What is it?
Abdominoplasty, commonly known as a tummy tuck, is a major surgical procedure. It removes excess skin and fat from the middle and lower abdomen and tightens the muscles of the abdominal wall. The procedure can dramatically reduce the appearance of a protruding abdomen. It does produce a permanent scar, which, depending on the extent of the original problem and the surgery required to correct it, can extend from hip to hip.

The best candidates
The best candidates are men or women in relatively good shape who are bothered by a large fat deposit or loose abdominal skin that won't respond to diet or exercise. The surgery is particularly helpful to women who, through multiple pregnancies, have stretched their abdominal muscles and skin beyond the point where they can return to normal. Loss of skin elasticity in older patients, which frequently occurs with slight obesity, can also be improved.

Patients who intend to lose a lot of weight should postpone the surgery. Women who plan future pregnancies also should wait, as vertical muscles in the abdomen that are tightened during surgery can separate again during pregnancy. If you have scarring from previous abdominal surgery, our surgeons may recommend against abdominoplasty or caution you that scars could be unusually prominent.

Abdominoplasty can enhance your appearance and your self-confidence, but it won't necessarily change your looks to match your ideal. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.

Uncertainty and risk
Thousands of abdominoplasties are performed successfully each year. Our surgeons, trained in body contouring, generally see positive results. However, there are risks with any surgery and specific complications associated with this procedure.

Post-operative complications such as infection and blood clots are rare, but they can occur. Infection can be treated with drainage and antibiotics, but will prolong your hospital stay. You can minimize the risk of blood clots by moving around as soon after the surgery as possible.

Poor healing, which results in conspicuous scars, may necessitate a second operation. Smokers should stop, as smoking may increase the risk of complications and delay healing.

You can reduce your risk of complications by closely following your surgeon's instructions before and after the surgery, especially regarding resumption of physical activity.

Planning your surgery
During your initial consultation, your surgeon will evaluate your health, determine the extent of fat deposits in your abdominal region, and carefully assess your skin tone. Be sure to mention if you smoke, and if you're taking any medications, vitamins or other drugs.

Be frank in discussing your expectations. Your surgeon will be equally frank with you, describing alternatives and the risks of each.

If, for example, your fat deposits are limited to the area below the navel, you may require a less complex procedure called partial abdominoplasty or "mini-tummy tuck." This often can be performed at Edina Plastic Surgery's on-site Surgery Center on an outpatient basis. Alternatively, you may benefit more from partial or complete abdominoplasty done in conjunction with liposuction. This removes fat deposits from the hips for better body contour. Liposuction alone may create the best result.

Your surgeon will explain the anesthesia, whether the surgery will be performed on-site or at a hospital affiliated with Edina Plastic Surgery, and the costs involved. In most cases, health insurance does not cover the cost of abdominoplasty. Please check your policy to be sure.

Preparing for surgery
Your surgeon will give you specific instructions, including guidelines on eating and drinking, smoking, and which vitamins and medications to avoid.

If you smoke, plan to quit at least two weeks before and after your surgery. Avoid overexposure to the sun before surgery, especially to your abdomen, and do not go on a stringent diet. Both can inhibit your ability to heal. If you develop a cold or infection of any kind, your surgery will probably be postponed.

Whether your surgery is done at our Surgery Center as an outpatient, or at an affiliate hospital as an inpatient, you should arrange for someone to drive you home. You may also need someone to help out for a day or two after you come home.

Anesthesia
Your doctor will either select general anesthesia, so you'll sleep through the operation, or local anesthesia, combined with a sedative to make you drowsy. With the local anesthesia, you'll be awake but relaxed, and your abdominal region will be insensitive to pain. However, you may feel some tugging or occasional discomfort.

About the surgery
Complete abdominoplasty usually takes two to five hours, depending on the extent of work required. Partial abdominoplasty may take an hour or two.

Your surgeon will make a long incision from hipbone to hipbone, just above the pubic area. A second incision is made to free the navel from surrounding tissue. With partial abdominoplasty, the incision is much shorter and the navel may not be moved. However, it may be pulled into an unnatural shape as the skin is tightened and stitched.

An incision just above the pubic area is used to remove excess skin and fat from the middle and lower abdomen.

Next, the surgeon separates the skin from the abdominal wall all the way up to your ribs. He or she lifts a large skin flap to reveal the vertical muscles in your abdomen. These muscles are tightened by pulling them close together and stitching them into their new position. This provides a firmer abdominal wall and narrows the waistline.

Skin is separated from the abdominal wall all the way up to the ribs.	The surgeon draws underlying muscle and tissue together and  stitches them, thereby narrowing the waistline and strengthening the abdominal wall.

The skin flap is then stretched down and the extra skin removed. A new hole is cut for your navel, which is then stitched in place. Finally, the incisions will be stitched, dressings applied, and a temporary tube inserted to drain excess fluid from the surgical site.

Abdominal skin is drawn down and excess is removed. With complete abdominoplasty, a new opening is cut for the navel. Both incisions are stitched closed.

In partial abdominoplasty, the skin is separated only between the incision line and the navel. This skin flap is stretched down, the excess removed, and the flap stitched back into place.

After your surgery
For the first few days, your abdomen will probably be swollen. You're likely to feel some pain and discomfort which can be controlled by medication. Depending on the extent of the surgery, you will be released within a few hours or remain for two to three days.

Your doctor will give you instructions for showering and changing your dressings. Although you may not be able to stand straight at first, you should start walking as soon as possible.

Surface stitches will be removed in five to seven days. Deeper sutures will come out in two to three weeks. The dressing on your incision may be replaced by a support garment.

Getting back to normal
It may take you weeks or months to feel like yourself again. If you start out in top physical condition with strong abdominal muscles, recovery will be much faster. Some people return to work after two weeks. Others take three or four weeks to recuperate.

Exercise will help you heal. Even people who have never exercised before should begin an exercise program to reduce swelling, lower the chance of blood clots, and tone muscles. Vigorous exercise should be avoided until you can do it comfortably.

Your scars may actually appear to worsen during the first three to six months as they heal. This is normal. Expect it to take nine months to a year before your scars flatten out and lighten in color. While they'll never disappear completely, abdominal scars will not show under most clothing, including bathing suits.

Your new look
Abdominoplasty, whether partial or complete, produces excellent results for patients with weakened abdominal muscles or excess skin. In most cases, the results are long-lasting if you follow a balanced diet and exercise regularly.

After surgery, the patient has a flatter, trimmer abdomen. Scars are permanent, but will fade with time.