A common misconception amongst patients considering cosmetic surgery of the abdominal area is that the choice exists to have either a tummy tuck or liposuction and that either of these two procedures will produce similar results. In most cases, a patient is a far better candidate for either a tummy tuck or liposuction and the procedures are not interchangeable. The decision as to which plastic surgery procedure is best must be made in conjunction with a qualified plastic surgeon but the following is a general guideline: Typically, patients whose abdominal area has loose excess skin, or significant stretch marks will need a tummy tuck and will not benefit from liposuction alone. This is because liposuction is a procedure that only removes fat. Skin is esentially unaffected. Therefore if there is substantial loose skin or stretch marks to start with, liposuction will not remove any of the extra skin or any of the stretch mark-bearing skin. Furthermore, liposuction in these circumstances can actually worsen the problem by removing the "foundation" on which the skin rests, i.e. the underlying fat thereby leaving even looser skin than the patient started with. Liposuction to the abdominal area is more appropriate in cases of younger patients with firm, taut abdominal skin whose main problem is extra fat. In these cases, skin reliably shrinks over the liposuctioned rea and a great cosmetic result can be obtained. Remember that this is only a guideline. The ultimate decision as to which procedure(s) is best for you should be made during a private consultation with a qualified surgeon.

Who is a Candidate for a Tummy Tuck?

A tummy tuck can benefit individuals with the following features of the abdominal area:

(1) excessive, loose, sagging skin
(2) stretch marks, such as after pregnancy
(3) excess fat on the abdomen
(4) a rounded tummy that would benefit from flattening

How is a Tummy Tuck Done?

A tummy tuck involves multiple surgical steps, each designed to enhance the cosmetic appearance and feel of your abdominal area. The tummy tuck starts by making an incision low down on the abdominal wall. Dr. Backstein places this incision as low down as possible so that it is generally not detectable in a bathing suit or a bikini. Depending on your body structure, fully hiding the incision scar may not be feasible. Following the initial incision, a tummy tuck will involve plication (firm tightening) of the muscle layer,
excision and removal of as much excess skin and fat as possible, and placement of the umbilicus (belly
button) into an anatomically pleasing location on the abdominal wall. Dr. Backstein includes liposuction of the upper abdominal area and love handles as part of the tummy tuck procedure.

Tummy Tuck Cosmetic Surgery Scars.

There are two scars that are left by a tummy tuck. These are a horizontal scar placed low down above the pubic area and a circular scar carefully placed around the belly button. Both of these scars are absolutely needed if a tummy tuck is to be done properly and effectively. Any procedure that attempts to avoid these scars will always compromise the result of the surgery in terms of tightening, flattening, and overall abdominal beauty.
Scars in general are dynamic. This means that scars go through phases during which the visibility of the scar changes from more to less. During the first two months after a tummy tuck or liposuction, scars will usually have a certain amount of redness to them. This is called the inflammatory phase of wound healing. Following this, for up to a full year, the scars will fade more and more. It is important to note that healing of surgical incisions is very much an individual trait much like hair color or skin tone. People will heal incisions and form scars differently even when undergoing the exact same surgery done by the same surgeon. As a rule, patients are so thrilled and excited by the dramatic flattening of their abdomens and the psychological lift that this provides that tummy tuck scars are quickly overlooked and ignored.

Tummy Tuck Recovery.

How Much Pain Will I Have?

Following a tummy tuck, patients describe a major feeling of tightness around the abdomen. The discomfort is described as an intense muscle ache similar to the feeling after an aggressive abdominal workout. Dr. Backstein feels that the best tummy tucks will cause a certain amount of post operative discomfort. This is related to the extent of tightening that the surgeon has achieved. If a tummy tuck doesn't hurt at all, the abdomen was likely not tightened adequately. Swelling and bruising is always seen after a tummy tuck or liposuction. Dr. Backstein always provides supplemental liposuction to the upper abdominal area and love handles and bruising will be seen in these areas.

Do I Need To Stay Overnight?

