Abdominoplasty (Tummy Tuck) in McAllen and Brownsville
What is an Abominoplasty?
An abdominoplasty, or “Tummy Tuck,” is a surgical procedure to firm and smooth your abdomen. A flat and trim abdomen is one of the main features we identify with youthfulness, physical fitness, and beauty. Flabby, loose skin, and a bulging abdomen may make it difficult to wear the clothes you want and may make you self-conscious about revealing your body at the beach, in the gym, or even in the bedroom. A protruding abdomen is often the result of stretched abdominal muscles from pregnancy, or repetitive cycles of weight gain followed by weight loss. Occasionally, there is an inherited familial pattern of localized abdominal obesity, while the rest of the body contours are normal.
Patients often ask if liposuction alone can create the changes they desire in hopes of avoiding the tummy tuck scar and recovery. The reality is that the scar location, appearance, recovery time, and the appearance of your belly button have a lot to do with surgical technique. This is what makes one surgeon’s results unique and different from everyone else’s. (Pay close attention to what a surgeon’s belly button results look like in their before and after images, because chances are that’s what your belly button will look like.) In addition, there are specific aspects of the abdominoplasty procedure that make it very different from liposuction alone. We often describe a tummy tuck as a trade off – trading the loose saggy skin and stretch marks from the lower abdomen for a tighter, flatter stomach with a smaller waist and a low, well-placed tummy tuck scar.
The natural changes of pregnancy or massive weight loss often cause the skin to lose its elasticity and create permanent stretch marks. In addition, these changes cause the connective tissue (the linea alba) between the abdominal muscles (rectus abdominus) to stretch and separate – a diastasis recti. This type of abdominal wall loosening often fails to improve with diet or exercise. Diastasis recti is an irreversible over-stretching of the abdominal wall where the underlying connective tissue surrounding the muscles have been overly stretched and weakened. Their resilience has been pushed beyond the point of recovery and requires surgical correction. This is true for both women and also men. In men, diastasis reci can occur as a result of weight gain and weight loss, or simply genetics. Many patients are discouraged by the lack of improvement in their abdominal contour, often in spite of rigorous diet and exercise, which never seems to translate into visible results – both because of the permanent stretch marks and loose skin as well as the underlying diastasis recti.
An abdominoplasty corrects these problems by removing the excess, stretched lower abdominal skin (including most of the stretch marks) and eliminating fat from throughout the abdomen and waist. We perform liposuction throughout the abdomen and waist as part of all our abdominoplasty procedures, often with VASER liposuction to further enhance our result – the “VASER TuckSM”. Most importantly, we plicate (tighten) the diastasis recti (see figure). This corrects the abdominal wall defect, restores the flat abdominal contour, and also creates the tiny waist that patients want! In addition, if a small umbilical hernia is present (an “outie” belly button), this will be repaired at the time of your procedure. Old unsightly scars from a previous C-section or appendectomy and stretch marks on the lower abdomen are also removed. The result is a more youthful, firmer and flatter abdominal contour with smoother skin.
It is important to have realistic expectations. An abdominoplasty is not a substitute for weight loss and healthy lifestyle. In some cases, we recommend that our patients enroll in a medically supervised weight management program, and often we recommend that our patients consult with a nutritionist or registered dietitian for initiation and long-term maintenance of healthy eating habits and weight stability.
Is a Tummy Tuck right for me?
An abdominoplasty is a very effective surgical procedure, which slims and tightens the abdominal area. Almost everyone who has a sagging stomach can benefit from an abdominoplasty, but it is particularly popular among women who have had multiple pregnancies and patients who have experienced significant weight loss, such as post-bariatric patients. Both women and men who have excess fat and loose skin of the abdomen with diastasis recti can benefit from a tummy tuck. We carefully consider age, weight, and overall health when evaluating a candidate for this procedure. The best candidates are healthy and physically fit, and we’ve successfully performed tummy tuck surgery on patients in their 20’s up to their 60’s and 80’s! Most patients are in women their 30’s and 40’s who do not plan a future pregnancy. Ideal body weight targets a Body Mass Index (BMI), which is a measure of body fat based on height and weight, less than 35 and preferably less than 32 to decrease operative risks. Post-bariatric patients should have maintained their new low stable weight for at least 6 months. It is important for tummy tuck patients to maintain their body weight with a disciplined program of diet and exercise in order to preserve their results. You may be a good candidate for Abdominoplasty if you have one or more of the following conditions:
- Excess or sagging abdominal skin with multiple stretch marks
- An abdomen that protrudes and is out of proportion to the rest of your body
- Abdominal muscles that have been separated and weakened by pregnancy or weight gain with subsequent massive weight loss (diastasis recti)
- Excess fatty tissue that is concentrated in your abdomen
Smokers, diabetics, and patients with uncontrolled obesity and intra-abdominal fat are poor candidates. I will work with patients to enter a smoking cessation program, and we have successfully performed abdominoplasty surgery on patients with well-controlled diabetes. Patients whose BMI is higher than 35 can be helped with some of the newer prescription weight loss medictions or bariatric surgery. We will discuss this with you in more detail during your consultation.
