can easily be concealed by a bikini bottom or underwear. The shape and length of the incision is dependent on the amount of excess skin involved. Full tummy tucks have a second incision at the belly button to remove excess skin on the upper abdomen. This is not always required and is based on each individual patient. After the incision(s) are made the abdominal skin is pulled away from the muscle beneath. The underlying muscles are pulled together and stitched into place for a firmer abdomen and narrower waist. Fat pockets may be removed with minor liposuction at this point. The skin is then stretched downward and over the newly tightened muscles, excess skin is trimmed, and the navel is moved to a new, natural position. The incisions are then closed.
In a mini tummy tuck, the incision made is shorter and the skin is only lifted to the navel area and the navel remains in place. A mini tuck is ideal for patients who don’t have large amounts of loose skin, and whose muscle strength is still relatively strong.
Your tummy tuck will look good for decades, as long as you maintain a healthy weight and remain active. As mentioned above, weight gain can negate your results.
Due to the length of the incisions Dr. Kimmel must make for these procedures, along with the amount of skin removed, recovery is involved. You will have some pain, but we provide you with prescription pain medication. The inability to lift anything over about 8 pounds and the initial need to stand somewhat hunched over are the two aspects of recovery most patients find the most difficult. You’ll be encouraged to walk after your surgery and should take a short walk three or four times a day for just a few minutes each time. You’ll have to walk a little hunched over and the skin of your abdomen may feel tight. If you have drains, they will be removed anywhere from four days to two weeks after your surgery. You’ll wear a compression garment to help your skin adapt to its new slimmer contour. Most patients can return to work two weeks after their surgery, but this is an individual thing — it may take longer. You’ll have residual soreness that will come and go, and it may last for weeks. Any strenuous exercise or lifting will have to wait for at least six weeks.
This varies dramatically among patients. As mentioned above, you’ll be able to walk short distances after a week or so. You can return to a desk job in as little as two weeks, but it can take longer. Any physical aspects of a job will need to wait.
Exercise is a great way to speed recovery because it promotes blood flow, which aids the healing process and reduces swelling. Your first return to exercise will be normal walking on a level surface and this usually is possible after two weeks of recovery. Low-impact aerobic exercise can begin around four to six weeks, but if extensive muscle adjustments were made this could be delayed.
The worst thing you can do is “test” or push your sutures or your incision; overdoing exercise could loosen your repair. After about two months you can return to most forms of exercise, although specific abdomen-focused exercises such as crunches should be approached carefully. Dr. Kimmel will guide you through your exercise progression timeline. Of course, a long-term exercise regimen will be crucial to maintain your slimmer contour from your tummy tuck procedure.
These changes made by Dr. Kimmel are permanent changes. The excess, sagging skin he removes is gone for good. Repositioned muscles will not separate again. Fat that is removed is gone.
Yes, you will have some slight sagging as you move through your life — this doesn’t stop the aging process — but as long as you maintain a healthy weight and incorporate some exercise into your life you’ll enjoy the results gained with this procedure for the rest of your life.
Really the only way to mar your results would be if you become pregnant or gain a large amount of weight again.
Dr. Kimmel makes it clear to our Keystone patients that they need to be sure they are not going to have any more children before committing to this surgery. Another pregnancy will negate the changes made by your surgery. After all, you will be stretching the same area all over again. Plus, pregnancy will place real stress on your incisions, possibly distorting the scars. A tummy tuck isn’t something to have if you’re even remotely considering having more children.
When considering an abdominoplasty, or indeed any cosmetic procedure, be sure to select a qualified, experienced plastic surgeon, certified by the American Board of Plastic Surgery (ABPS). As a board-certified plastic surgeon with over 20 years of clinical practice experience and member of the American Society of Plastic Surgeons (ASPS) and American Society of Aesthetic Plastic Surgery (The Mark of Distinction in Cosmetic Plastic Surgery® ASAPS), Dr. Robert Kimmel welcomes the opportunity to help you achieve your goals and enjoy a happier, more confident lifestyle.