Abdominoplasty

Check out Dr. Michele Sasmor's new video on Abdominoplasty

Procedure Description:
Surgery of the Abdomen--Abdominoplasty

What To Expect:
If you're considering abdominoplasty…

Abdominoplasty, known more commonly as a "tummy tuck," is a major surgical procedure to remove excess skin and fat from the middle and lower abdomen and to tighten the muscles of the abdomen 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.

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 your surgeon about anything you don't understand.

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 should wait, as vertical muscles in the abdomen that are tightened during surgery can separate again during pregnancy. If you have scarring 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 your surgeon.

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.

Preprocedure:

Prior to surgery, your will need to obtain: Hibaclens or Phisoderm cleanser (no prescription required, ask your pharmacist). Multivitamin with iron. Vitamin C 500 mg. tablets.

TWO WEEKS PRIOR TO SURGERY: We recommend that you be on a well balanced diet with adequate protein. Take one multivitamin with iron and two 500 mg. vitamin C tablets every day. Do not take any aspirin, Ibuprofen, Advil, Aleve or similar type drugs Do not take vitamin E, gingko biloba, ginger, echinacea, ginsing, black cohash or any other herbal substances. If necessary, use Tylenol for pain. No red wine for at least one week prior to surgery. If you are going home directly after your operation, please make sure you have arranged transportation and that there is someone who will stay with you (family or friend) the night after your operation. Walking up stairs will be uncomfortable after your operation. If you have lots of steps into or within your home, consider staying with family or friends until you are comfortable enough to negotiate your steps.

NO SMOKING FOR AT LEAST TWO WEEKS BEFORE YOUR SURGERY THE EVENING BEFORE SURGERY: Shower with the Hibiclens or Phisoderm cleanser. These do not suds very well; they work best with a sponge or wash cloth. Please soap and rinse twice. No alcoholic beverages the night before surgery. Do not eat or drink anything after midnight. Please confirm that you have a ride home and a person to stay with you after your operation. You will not be allowed to drive after surgery.

THE MORNING OF YOUR SURGERY: Shower again with the Phisoderm or Hibaclens cleanser. Again soaping twice, and rinsing well. Do not apply any moisture cream or topical lotions. Do not wear any make-up, especially lipstick. Please remove all jewelry including wedding rings and earrings, and leave them at home. Wear loose comfortable clothing, preferably something that buttons in the front.

Postprocedure:

IF YOU HAVE EXCESSIVE PAIN, BLEEDING, OR NOTICE REDNESS AROUND YOUR SURGICAL SITE, PLEASE CALL Dr. Sasmor/Dr. Kutka'S OFFICE IMMEDIATELY.

If you are going home, a family member or friend must drive you because you have been sedated, or have had general anesthetic. Someone should stay with you overnight as you may need assistance due to sedation and/or discomfort.

MEDICATIONS REGULAR MEDICATIONS: At home, you should be taking all medications that you were taking before your operation.

PAIN MEDICATIONS: Post surgical pain is expected after any major surgery procedure. Use your pain medication, as you need it. You will find as you go further out from your surgery, your need for medications will slowly decrease. When pain has become minimal, you may want to change to using Tylenol or Advil instead of your narcotic pain medication. Please contact Dr. Sasmor/Dr. Kutka's office if you are having any nausea or vomiting, bad dreams, sweats, itching or rashes related to taking your pain medication.

CONSTIPATION: Reduced activity, decreased dietary intake, and pain medications can all lead to constipation. Please take an over-the-counter stool softener beginning on the day that you return home. Dr. Sasmor/Dr. Kutka suggests two to three tablespoons of Milk of Magnesia at bedtime if you have not had a bowel movement by the second day you are home after your surgery.

VITAMINS: Take one multivitamin with iron and two vitamin C 500mg tablets a day for the first month after your surgery.

