How Tummy Tuck Surgery Works

A tummy tuck is a great way to get your body ready for summer and improve your confidence.

Tummy tucks (also known as abdominoplasty) usually involve three or four elements:

Tummy tucks usually involve three or four elements:

• Removal of excess skin

• Tightening the abdominal muscles

• Relocating the belly button (umbilicus)

• (Optional) liposuction removal of fat in the upper abdomen and sides (flanks)

In this post on how tummy tuck (abdominoplasty) surgery works, we will help you understand what is involved with planning for and going through with one of the most successful operations in cosmetic surgery.

Fitness and the appearance of fitness has become an obsession in our culture. Our torso shapes are revealed in form fitting clothing, in athletic garments and in the minimalist swimsuits for which there are little in the way of alternatives. Since mass produced clothing took the place of made to measure, we have been forced to wear clothing which is standardized, whereas our bodies are not. I call this the “tyranny of prêt-a-porter” (ready to wear). A full video of abdominoplasty with liposuction is available to view.

A full video of abdominoplasty with liposuction is available to view.

An Overview Of The Tummy Tuck Procedure:

The tummy tuck surgery is done under general anesthesia (completely asleep). We add local anaesthetic by injecting it at the start of and during surgery which helps to minimize post-operative pain. There are some surgeons who advocate doing tummy tucks under local anaesthesia with sedation (“twilight”). This may sound attractive, but I think a modern well run general anaesthetic administered by a qualified anaesthesia specialist provides a patient with the best possible experience.

Once you are put to sleep, and the torso has been washed with antiseptics and surrounded with sterile towels, the operating team has done a final “time-out” safety checklist. If liposuction is going to be done, we do it first, through small incisions, usually within the skin area that is going to be removed..

The incision is now created and the skin of the abdomen is separated from the underlying muscle layer, first up to the belly-button, which is next separated from the surrounding skin and left in place. Surgery continues into the upper abdomen and right to the start of the breast bone. We do as little separation of the skin from beneath as possible, to preserve circulation and sensation.

The muscles of the abdominal wall are now visible, and the rectus abdominis muscles (the ones you use to do “crunches” and “sit ups”) are nearly always separated after pregnancy (diastasis recti). I bring the muscles back together with a series of stitches (I usually do this in two layers).

Skin Removal (Resection) and Repair:

Here’s where I get to be a tailor, a disappearing craft in our culture.

Traditional abdominoplasty involved removing all the skin from the top of where the belly button was to the pubis. This required folding the operating room table and the to flex the patient’s hips and waist to an extreme, just to bring those edges together. This often left patients unable to stand up straight for weeks and weeks. It also put a lot of strain on the incision repair, and led to all sorts of healing problems and widening of scars. I think it increased the risk of deep vein thrombosis (blood clot), a feared and potentially lethal complication.

Tummy tucks no longer rely on skin tension for getting good results. Dr. Ted Lockwood, who practiced in Kansas city, revolutionized body contour surgery with his careful study of anatomy. He applied his knowledge of the superficial fascial system (SFS) to put tension on the tissues than can really support the repair and leave little tension on the skin. I was fortunate to hear Dr. Lockwood in my early practice years and to later watch him operate. His ideas and techniques struck me as profound. They fit together with similar ideas which had come earlier in facelift surgery.

Using his ideas, we first estimate the amount of skin removal with gentle flexing of the OR bed. We then proceed to use a series of “basting” stitches in the deeper layers to further refine that estimate. Finally, the skin removal and repair take place with minimal skin tension.

How Tummy Tucks Can Help You Achieve Your Summer Body:

Tummy tuck surgery can achieve dramatic and long lasting restoration of body contour after pregnancy and weight loss. As with any surgery, good preparation including having a thorough understanding of the risks and benefits will help achieve your goals this summer. 

If you have any questions about breast augmentation procedures, the friendly staff at our Vancouver clinic is available to assist you.

You are welcome to call us at (604) 874-2078 or you can book a consultation to speak directly with Dr. Gelfant.

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