Women seeking abdominoplasty should be relatively certain that they do not plan a future pregnancy. Many women choose to combine their tummy tuck with a tubal ligation, which we can perform safely, prior to tightening the muscles as part of the tummy tuck. We are also one of the few centers that safely perform combined hysterectomy-tummy tuck procedures, which offer patients the advantage of a combined recovery from these procedures. In fact, my combo hysterectomy-tummy tuck patients often have faster recovery than hysterectomy patients alone.
For properly selected patients, an abdominoplasty can provide a dramatic improvement in physical appearance, self-confidence, and general sense of well-being. In addition to the dramatic change in the styles of dress and clothing, patients often experience increased exercise tolerance and motivation to maintain the outward improvement in body shape with healthier lifestyle and dietary choices.
Patients often choose to combine additional procedures at the time of their abdominoplasty. Almost 99% of my patients benefit from additional VASER liposuction to the flanks and back, and many desire butt augmentation with fat transfer to the butt (the “Brazilian Bubble Butt Lift®”). Some women choose to combine their tummy tuck with additional procedures for vaginal rejuvenation, such as labiaplasty or vaginoplasty. One of the most popular combinations is known as the “Mommy Makeover”, because it includes breast augmentation or breast lift surgery with a tummy tuck – thereby correcting the two primary areas of a woman’s body that are affected by pregnancy and breast feeding. For select patients who are candidates for a transumbilical breast augmentation (TUBA, the “Belly Button Boob Job™”), a tummy tuck provides an opportunity to perform a TASBASM – Trans Abdominoplasty Silicon Breast Augmentation with silicone implants!
We will take a complete medical history and conduct a thorough examination to evaluate your overall health. As with all cosmetic surgery, patients should be otherwise healthy with minimal health problems. Hypertension or diabetes, if present, must be well controlled to minimize risks, and we will check hemoglobin A1C levels to ensure good blood sugar control. Patients on a personal or medically supervised weight-loss plan should be relatively close to their target weight and stable for at least 6 months before having the operation. Women planning future pregnancies should delay their tummy tuck, as pregnancy will undo the results and cause further abdominal stretching.
Photographs will be taken before and after surgery.
Antibiotics will be prescribed at the time of surgery to prevent infection. To minimize the possibility of excess bleeding, you should avoid taking drugs containing aspirin for at least 2 weeks prior to your procedure, and you will receive a complete list of medications and supplements to avoid before surgery. Women on birth control pills or estrogen supplements will be asked to discontinue these prior to surgery to decrease risks of blood clots. You will be advised to shower with an antiseptic soap on the night before or morning of your surgery.
The Abdominoplasty Procedure
A tummy tuck is real surgery, especially when combined with multiple additional procedures. For this reason, we only operate in either the hospital setting, such as Cornerstone Regional Hospital or Women’s Hospital at Renaissance, or in a fully accredited outpatient surgical center, such as our facility or the North Brownsville Ambulatory Surgery Center. An abdominoplasty can be performed within 2 to 4 hours, depending on the individual circumstances and the extent of tissue to be excised. If additional procedures are planned in conjunction, the length of surgery will determine whether an overnight stay will be recommended for your safety and comfort. We perform all of our surgery under light general anesthesia administered by a certified anesthesia provider, and I administer additional local anesthesia during the procedure to minimize any post-operative discomfort and help with your “Rapid-Recovery AbdominoplastySM”.
