The best time to have a tummy tuck if you are female, is after you have had pregnancies.  It is always advisable to wait until you decide not to have more children.

The other type of patient would be those who are in the process of losing weight.  It is very highly recommended to get to your ideal weight  and maintain it before getting your tummy tuck, so you will get the best result.

The operation is technically very simple: usually under epidural anesthesia placed by the anesthesiologist, we begin with an incision in the lower part of the abdomen (it can be designed to the type of underwear you like). We proceed to undermine the skin and fat from the abdominal wall, realign the belly button, and continue with the undermining up to the rib cage. We proceed with tightening muscles.

Vertical abdominal muscles that have been stretched and weakened over time are tightened, restoring the appearance of a firmer, flatter abdomen.

We proceed to tighten the muscles and stretch the excess of skin.  We then remove the excess, and make a small incision to pop up your belly button in the same location.  The wound is closed in 4 different layers. We always leave a small drainage.

There are some technical refinements in a tummy tuck that will make the operation stand more than any average tummy tuck.

  In order to eliminate the excess skin in the corners (called the ear dogs or folds of skin), we must extend the incision as far as necessary, as a small incision most likely would leave excess in the corners.

Another important problem is a lot of fat in the pubic area.  Most of the Doctors don’t remove the fat in the pubic area which results in a flat stomach with a large and bulgy pubis. The way to address this problem is at the time we do the incision.  From the center we elevate the pubis, trim half of the fat and then we remove the excess skin (all of our patients love this procedure).

The last refinement is a small belly button.  At the time we undermine and realign the belly button, we cut in a triangular shape.  Then, at the time of stretching the skin, we do another incision in an inverted “V” that adapts nicely with the triangular one. The result is a small triangular incision which is less likely to close up or show a large scar.

Tummy tuck procedures can be performed alone, but are often performed with liposuction to further improve body contours.  A tummy tuck should not be considered as a treatment for obesity, or a substitute for proper diet and exercise. Individuals considering a tummy tuck should be healthy and relatively fit. Future pregnancies and substantial changes in weight following a tummy tuck, as well as the presence of scars from prior surgeries may decrease the effectiveness and longevity of treatment.

Upon completion of the operation, the patient is transferred to the recovery room with sterile strips in the wound, drainage, and a compression garment. The patient must sleep and rest at 45 degrees. The next morning they must walk and have a daily shower. The sooner you start moving the faster the recovery, movement helps to remove the excess fluids and ensures circulation.

Postoperative Instruction

Daily shower (no baths), blow dry the tape that covers the wound, clean your belly with q-tip and hydrogen peroxide once a day, keep the incisions dry avoid putting any creams or gels on the site for up to 4 weeks..

Take your medication according to instructions (antibiotic 3 times a day, pain relief medication alternate up to every 4 hours), empty the drainage 3 times a day.  Sleep at 45 degrees, you can sleep on your side but not your stomach.  You must walk every 2 hours, and must have a bottle of water every 2 hours with regular bathroom breaks. You can eat anything except hard to digest foods (no red meat or spicy foods).  You must wear a firm compression garment all day and night for 4 weeks with no exercise for 4 to 6 weeks.

During the first week you are allowed small walks inside the house.  Whenever you are resting, keep your legs elevated.  Avoid constipation, if you suffer begin prevention on day one (papaya, plums, orange juice, fiber), and the most important, avoid dehydration. Avoid walking a lot, going up and down stairs, no walking the dogs, etc.  Never apply any heat on the abdomen. You can begin exercising after 4 to 6 weeks, with abdominal work in 3 months.

In the long run, patients can have a permanent numbness in the lower part of the abdomen.  The scar is permanent and the best result of the scar is after one year, 4 weeks after surgery use a good scar cream / gel such as anica to massage on the scar twice to three times a day, this will help to stimulate and reduce the scar tissue.  If you want to have the best result, you must wear the tape for the first month, and after you must wear the silicone sheets.  This is a self-adhesive sticker made of silicone that will create pressure on the wound.  It will control the production of collagen and minimize scarring.  You must wear it for 4 to 6 months non stop.

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