Abdominoplasty

Editors-In-Chief: Martin I. Newman, M.D., FACS, Cleveland Clinic Florida, [mailto:Newmanm@ccf.org]; Michel C. Samson, M.D., FRCSC, FACS [mailto:samsonm1@ccf.org], Paul C. Zwiebel, M.D., D.M.D., FACS [mailto:pz@pzwiebel.com]

Overview
Abdominoplasty or "tummy tuck" is a cosmetic surgery procedure used to make the abdomen more firm. The American Heritage Stedman's Medical Dictionary defines abdominoplasty as "Plastic surgery of the abdomen in which excess fatty tissue and skin are removed, usually for cosmetic purposes." The surgery involves the removal of excess skin and fat from the middle and lower abdomen in order to tighten the muscle and fascia of the abdominal wall. This type of surgery is usually sought by patients with loose tissues after pregnancy or individuals with sagging after major weight loss.

Procedures
Abdominoplasty operations vary in scope and are frequently subdivided into categories. Depending on the extent of the surgery, a complete abdominoplasty can take 1 to 5 hours. A partial abdminoplasty (Mini-Tuck Abdominoplasty) can be completed between 1 to 2 hours.

Complete Abdominoplasty
A complete (or full) abdominoplasty involves:
 * 1) An incision is made from hip to hip just above the pubic area.
 * 2) Another incision is made to free the navel from the surrounding skin.
 * 3) The skin is detached from the abdominal wall to reveal the muscles and fascia to be tightened. The muscle fascia wall is tightened with sutures.
 * 4) The remaining skin and fat are tightened by removing the excess and closing the defect.
 * 5) The old belly button stalk is brought out through a new hole and sutured into place.
 * 6) Liposuction is often used to refine the transition zones of the abdominal sculpture.
 * 7) A dressing and sometime a compression garment are applied and any excess fluid from the site is drained.

Partial Abdominoplasty
A partial (or mini) abdominoplasty involves:
 * 1) A smaller incision is made.
 * 2) The skin and fat of the lower abdomen are detached in a more limited fashion from the muscle fascia. The skin is stretched down and excess skin removed.
 * 3) Sometimes the belly button stalk is divided from the muscle below and the belly button slid down lower on the abdominal wall.
 * 4) Sometimes a portion of the abdominal muscle fascia wall is tightened.
 * 5) Liposuction is often used to contour the transition zone.
 * 6) The flap is stitched back into place.

Extended Abdominoplasty
An extended abdominoplasty is a complete abdominoplasty with extensions into the thighs (front) and/or flanks (sides).

Combination Procedures
An abdominoplasty is a component of a lower body lift and can be combined with liposuction contouring, breast reduction, breast lift, or occasionally hysterectomy, depending on the reason for the hysterectomy.

Recovery

 * Depends on the problem to be treated, surgical technique(s), and other factors. Can take one to four weeks and patients are advised to take at least a portion of this recovery time off from work.


 * Heavy activity especially is best avoided during this time.


 * Initially there may be bruising and discomfort.


 * A supportive abdominal binder or compression garment can minimize swelling / bruising, and support the repaired tissues.


 * Patients are advised to avoid all forms of nicotine for a month or longer prior to surgery and also during the recovery period.


 * Full recovery takes 3 - 6 months, with further fading of scars thereafter.

Cost
The cost of a "tummy tuck" varies from country to country and even within locales of countries. As with most cosmetic surgery operations, the cost depends on a variety of factors like the age of the patient, their weight and the state of their health. Depending on the individuals, there may also be other costs involved after the operation. This does not include the follow-up visits as required by some doctors.

On average in the United States, this procedure can cost from $4,000 to as much as $20,000.

The pre-operative and post-operative care, facility fees, anesthesia, and medications must be taken into consideration when reviewing surgery costs. No surgeries are a guaranteed success and therefore a second procedure or a touch-up may be required to achieve the desired appearance. These costs are typically not included in the original cost.