Our “Rapid-Recovery AbdominoplastySM” reflects my synthesis of the traditional abdominoplasty techniques I learned at UCLA and the innovative Avelar Technique for lipo-abdominoplasty that we employed at the Body Sculpting Center in Scottsdale during my cosmetic surgery fellowship. This approach results in a technical advancement that permits more aggressive liposuction throughout the upper abdomen, flanks, waist as part of the procedure, and decreases the amount of trauma to the tissues. The excess skin is removed from the lower abdomen; loose, separated muscles are tightened with sutures (plication of diastasis recti); and any abdominal hernias are repaired. This results in a firmer abdominal wall and a narrower waistline. The skin is re-draped and tightened over the abdomen, and the navel is restored to its normal location through a new incision in the abdominal skin. Existing stretch marks in the lower abdomen are often removed in the process, and any remaining stretch marks tend to be flattened and improved.
In the case of a full abdominoplasty, a gently curving incision is made between the hipbones and above the pubic area, below any pre-existing C-section scars and below the bikini line. The length of this incision depends upon the amount of excess skin to be removed. A second incision is made around the navel (umbilicus), the abdominoplasty flap is developed, and the muscles are tightened (plication of the diastasis recti). The skin is then stretched tight and a new opening is made to reconstruct the belly button. All incisions are carefully closed with absorbable sutures and surgical tape. Temporary suction drains are inserted to eliminate fluid buildup, and these are usually removed within the first 2 weeks.
Recovery and Results
You will awaken gently from anesthesia in the recovery room, usually free of nausea or pain. Mild discomfort is usually well controlled with oral pain medication. Over the counter Tylenol and Aleve are encouraged and you will have prescription muscle relaxants to help with any muscle spasm pain at home. Patients are reminded that tightness is expected after a tummy tuck, but that tightness is not pain. When you are fully awake, you will be ready to be transferred home. You will need a friend or family member to drive you home and stay with you through the first night following your surgery. As part of your “Rapid-Recovery AbdominoplastySM” you are encouraged to get out of bed periodically for short walks in order to promote circulation and to facilitate deep breathing. Our surgical techniques are unique in that patients can walk the first day after surgery. Although you may not be able to stand up completely straight, it is best that you do not lie in bed or sit for long periods of time during the first several days in order to prevent blood clots in the legs.
A mild amount of swelling and bruising is normal. You will be sent home with dressings on your incisions, as well as a comfortably fitting compression garment that provides support and helps to minimize swelling. You should wear this garment 24 hours a day for 6 weeks and should remove it only when showering. If you don’t spend the night in the hospital, you will be seen at the practice the morning after surgery to ensure that you are up and walking and receive additional instructions.
You will be restricted to light activities for the first 7 to 10 days after surgery while your body heals. The speed of recovery depends on your physical condition prior to surgery; those with stronger abdominal muscles usually recover faster. Straining, bending, and lifting heavier than 10 pounds (one gallon of milk) must be avoided, since these activities might cause increased swelling, bleeding, or disruption of the surgical repair. Allow at least 1 to 2 weeks to recuperate before returning to non-strenuous work; sexual activity should be avoided for at least two weeks. Most patients may resume light to moderate exercise 3 to 4 weeks after surgery. If muscle repair was performed, avoid lifting more than 10 pounds (approximately one gallon of milk) for 6 weeks after surgery. It may take several weeks for all of the swelling to subside to the point that the final results of your improved abdominal contour can be fully appreciated. You may experience prolonged numbness over portions of the abdominal area, which may persist for several months but will ultimately resolve. The incisions may remain red or pink for many months following surgery before they finally begin to fade. We want you to have the best appearing scar possible, and we will give you specific recommendations for scar care after your procedure.
Options and Alternatives
There are several variations of the standard Abdominoplasty technique, which I will discuss with you if appropriate to your condition. For select patients requiring minimal excess skin removal, a lower abdominoplasty without translocation of the umbilicus (i.e. the “mini” tummy tuck) can be performed with a shorter horizontal incision and without an incision around the navel. It is important to realize that there is nothing mini about a “mini” tummy tuck. The muscles are still tightened, drains are still needed, and the recovery is similar. Very few patients are candidates for a mini-tummy tuck. For select slender patients with diastasis recti and minimal loose skin, I offer an exotic combination of VASER liposuction and an extended lower abdominoplasty with a floating navel technique that allows me to fully plicate the diastasis recti and excise a small amount of excess skin through a small C-sections sized scar with no visible scarring around the belly button. Additional skin tightening occurs over the 3-4 months after surgery as VASER energy takes effect.
