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Tummy Tuck Surgery

Tummy Tuck SurgeryA tummy tuck is a surgical procedure involving multiple steps that are designed to improve the aesthetic appearance and touch of the abdominal area. The process begins with an incision way below the abdominal wall. In accordance with body structure, the resulting scar may or may not be completely buried. The next step involves in firmly tightening the muscle layer, followed by the removal of excess skin and fat, and finally, the placement of the belly button on the abdominal wall. Part of the procedure includes liposuction of the upper abdominal area as well as love handles.

Factors that Affect Tummy Tuck Results

As with most cosmetic surgeries, the results of a tummy tuck vary significantly depending on pre-operative weight, body type, skin quality, and stretch marks. A fit patient with loose skin and minimal stretch marks tends to obtain amazing results. On the other hand, while patients with extremely loose skin or very significant stretch marks are able to have the loose skin removed, their skin will partially stretch months after surgery, causing a partial recurrence of skin laxity. Regardless, these patients will obtain great benefits from a tummy tuck operation.

Patients with very thick fat layers or intra-abdominal fat may not obtain as excellent a result as slimmer patients with only loose skin. While liposuction can be used effectively to decrease the thickness of the abdominal fat layer, too much thinning may cause extreme healing complications.

Patients with extensive stretch marks may have skin that is unable to maintain itself in the taut and stretched condition that results from a tummy tuck. These patients may notice minimal loosening of skin in the months post surgery. This occurs because the same skin that develops drastic stretch marks due to pregnancy tends to be skin that consequently loosens and weakens as collagen and elastic fibers stretch, caused by tension placed on the skin layer that occurs during the tummy tuck. Patients with stretch marks extending high up on their abdominal walls above the belly button, will generally have a few remaining stretch marks as part of the final result.

Tummy Tuck Post-Op Care

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    Elevate your legs and head when lying down (place pillows under both)

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    Keep your garments on until your first follow-up appointment with Dr. Backstein

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    If the binder feels too tight, you can loosen it a little

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    Make sure to move around every hour and don't lie in bed for hours at a time (other than bedtime)

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    No lifting

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    You may encounter spotting of blood or fluid on your garment. Don't worry this is normal

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    You can sponge bath but don't get the binder wet

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    When you wash the binder, hang it to dry (no machine drying)

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    Empty and reset your drains as necessary

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    DO NOT SMOKE AT ALL

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    Contact Dr. Backstein at drbackstein@gmail.com if you have any significant concerns

Complications Associated with Tummy Tucks

There are typically minimal complications post tummy tuck surgery, significantly for the reason that the procedure involves a cosmetic surgery of the skin, fat, and upper muscle layers, rather than the major organs. Dr. Bernstein will review any potential complications during the initial consultation. Some complications that may occur, but are rare include:

  • Anesthesia
  • Infections
  • Post-operative bleeding
  • Incision separation
  • Blood clots
  • Slow healing areas
    • Do I need to wear a special garment after my Tummy Tuck?

Yes, tummy tuck patients should wear a compressive corset provided by Dr. Backstein for the first 3-4 weeks post plastic surgery.

    • How long after my Tummy Tuck do I have to wait before I start exercising?

Light work outs involving exercises that do not strain the surgical incision or the abdominal muscles can begin at 2-3 weeks. This includes brisk walking or stationary bike riding. Heavier work outs including abdominal crunches, sit-ups and running should not be attempted for about 1 month.

    • How long should I wait after my Tummy Tuck before returning to work?

Patients with jobs that require significant physical activity including bending, lifting, or quick movement will need about 4 weeks off before being able to return to full duties comfortably. Those patients with jobs not demanding physical activity can return to work after 2 weeks.

    • Do I need to stay overnight after my abdominoplasty (Tummy Tuck Surgery)?

