Loose abdominal wall skin which is often associated with excess fat is of concern to most women especially after pregnancies. With each pregnancy, the rectus abdomini muscles which are visible as "six packs" on the abdominal wall, stretch apart and loosen. With this loosening comes increased bulging of the abdominal contents leading to a "protruding abdomen." An abdominoplasty procedure, otherwise known as a "tummy-tuck", addresses the excess fat and skin, as well as the weakness and spreading apart of the rectus abdominis muscles.



In preparation for this procedure, you may be asked to clear your gastrointestinal tract with Fleet's. This medication will make it more comfortable to go to the bathroom, while minimizing surgical risks. The day prior to your surgery, that you should only consume a clear liquid diet to maintain your intestines clear of any residue.

You can otherwise perform your regular activities and work until the day of surgery. Be certain to drink plenty of fluids to remain well hydrated. On your last appointment prior to the day of surgery, it's suggested that you wear your favorite bikini bottom. This will be used to mark the surgical incisions to assure your final abdominal scar will be well hidden by the bikini.

Background

Most surgeons prefer light general anesthesia for his procedures. With this anesthetic technique, you will breathe on your own, completely unaware of the surgery. While you sleep, a local anesthetic is injected into the surgical site to minimize post-surgical pain.

Using markings made prior to procedure, incisions are made at the bikini line and around the umbilicus (belly button). The abdominal skin and underlying fat are then raised surgically. The loose abdominal muscles which have spread apart with time are sutured together in a special manner to bring them back to their anatomically correct position. This technique will also tighten the abdominal wall and give you an improved figure. Liposuction is performed to remove any excess fat which remains on the sides. The skin is then re-draped over your abdomen and the excess skin and fat are excised. Multiple layers are used to close the skin in order to minimize scarring, and to ensure that the final scar will remain within the "bikini region."

Before the completion of the surgery, a long-acting anesthetic is injected into the surgical sites to minimize pain post-operatively. Silastic drains are typically placed to collect any oozing that may occur during the few days after surgery. The drains are typically removed during the first week. An abdominal binder is applied at the completion of the procedure. You are asked to take the binder off every 4 hours until your first visit.

Post procedure (Abdominoplasty)

Following your procedure, you will be asked to walk with your back flexed forward at the hips in order to minimize tension on the abdominal. When getting into and out of bed, turn onto your side and get up sideways to minimize any straining of the wound. Do not attempt to sit-up in bed. Lie down in bed only with your back elevated with a few pillows. You should not lie flat for the first 2 weeks after surgery. It is also recommended to not sit perfectly upright for longer than one hour per day during the first week.

On the day of surgery you should drink fluids; but if you experience discomfort, please advance your diet slowly. Take your medications as prescribed including your antibiotics and pain medicine. You should sleep restfully on this evening.

On first day after surgery, get out of bed by first rolling onto your side. You will be encouraged to walk around as much as possible, and to not lie in bed for prolonged periods. When in bed, move your calves regularly to keep blood circulating in your legs. Take plenty of deep breaths to maintain your lungs well aerated and to avoid collapse of certain portions of your lungs. You may be aided with your deep breaths by holding a pillow against your abdomen to minimize abdominal motion with deep inspiration. Remember to remove your compression garment (girdle) every 4 hours while you are awake. Empty the drains and record the time and amount whenever the "bulb" appears to be about half full. The bulb must be fully collapsed in order to function properly.

During the following week, you are encouraged to walk as much as comfortably possible. The office staff should be contacting you regularly to ensure your comfort, and to answer any questions. In order for the swelling to resolve more rapidly and to improve your final results, it is suggested that you wear your compression garment (girdle) for 6-8 weeks.