An abdominoplasty (tummy tuck) is one of the most commonly performed post-pregnancy plastic surgery options selected by women. This is because the pregnancy can cause the abdomen to be protuberant for three reasons:
- The patient may have loose skin.
- There may be excess subcutaneous fat.
- The abdominal wall may become stretched out (called diastasis).
The abdominoplasty procedure addresses all three of the problems. Often, small hernias, especially near the umbilicus, will be encountered that are surgically corrected at the same time.
Most patients who undergo abdominoplasty benefit from concurrent liposuction of the waist. This helps to improve the curves of the abdomen and adds very little to convalescence. Liposuction is performed through small punctures in the skin and leaves very small and nearly invisible scars.
In most cases, all of the skin from the umbilicus to the pubis is removed including the subcutaneous fat. If stretch marks are confined to that skin they will be completely removed. Skin removal, however, is at the expense of a scar along the lower abdomen. Usually, these are very acceptable in time but it may be many months before the scars arrive at the final resting point. In my practice, I show patients examples of how the scar looks at different time intervals after surgery. The patient keeps their own umbilicus but it does exit through a new hole in the redraped abdominal skin.
Patients will be significantly sore after the operation primarily because of the abdominal wall tightening. However, in the past decade, the introduction of long-acting anesthetics directly injected into the abdominal wall at the time of surgery has made recovery considerably easier. Patients are expected to be up and about the day after surgery. This may be a bit unpleasant, but it is necessary for a safe recovery.
Resumption of activity after abdominoplasty is staged. After the sutures are out, about a week, aerobic excise is allowed provided the abdomen is protected. Exercise on a recumbent bicycle is an example of a permitted activity. At 6 weeks, patients can resume exercise where the abdominal muscles are involved but should start easy and gradually increase to full and unlimited activity at 3 months.
Abdominoplasty is part of what some refer to as a mommy makeover surgery. This basically means abdominoplasty, plus one or more additional procedures, are used to address the aesthetic consequences of pregnancy. The most common operation added to the abdominoplasty is breast augmentation.
