After childbirth or weight loss, the abdominal area often has loose or sagging skin, and may also exhibit stretching of the abdominal wall muscles or fascia (the tough gristle-like layers that surround the abdominal wall muscles and give the area strength). There may also be hernias (bulges of intraabdominal contents such as intestines and fat) through tears or openings in the abdominal wall. These can be tiny asymptomatic bulges, such as those that commonly occur in the umbilicus, or they can be large enough to cause strangulation of the sections of the small bowel which protrude and become caught in the hernia. The latter is rare and dangerous, the former, common and unsightly. Generalized weakness and protrusion of the abdomen with loose overlying skin that often has visible stretch marks are the hallmarks of patients who need abdominoplasty, or “tummy tuck.” This operation removes loose skin, tightens the abdominal wall muscles, and repairs any hernias found. Minneapolis Plastic Surgery, LTD., serving the Minneapolis / St. Paul, Minnesota area, offers the tummy tuck procedure, also known as abdominoplasty, to people who feel that their appearance would be improved by this treatment.
If you have loose, wrinkled, or sagging abdominal skin, no amount of exercise will restore the lost elasticity and collagen content in that stretched skin. Abdominoplasty is the only answer for this concern. The good news is that other areas of localized fatty tissue, such as the hips, lateral thighs (“saddlebag” area), or other areas, can be treated with liposuction at the same time as abdominoplasty. If the loose skin continues to the hips, thighs, and buttocks, extended abdominoplasty, or even complete circumferential beltlift (lower body lift), can be performed.
Some patients may have tight abdominal skin but still have localized fatty tissue outside the abdomen; these patients may be candidates for suction-assisted lipoplasty (liposuction). Other patients, including some men with round or protruding abdominal areas and little fat outside the abdominal wall, are not candidates for abdominoplasty or liposuction, since their weight is carried inside the abdomen and will respond only to diet and exercise. Good candidates for abdominoplasty include:
After careful assessment of the location and extent of your skin laxity, Dr. Richard H. Tholen and Dr. Douglas L. Gervais will mark the planned incisions and any fatty areas to be addressed at the time of your operation. The abdominoplasty scars are usually just above the pubic area (and around the belly button), and in most patients fade nicely over time. The scars are usually concealed by normal swimwear and clothing choices. In addition to excess skin removal and tightening, abdominoplasty and abdominal contouring include tightening of the abdominal wall muscles with several layers of suture—restoring the abdominal fascia and its contour to their pre-pregnancy or pre-stretched state. This usually results in flattening of the abdomen and a loss of one or more belt or dress sizes!
Both Dr. Tholen and Dr. Gervais perform abdominoplasty, abdominoplasty plus liposuction (abdominal contouring), and other forms of body contouring such as circumferential beltlift (lower body lift), thigh lift, breast lift, and arm lift (brachioplasty), all in our Minneapolis, Minnesota surgical facility on an outpatient basis. Abdominoplasty, also referred to as tummy tuck surgery, is made as comfortable as possible for our patients with our quality anesthesia and surgical techniques. Abdominoplasty is often combined with breast augmentation or breast lift, as these areas are most commonly affected after childbearing and/or breastfeeding.
Most patients undergoing abdominoplasty or abdominal contouring will require one or two small surgical drainage tubes beneath the skin to evacuate fluid or blood that may collect after this surgery. To minimize drainage as well as bleeding, it is essential that every patient avoid aspirin, ibuprofen, Aleve™, vitamin E (the amount in a daily multivitamin is OK), or herbal preparations for a minimum of two weeks prior to surgery. The drain(s) remain in place until drainage is reduced to less than an ounce of fluid per drain per day. Drain removal is simple and is carried out at a routine recheck visit without anesthesia. While drains are in place, and for at least two to three weeks after surgery, an abdominal binder or compression garment will need to be worn to assist the tissues in healing in their new tightened positions. The belly button remains in exactly in the same place it was when you were born—just with a new opening for it in the tightened skin that has been brought down around it. Except for the drain stitch and a few tiny sutures around the belly button, all sutures are below the skin surface, leaving no cross-hatch or suture marks and yielding the best scar possible when fully healed.
There will be numbness in the lower abdominal skin after surgery; most, but not all, sensation returns as the sensory nerves re-grow in the ensuing months. Strenuous activities should be limited after this kind of surgery for at least two weeks, and no sit-ups or abdominal crunches should be performed for at least six weeks. Most other activities are resumed quickly, and most patients return to social activity and work after one to two weeks, or after drain removal.
Because abdominoplasty, abdominal contouring, and more extensive operations such as extended abdominoplasty or beltlift all lift, remove, and tighten skin, adequate circulation to the skin flaps is necessary for proper healing and minimal scarring. In nonsmokers, circulation problems that can impair healing and increase scarring occur in less than one to two percent of patients. Smoking just one cigarette, using nicotine gum or patches, or even exposure to second-hand smoke can raise the risk of developing dead skin or a dead belly button to as much as 15-20 percent. For this reason, the use of all tobacco and nicotine products must be stopped completely at least two weeks before surgery, and they must be avoided after surgery until all things are healed. Failure to comply with this requirement will result in the cancellation of your surgery; concealing your own failure to follow this requirement may result in prolonged dressing changes, skin grafts, or additional surgery to deal with scarring.
Fortunately, abdominoplasty and abdominal contouring are among the most common plastic surgical procedures we perform; Dr. Tholen and Dr. Gervais conduct well over 100 of these operations for Minneapolis / St. Paul area patients per year. Most patients are thrilled with their results. A complimentary consultation can help you determine what procedure or procedures are best suited for your own concerns.
For more information or to arrange a complimentary consultation with one of our plastic surgeons at our Minneapolis, Minnesota office, please contact our practice. Our doctors can help you determine whether abdominoplasty, or tummy tuck surgery, is an appropriate option for you.
Please contact Minneapolis Plastic Surgery, LTD. if you have any questions about our procedures or would like to schedule a complimentary consultation with one of our plastic surgeons.
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Minneapolis Plastic Surgery, LTD.
4825 Olson Memorial Highway (Hwy 55) Suite 200
Minneapolis, Minnesota 55422
Phone: (763) 545-0443
Fax: (763) 545-2784