
Abdominoplasty, known more commonly as a "tummy tuck," is a major sugical procedure to remove excess skin and fat from the middle and lower abdomen and to tighten the muscles of the abdominal wall. The procedure can dramatically reduce the appearance of a protruding abdomen. But bear in mind, 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.
"Mommy Makeover" includes a wide array of cosmetic surgery options, including tummy tuck, breast lift, breast augmentation, body sculpting with liposuction and skin rejuvenation procedures. These procedures, which can dramatically improve how you look and feel.
If you're considering abdominoplasty, this will give you a basic understanding of the procedure-when it can help, how it's performed, and what results you can expect. It can't answer all of your questions, since a lot depends on the individual patient and the surgeon. Please ask Dr. Rieger about anything you don't understand.

The best candidates for abdominoplasty
The best candidates for abdominoplasty are men or women
who are in relatively good shape but 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. Also, women who plan future
pregnancies may consider waiting, as vertical muscles in
the abdomen that are tightened during surgery can
separate again during pregnancy. If you have scarring in
the upper part of the abdomen from previous abdominal
surgery, your doctor may recommend against
abdominoplasty or may 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, or cause other people to
treat you differently. Before you decide to have
surgery, think carefully about your expectations and
discuss them with Dr. Rieger.
All surgery carries some uncertainty and risk
Thousands of abdominoplasties are performed successfully
each year. When done by a qualified plastic surgeon who
is trained in body contouring, the results are generally
quite positive. Nevertheless, there are always risks
associated with surgery and specific complications
associated with this procedure.
Post-operative complications such as infection and blood
clots are rare, but 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 be
advised to 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 with regard to when and how you
should resume physical activity.
Planning your surgery
In 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 tell your surgeon if you smoke, and if
you're taking any medications, vitamins, or other drugs.
Be frank in discussing your expectations with your
surgeon. He or she should be equally frank with you,
describing your alternatives and the risks and
limitations of each.
You may, on the other hand, benefit more from partial or
complete abdominoplasty done in conjunction with
liposuction to remove fat deposits from the hips, for a
better body contour. Or maybe liposuction alone would
create the best result.
In any case, your surgeon should work with you to
recommend the procedure that is right for you and will
come closest to producing the desired body contour.
During the consultation, your surgeon should also
explain the anesthesia he or she will use, the type of
facility where the surgery will be performed, and the
costs involved. In most cases, health insurance policies
do not cover the cost of abdominoplasty, but you should
check your policy to be sure.
Preparing for your surgery
Your surgeon will give you specific instructions on how
to prepare for surgery, including guidelines on eating
and drinking, smoking, and taking or avoiding certain
vitamins, and medications.
If you smoke, plan to quit at least two weeks before
your surgery and not to resume for at least two weeks
after your surgery.
Avoid overexposure to the sun
before surgery, especially to your abdomen, and do not
go on a stringent diet, as 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 on an outpatient or
inpatient basis, you should arrange for someone to drive
you home after your surgery, and to help you out for a
day or two after you leave the hospital, if needed.
Where your surgery will be performed
Dr. Rieger prefers to perform the operation in a
state-of-the art accredited outpatient surgery center.
Dr. Rieger prefers to allow patient a 23 hour stay in
the surgery center. The center combines state-of-the-art
technology with an exceptional degree of
confidentiality, personalized attention, convenience and
affordability. These centers offer overnight
accommodations with round-the-clock nursing care.
Types of anesthesia
General anesthesia is usually selected, so you'll sleep
through the operation.
The surgery
Complete abdominoplasty usually takes four to five
hours, depending on the extent of work required.

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

Skin is separated from the
abdominal wall all
the way up to the ribs.
Next, the surgeon separates the skin from the abdominal
wall all the way up to your ribs and 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.

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
is removed. A new hole is cut for your navel, which is
then stitched in place. Finally, the incisions will be
stitched, dressings will be applied, and a temporary
tube may be inserted to drain excess fluid from the
surgical site. Dr. Rieger places most of the stitches
under the skin surface to improve the appearance of the
incisions. In most cases only simple butterfly paper
tapes or steristrips are placed on the skin and only two
or three suture require removal.

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.
After your surgery
For the first few days, your abdomen will probably be
swollen and you're likely to feel some pain and
discomfort which can be controlled by medication.
Depending on the extent of the surgery, you may be
released within a few hours or you may have to remain
hospitalized for two to three days.
Your doctor will give you instructions for showering and
changing your dressings. And though you may not be able
to stand straight at first, you should start walking as
soon as possible.
Surface stitches will be removed in seven days, and
deeper sutures, with ends that protrude through the
skin, will come out in two to three weeks.
Getting back to normal
It may take you weeks or months to feel like your old
self again. If you start out in top physical condition
with strong abdominal muscles, recovery from
abdominoplasty will be much faster. Some people return
to work after two weeks, while others take three or four
weeks to rest and recuperate.
Exercise will help you heal better. 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, however, 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, but 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, even under bathing suits.
Your new look
Abdominoplasty, whether partial or complete, produces
excellent results for patients with weakened abdominal
muscles or excess skin. And 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.
If you're realistic in your expectations and prepared
for the consequences of a permanent scar and a lengthy
recovery period, abdominoplasty may be just the answer
for you.
call 316-652-9333 for a consult
about Abdominoplasty, Tummy Tuck and Mini Tummy Tuck in
Wichita, Kansas.
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Brochure © 2003 American Society of
Plastic Surgery