A tummy tuck is an outpatient procedure that lasts about 3 hours. There are several steps and goals associated with the procedure. This allows us to address the excess skin, excess fat and weakness in the abdominal wall.
This operation is usually done under general anesthesia. This gives the most comfort and safety for the procedure.
The operation starts with a curved horizontal incision on the lower abdomen. The skin and fat is the lifted off the abdominal wall. This allows removal of the excess skin and fat from the lower abdomen. Most of the skin and fat from below the belly button down to the lower abdomen is removed. The upper abdominal skin is then elevated and brought downward over the belly button and sewed to the remaining lower skin on the lower abdomen. The belly button is then brought to the front and carefully sewed in place.
This standard incision used for a tummy tuck is placed in a way so that it is hidden in the contours of the lower abdomen.
After lifting the skin off the abdominal wall, the underlying muscles and fascia are visible. The weakness of the abdominal wall (rectus diastasis) involves a separation of the muscles of the abdominal wall. This is repaired w ith a very strong two layer closure that dramatically improves the shape of the underlying muscles.
The final incision heals well and is well hidden underneath clothes. The length and amount of curve can vary depending on the amount of skin that needs to be removed and each patients individual anatomy.
A seemingly minor, but critical part of the operation is how the belly button is sewed in place. The lower abdominal incision is usually hidden underneath clothes and even under some bikinis. The incision around the belly button is usually the most visible incision after this operation. Dr. Lewis uses an inverted chevron (upsidedown V) to inset the belly button. This is a more complicated way to close the belly button, but we feel as it gives the most natural appearing results.
Most patient having a tummy tuck also have some weakness in the abdominal wall fascia. This often involves a separation between the abdominal muscles called rectus diastasis. This is repaired during the tummy tuck with strong sutures. This is a critical portion of most tummy tucks and restores a flat contour to the underlying muscles.