Most patients are able to leave the hospital on the evening of the surgical day. Arrangements can always be made for patients to stay overnight if so desired. Although straining, heavy lifting and bending should be avoided, tummy tuck patients must start minimal walking and leg exercises the day of the surgery. Lying in bed for hours at a time is dangerous and must be avoided to minimize the risk of blood clots. When going to sleep, a couple of pillows under the knees and behind the head will act to ease the tension on the surgical incision and will help relieve discomfort.

When Can I Return To Work?

Patients with jobs that require significant physical activity including bending, lifting, or quick movement will need about 4 weeks off before being able to return to full duties comfortably. Those patients with jobs not demanding physical activity can return to work after 2 weeks.

When Can I Work Out?

Light work outs involving exercises that do not strain the surgical incision or the abdominal muscles can begin at 2-3 weeks. This includes brisk walking or stationary bike riding. Heavier work outs including abdominal crunches, sit-ups and running should not be attempted for about 1 month.

Do I Need to Wear a Special Garment?

Yes, tummy tuck patients should wear a compressive corset provided by Dr. Backstein for the first 3-4 weeks post plastic surgery.

Complications Associated with Tummy Tucks.

Significant complications following a tummy tuck are rare. This is very much related to the fact that a tummy tuck is a superficial cosmetic surgery focusing on the skin and fat and upper muscle layers and not involving major or vital organs. Potential complications include:

anesthesia side effects and complications

infections

post-operative bleeding

incision separation

blood clots

slow healing areas

Tummy Tuck: The Only Cure For Stretch Marks.

One thing is abundantly clear about stretch marks and that is that absolutely no cream or topical ointments exist to remove them. Stretch marks are scars that occur within the substance of the skin when it is exposed to excessive stretching or shearing force. The abdominal area develops stretch marks during pregnancy due to the stretching of the skin by the growing fetus in the womb.
Just as no cream exists to erase scars on the skin, none exists to eliminate stretch marks either although there are many products on the market that claim to do so.A tummy tuck will remove about 90% of stretch marks from the abdominal wall. As a rule of thumb, all the stretch marks below the level of the belly button will be removed with the large piece of skin and fat that is discarded during the tummy tuck surgery. Moreover, the stretch marks that are above the belly button get pulled far down on the abdomen, just above the pubic area as part of the tummy tuck procedure. This means that about 90% of your stretch marks are removed completely and the rest shift to a much less visible area. It truly is fair to say that tummy tuck surgery is the only cure for abdominal stretch marks.

The Effects of Pregnancy On Tummy Tuck Surgery.

It is all too clear that pregnancy induces unwanted changes in the abdominal area that often lead people to seeking surgical improvement. These pregnancy-induced changes include general weight gain, looseness and laxity of abdominal skin, and of course, stretch marks. A tummy tuck operation is the very best surgical procedure to dramatically improve all of the above mentioned changes of the abdominal region. Unfortunately, much of the improvement achieved through a tummy tuck can, at least in part, be diminished by the effects of subsequent pregnancy. It is important to remember that our bodies are dynamic and constantly changing. The beneficial effects of tummy tuck surgery are not "carved in stone", but need to be maintained. Pregnancy after a tummy tuck will lead to generalized weight gain, and stretching and distension of the abdominal wall as the baby grows in the womb. This will cause some degree of skin laxity and stretch marks similar to that present prior to the tummy tuck surgery. Your tummy area will, however, still look better than it would have had you never
undergone tummy tuck surgery.

Exercise and Diet: Maintaining The Results of Your Cosmetic Surgery.

The human body is dynamic and always in a state of change. No surgical procedure exists to reshape, recontour or tighten a body region that is absolutely permanent. The results of a tummy tuck and liposuction need to be maintained. A healthy lifestyle must be followed after surgery to maintain the dramatic flattening and tightness of the abdominal region that a tummy tuck or liposuction provides. Poor diet and sedentary lifestyle will, over time cause weight gain and skin stretching after tummy tuck surgery. Happily, the vast majority of patients find that after a tummy tuck or liposuction, they feel so good both mentally and physically that exercise and healthy eating become a welcome part of their post surgical lifestyle.

Robert S. Backstein, MD
http://www.cosmeticsurgerytoronto.com