WHAT IS A TUMMY TUCK?

 

A tummy tuck, also known as  abdominoplasty, is a surgery that flattens, tones and shapes the belly after other means have failed. This surgery addresses the excess skin, excess fat, and weakness of the abdominal wall and can dramatically change the appearance of the abdominal wall.  It is an excellent cosmetic treatment for patients struggling with excess abdominal fat and droopy skin due to heredity, weight gain or loss, and physical changes caused by pregnancy.

A tummy tuck procedure simultaneously addresses multiple concerns, including:
⦁    Tightens the abdominal wall
⦁    Eliminates excess fat deposits of the mid and lower belly
⦁    Removes excess skin
⦁    Tightens skin that has lost its elasticity

 

Patient Testimonials Before and After Gallery Contact Us

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.

incision-front incision-sideThis standard incision used for a tummy tuck is placed in a way so that it is hidden in the contours of the lower abdomen.

 

 

 

 

 

abdomen1 abdomen2 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.

 

 

 

 

result-side incision-frontThe 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.

Will anesthesia and pain relief be used during / after surgery?

You will be made comfortable throughout the whole procedure. Abdominoplasties are usually performed under general anesthesia, but can be performed under deep sedation if this is requested.   After surgery, you will have narcotic pain relief medication.  Most people can transition to NSAIDS (Advil, Alleve) or Tylenol after 7-10 days.   You will have instructions for this.

What happens immediately after surgery?

Most tummy tuck patients will usually go home the same day as the procedure, but they do have the option to spend the first night at the medical facility for a smalladditional cost. If you opt for this a medical team closely monitors you overnight.   You will have dressings in place that we recommend leaving in place until the first visit after surgery (usually two to three days).   You will also have two drains in place that remove the extra fluid that will otherwise accumulate underneath the skin.  These drains decrease the chance of bleeding or fluid collections underneath the skin.  They are usually removed about a week after surgery.  Although they are annoying, they are easy to care for and do not stop you from showering after surgery.   You may shower after your first post-operative visit. You should not take a bath for a couple of weeks.

 

How long will complete recovery take?

The first few days at home are very important and patients will be asked to follow post-operative instructions in great detail in order to experience minimal discomfort and prevent any complications. Our abdominoplasty patients are required to walk around the house on the first post-operative day, and activity is increased over time.
The first visit back to us is two to three days after surgery. Surgical garments are worn for up to three weeks. We will be available during recovery to answer any questions or concerns and provide medical care when necessary.

It does take a few weeks to a few months to feel completely normal.   If you are in good physical strength prior to the surgery you will have a faster recovery.     Many women with jobs that are not terribly physical can return to work in a week, but more physical jobs may require a bit more time.   You may drive once you are no longer consistently taking narcotic pain medications; this is usually 4-7 days after surgery.  You should plan to have someone bring you to you first couple of postoperative appointments.

It is important that you start walking the day after surgery, but vigorous exercise should be avoided for 4-6 weeks after surgery.   The incisions can tend to darken and widen over the first few months.  Over the 9-12 months following the operation, the incisions will flatten and fade.   While the incisions will never completely be invisible, they do decrease greatly with time, and are usually easily covered with clothing and even under bathing suits.

Am I a Good Candidate for Tummy Tuck Surgery?

Tummy tuck surgery is appropriate for a wide range of people interested in improving the contour of their abdomen.   With modern tummy tuck techniques, the surgery is individualized to help a wide range of people restore a normal contour to the abdominal wall.

There are three common categories of people who are good candidates for abdominoplasty surgery.

After pregnancy:

Pregnancy stretches the skin and the muscular layers of the abdominal wall.  Often, after pregnancy, these do not return to their pre-pregnancy state.  These changes involve loss of skin elasticity, stretch marks, more prominent fat in the abdominal wall, weakness in the muscular layers, and separation of the muscular layers (rectus diastasis).

Weight Loss:

After weigh loss, whether though diet and exercise, or through a surgical weight loss procedure such as a gastric bypass, people are left with a large amount of excess skin and loose fat. Tummy tucks can often be used to restore a normal contour to the anterior abdominal wall.  This can often be done in conjunction with other procedures (lower body lift, breast lift, or circumferential body lift) to assist in the contour of other areas as well.