For those patients with excessive loose skin on the flanks, hips, and the upper, lower and lateral abdomen after massive weight loss, more extensive procedures such as the Fleur-de-lys Abdominoplasty or an Around-the-World-Abdominoplasty with Lower Body Lift may be required in order to achieve the best results. Alternatively, Laser Liposuction or VASER Liposuction may be used in cases where there is good skin elasticity and where there is only localized excess abdominal fat with no stretched muscles. We typically use VASER Liposuction in conjunction with abdominoplasty procedures to remove additional unwanted fat deposits to improve the overall contours of the waistline, hips, and thighs and to enhance skin tightening throughout the areas treated.
Anyone considering surgery should be aware of both the benefits and risks. Fortunately, significant complications from abdominoplasty are rare, and our patients are extremely gratified with the results.
Potential risks of abdominoplasty include bleeding, infection, reactions to anesthesia, and blood clots in the leg veins (DVT). There may occasionally be tissue loss and delayed wound healing along portions of the horizontal incision, especially in patients with high BMI, or in smokers and diabetic patients. There may also be an accumulation of serum fluid beneath the abdominal skin, requiring prolonged drainage. A review of our results has shown that our outcomes in all these areas surpass the nationally reported outcomes for complications, even for longer, more complex procedures.
Patients are encouraged to walk as much as possible in the first few days after surgery to avoid the possibility of pneumonia or of blood clots forming in the leg veins. All scars will be permanent, although they do fade over time as they progress through the wound healing phases. Very rarely, scars may require revision involving a subsequent procedure if they have healed poorly, or additional contour-correction procedures (dog-ear excision or liposuction) may be required to achieve optimal results.
It is not possible to list or anticipate every conceivable complication. However, most risks can be mitigated by choosing a board-certified cosmetic surgeon who specializes in abdominoplasty and body contouring surgery. Carefully follow the recommendations and instructions provided during your consultation. We will fully address any of your personal questions or concerns at that time.
Your New Look
Although the recovery period may be somewhat longer than that of other cosmetic procedures, Abdominoplasty provides significant and lasting results for patients previously distressed by a protruding, sagging abdomen. Although the incision lines are permanent, they will fade over time and they are generally well hidden in natural skin folds and are covered by most common undergarments and swimwear.
A word about beautiful scars and your belly button….
It is important to understand that the final result of your tummy tuck scar reflects a combination of your body’s healing process, your surgeon’s techniques, and the quality of the suture materials used. A fine linear scar that is strategically placed and well hidden with low-cut underwear is not an accident. It is the result of meticulous surgical planning and technique. Just as important, and often overlooked, is how natural and beautiful your belly button will look after your tummy tuck. The belly button is like a surgeon’s signature on a tummy tuck. Although we can never guarantee results in surgery due to the variation of natural healing, patients should seek a surgeon who delivers consistent results. Patients are encouraged to pay close attention to the before and after images when comparing different surgeons for your procedure. What do their belly buttons look like? How do you want your belly button to look – natural and beautiful, or scarred and fake?
After having a tummy tuck, our patients generally feel more confident about their appearance, both in and out of clothing. Most patients will have a greater variety regarding the types and styles of clothing they feel comfortable wearing. Our patients who follow a proper exercise routine and healthy diet, and who dedicate themselves to maintaining the results we achieve with surgery, tend to benefit the most from their tummy tuck.
As with any cosmetic surgery procedure, it is critical that you choose a cosmetic surgeon with high levels of training, experience, and patient satisfaction. To learn more and to begin your journey to a flatter abdomen and a smaller waist, please click here to request a consultation with Dr. Filiberto Rodriguez, a double board certified cosmetic surgeon specializing in “Rapid-Recovery AbdominoplastySM” in McAllen and Brownsville. Or, you can call us schedule your private consultation at 956-687-8346 in our Del Prado offices in Edinburg, or 956-350-6561 in north Brownsville.
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