ANTIBIOTICS: Please take antibiotics on a regular basis if prescribed by Dr. Sasmor/Dr. Kutka. If you have any nausea, vomiting, itching or rash related to taking your antibiotics, please call the office at once. SMOKING: No smoking for at least two weeks afdter your surgery. Smoking reduces blood flow in your skin. Necrosis (dead tissue) and poor healing can result from smoking.

DRESSINGS: You may change the gauze pads under your surgical garment to keep them clean and dry. Some oozing of bloody drainage and subsequently pinkish yellow serous drainage is expected after all surgery.

DRAINS: The drains are important and are in place to prevent collections of serrous fluid under the tissue in the areas of your surgery. The tubing should be “stripped” and the bulb emptied at least 4 times during the day, especially before going to bed at night. Output from each drain should be recorded separately. We know that the drains are uncomfortable, they will be removed as soon as possible. If you have any problems with the drains please call the office.

YOUR SURGICAL GARMENT: You will go home in a surgical garment.. These act as a sort of dressing to hold the tissues in the proper position. Try to keep your garment in a natural position. If your garment feels too tight or hurts, please contact Dr. Sasmor/Dr. Kutka's office immediately. A garment that is too tight can cause ulceration or blisters of the skin. You will wear a surgical garment for one to three weeks after your surgery. Dr. Sasmor/Dr. Kutka will give you specific instructions for removing your garment to shower and to wash the garment.

SHOWERING AND BATHING: You may shower as directed by Dr. Sasmor/Dr. Kutka. Allow the water and soap to run over the Steri-Strips, rinse, and pat the Steri-Strips dry. Leave the steri stips in place.

SLEEPING POSITION: During the first two weeks post surgery, please attempt to sleep on your back instead of on your sides or stomach. This allows the tissue to stay in the perfect position during the initial healing processes. This is not a “life and death issue”. If you cannot sleep on your back, sleep in another comfortable position.

ACTIVITY: Take it easy and pamper yourself. Avoid heavy activity, straining, bending or lifting. You may walk around in your house and outside.

NO MATTER HOW GOOD YOU FEEL, DO NOT CLEAN THE HOUSE, REARRANGE THE FURNITURE, etc!! Excessive activity may cause bleeding, increased swelling and bruising.

VIGOROUS EXERCISE/AEROBIC EXERCISE: Dr. Sasmor/Dr. Kutka will instruct you when you can return to vigerous aerobic activity. Return to vigerous activity is usually in 3-6 weeks, depending on the type of surgical procedure.

SEXUAL ACTIVITY: If you are comfortable, you may resume sexual activity at three weeks after surgery. Breasts should be treated gently until they are completely pain free.

NUMBNESS: Small sensory nerves to the skin surface are injured during breast and reconstructive surgery. This will result in numb areas on the skin. The sensation in these areas will gradually return, usually within three to six months after surgery. Sensation returns as the nerve endings heal spontaneously. Occasional shooting pains or tingling may be noted as the nerves are healing.

ITCHING: Itching and occasional pulling or shooting pains may occur in your scar tissue as the incisions heal. This is due to maturation of the scar tissue itself, and to healing of the small sensory nerves. Ice, skin moisturizers, and massage are frequently helpful. The symptoms are common during the first several months of recovery, and will resolve spontaneously over three to six months.

REDNESS OF SCARS: All new scar tissue is red, pink, or even purplish in color. With massage and proper attention, scars tissue will slowly soften and fade. Scars on the breasts or body may take up to one year or longer to completely fade.

DRIVING: Dr. Sasmor/Dr. Kutka will advise you when you may return to driving. Before driving, sit in the car with seat belt and shoulder harness on. Turn fully to the right and left to make sure you can see out the back window without pain. If you have pain—wait 2-3 more days then try again. You should not drive at all if you are taking pain medicine.

QUESTIONS AND CONCERNS: If you have other questions, please call the office at any time. You can also write down your questions and bring them with you to your follow-up visits.

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