Aging:

Over time everyone’s skin and fat will become more loose.  This can be very problematic to some people and can be addressed with a tummy tuck.   This operation allows a careful sculpting of the abdominal wall and can greatly improve the contour and shape.



What are the Risks of Tummy Tuck Surgery

Check Accreditation

With any surgical procedure there are risks that you must be aware of. To minimize the risks, ensure your surgery is conducted in a safe and secure environment using the latest surgical techniques by checking the certifications and accreditation of your surgeon. Accreditation boards and bodies are there to protect you. Dr. Gordon Lewis has 9 years surgical experience and is affiliated to several important professional organizations.

  • He is board certified by the American Society of Plastic Surgeons www.plasticsurgery.org
  • Affiliated to the Richmond Academy of Medicine www.ramdocs.org and the Medical Society of Virginia www.msv.org
  • He is also an associate member of the American Society for Aesthetic Plastic Surgery www.surgery.org and the American College of Surgeons www.facs.org
  • A candidate member of the American Society for Surgery of the Hand www.assh.org

Possible Complications

Tummy tuck risks and a patient’s tummy tuck scar are discussed in this plastic surgery video from ASPS.

Tummy tuck surgery is a complex procedure and there is a lot to learn. We are specialists in abdominoplasty at Lewis Plastic Surgery. Dr. Lewis will need to examine you and particularly your abdominal wall.  After this exam, he will formulate a plan to help you achieve this.  After this, he will discuss your options for the care of your abdomen.  We believe that education is paramount in helping you make the right decision. During a your initial consultation with us you will be thoroughly informed about all aspects of tummy tuck surgery, including:
⦁    The surgical technique that will be used: incisions and scarring
⦁    What to expect prior, during and after the procedure, including recovery
⦁    Surgical facility and anesthesia
⦁    Aftercare instructions and guidelines that will reduce the risk of complications
⦁    Cost of surgery and financing options

Surgical procedures are performed at an accredited outpatient surgical center or a local hospital in Richmond VA. Dr Gordon Lewis is affiliated with several local medical centers where his patients undergo surgery. He primarily operates at these locations:
⦁    Johnston-Willis Hospital
⦁    Stony Point Surgery Center
⦁    Chippenham Hospital
⦁    Parham Surgery Center

He also has privileges at St. Mary’s Hospital and Henrico Doctors Hospital, but operates there less frequently.

Initial consultations, follow up appointments and all non-surgical treatments and minor surgical procedures are performed at Lewis Plastic Surgery practice which is located in the grounds of the Johnston Willis Hospital, Richmond, VA.

During your initial consultation we will be able to give you a break down of all costs relating to your tummy tuck procedure.   This will include:
⦁    Dr. Lewis’s Fee
⦁    Operating room fee
⦁    Anesthesia fee
⦁    Additional over night stays
We make absolutely sure there are no hidden costs and no surprises.

Every patient is required to attend an initial consultation before a procedure can be booked.Once you decide to proceed with surgery, we will assist you in finalizing a date and getting everything ready for surgery. We try to be as flexible as possible and will make arrangements to see you at Lewis Plastic Surgery, in the grounds of the Johnston Willis hospital, within a few days of you contacting us.Depending on your requirements, we can normally perform your procedure within 2 weeks.You can book a consultation online or by calling 804 267 6009.

Frequently in cosmetic surgery procedures are combined.  This can not only help you save money by decreasing associated costs, but also can often create a more balanced result over a larger area.

LIPOSUCTION

Liposuction is frequently performed as an adjunct procedure.  This allows the removal of fatty deposits outside the effective area from a tummy tuck.   Liposuction is commonly performed on the flanks (saddle bags), hips, back, or thighs to help create a smooth contour to the torso.

Please see our section on liposuction for more information about this.

MOMMY MAKEOVER

A mommy makeover is a combination of procedures that is frequently performed on women after they are done having children.  Many women would like to compliment their belly procedure with an improvement to their breasts.    This can be a mastopexy (breast lift), augmentation (breast implants), or a combination of the two.     With these combination of procedures, many women can restore their body to a near pre-pregnancy state.