Most patients are able to leave the hospital on the evening of the surgical day. Arrangements can always be made for patients to stay overnight if so desired. Although straining, heavy lifting and bending should be avoided, tummy tuck patients must start minimal walking and leg exercises the day of the surgery. Lying in bed for hours at a time is dangerous and must be avoided to minimize the risk of blood clots. When going to sleep, a couple of pillows under the knees and behind the head will act to ease the tension on the surgical incision and will help relieve discomfort.

    • How much pain will I have after my Tummy Tuck (abdominoplasty)?

Following a tummy tuck, patients describe a major feeling of tightness around the abdomen. The discomfort is described as an intense muscle ache similar to the feeling after an aggressive abdominal workout. Dr. Backstein feels that the best tummy tucks will cause a certain amount of post operative discomfort. This is related to the extent of tightening that the surgeon has achieved. If a tummy tuck doesn't hurt at all, the abdomen was likely not tightened adequately. Swelling and bruising is always seen after a tummy tuck or liposuction. Dr. Backstein always provides supplemental liposuction to the upper abdominal area and love handles and bruising will be seen in these areas.

    • Are Tummy Tucks covered by OHIP?

A common area of confusion is that a tummy tuck is covered by OHIP. This is not the case. A surgical procedure called a panniculectomy has some minor similarities to a tummy tuck and may be covered by OHIP (each patient must be approved individually by the Ministry of Health). A panniculectomy is a very different operation than a tummy tuck. A fundamental principle to understand is that OHIP does not cover cosmetic surgery. A panniculectomy is covered by OHIP because it is not a cosmetic surgery but instead a functional surgery, i.e. one that is designed to relieve the patient of medical issues and concerns.

Panniculectomy - Technically, a panniculectomy removes ONLY the skin and fat tissue that overhangs the waist-line. The idea is that by removing this overhanging tissue, the space behind the overhang is eliminated thereby preventing the infections and rashes that often occur in this space. A panniculectomy does NOT address the excess skin and fat above the waist-line, does NOT involve tightening of the abdominal muscles, and does NOT involve liposuction of the love handles or upper abdomen. The overall esthetics of the abdominal region are only minimally improved with a panniculectomy procedure and the belly button (umbilicus) is often lost as a result of this operation.

Dr.Backstein is currently not performing panniculectomy procedures.

Tummy Tuck - Technically, a tummy tuck removes the largest piece of extra skin and fat that can possibly be removed from the abdominal wall. As a rule of thumb, this generally involves removal of the loose skin and fat between the waistline and an area several centimeters above the belly button. Additionally, the abdominal muscles are tightened so as to create a dramatic flattening of the abdominal wall and eliminating the "ponch" that often exists in the lower abdomen. Additionally Dr. Backstein performs supplemental liposuction of the love-handles and upper abdomen as part of a tummy tuck. Tummy tucks are, by definition, not covered by OHIP.

    • Who is a Candidate for a Tummy Tuck?

A tummy tuck can benefit individuals with the following features of the abdominal area:

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    excessive, loose, sagging skin

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    stretch marks, such as after pregnancy

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    excess fat on the abdomen

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    a rounded tummy that would benefit from flattening

    • What should I do to maintain my Tummy Tuck surgery?

The human body is dynamic and always in a state of change. No surgical procedure exists to reshape, re-contour or tighten a body region that is absolutely permanent. The results of a tummy tuck and liposuction need to be maintained. A healthy lifestyle must be followed after surgery to maintain the dramatic flattening and tightness of the abdominal region that a tummy tuck or liposuction provides. Poor diet and sedentary lifestyle will, over time cause weight gain and skin stretching after tummy tuck surgery. Happily, the vast majority of patients find that after a tummy tuck or liposuction, they feel so good both mentally and physically that exercise and healthy eating become a welcome part of their post-surgical lifestyle.

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Robert S Backstein, MD STEELES AVENUE COSMETIC SURGERY
5109 Steeles Avenue West, Unit 13 Toronto, Ontario, M9L 2Y8
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