TUMMY TUCK

Tummy tuck is a procedure that restores a fit, firm, taut condition to the abdomen by removing excess skin, removing excess fat, tightening and repairing split or stretched muscles and repositioning the belly button when needed.  

 

Tummy tuck is very popular among women who’ve been left with abdominal muscle laxity and excess skin as a result of significant weight loss or multiple pregnancies. In most cases it is a combination of muscle and skin tightening.

The procedure

Muscle tightening

During pregnancy, fetus puts a lot of pressure on the rectus abdominis muscle, pushing from the inside and gradually developing a gap between the right and left portion of the muscle, a condition called diastasis. Diastasis recti repair is one of the two main components of tummy tuck surgery as it is essential for restoring anatomy of the muscle and for the overall tightening of the abdomen.

 

Skin Tightening

Removing the excess skin (panniculectomy) is the second main component of tummy tuck. It is a surgical procedure that removes the panniculus, an “apron” of loose skin and fat the hangs from the lower stomach. It is the only way to efficiently tighten skin. 

 

Fat removal

In the early versions of tummy tuck, liposuction was performed mostly to maximize blood supply to the remaining abdominal skin and ensure proper healing. Nowadays, liposuction is an essential tool to sculpt the waist and flanks and to enhance the shape of the abdomen. Dr Pagkalos believes that even the skinniest patients can benefit from targeted liposuction during tummy tuck as it can bring our muscle anatomy and make the body look more toned and fit. 

Pros

  • Tummy tuck is the gold standard if you are looking to trim the waistline and create a smoother, firmer and more contoured abdominal profile. 
  • Patients look better and feel more confident in clothes and swimwear with a patient “worth it” rating of 95% according to RealSelf.com. 
  • The procedure removes or reduces stretch marks from the lower abdomen. 
  • Restoring muscle anatomy can also strengthen the core, making exercise easier and more productive. 
  • Results are practically permanent, unless patient gains a lot of weight or becomes pregnant. 

Cons

  • Tummy tuck is a major surgery with long recovery. One should expect 3-4 weeks of downtime and the full healing progress can take three months to a year. 
  • Smokers should quit smoking before opting for a tummy tuck. 
  • Although it fades with time, tummy tuck leaves a permanent, long scar. 

Recovery

Tummy tuck recovery can be uncomfortable, with significant tightness in the abdominal area. Patients vary in how much pain they experience; some have significant pain, while others find that it is not as bad as they expected. Most of the pain comes from the tightening of the abdominal muscles. Although Dr Pagkalos injects anesthesia into the abdominal muscles before the procedure is complete and give a post-op protocol for pain relief, he advises his patients to always be prepared for the worst case scenario and take it easy for the first couple of weeks. The first few days after tummy tuck surgery are the most uncomfortable, after that, pain diminishes rapidly. 

Patients need 3-4 weeks of downtime before they can go back to work and up to six weeks for total recovery. 

Sleeping position is very important when recovering from a tummy tuck. During the first month after a tummy tuck it is best for the patient to sleep on her back with her torso and head elevated so that the body is bent to help avoid putting tension on the incisions or stretching the abdominal tissues and muscles while they are still healing. 

Regarding compression garments, many plastic surgeons consider three to six weeks an appropriate amount of time. Dr Pagkalos recommends four weeks with the garment putting less pressure during the first week post op and gradually adding pressure in the upcoming weeks. 

Patients are encouraged to get up and move around a few times a day to promote blood circulation and prevent blood clots. 

Swelling after a tummy tuck can last up to 3 months. Once all swelling in the abdominal area has subsided, patient can see her/his final results.

Tummy tuck results can practically be permanent. However the longevity of the results depends on whether the patient maintains a healthy lifestyle and avoids significant weight gain. Skin quality prior to to surgery, as well as changes that occur naturally with aging, can also impact the results of the tummy tuck. 

The modern tummy tuck

Being very popular, tummy tuck has been in the center of interest throughout the years. Many talented plastic surgeons have made several important additions to the extent that modern tummy tuck has almost become a new surgical technique, a much more delicate and advanced procedure. Devices, such as VASER® have pushed tummy tuck to the area of precise body contouring. Plastic surgeons such as Dr Pagkalos don’t just pull down and remove excess skin. Their approach to the abdominal wall is more of that of a sculptor trying to bring out the beauty of the muscles and to restore youthness to the body. In order to achieve that, modern tummy tuck includes high definition liposuction, meticulous suturing of the surgical incision, belly button reposition that mimics the natural anatomy and, finally, strategically put supportive sutures that highlight muscle anatomy, add extra support to the tissues and make drains obsolete (drain-less tummy tuck).