Abdominoplasty is often performed with general anesthesia. It can also be done using a local anesthetic with a sedative. There may be some discomfort with local anesthesia. The tummy tuck surgery takes about two to five hours.
A tummy tuck usually begins with a relatively long incision across the abdomen, from hip bone to hip bone. The shape of the incision is like a smile, with a flat bottom. The flat part of the smile occurs at the bottom point of the abdomen immediately above the pubic area. The sides of the smile form a gentle curve along the pelvis up to the top of the hip bone. A second incision is made around the belly button to free it from the abdominal tissue.
The skin is separated from the abdominal wall, up to the ribs, exposing the vertical abdominal muscles (rectus muscles). These muscles have usually been stretched apart by previous pregnancies. The rectus muscles are then stitched into a new position, tightening the muscles and reducing the waistline. After the muscles have been repositioned and tightened, the excess skin is stretched and removed.
The remaining skin is redraped over the abdominal area and sutured in place. The belly button is then brought out through the overlying skin in its new location.
What is a “Mommy Makeover”?
This term refers to a group of cosmetic procedures that address the body changes that can occur as a result of pregnancy and breast feeding. When the abdomen and breasts get stretched out, the skin can show changes that are impossible to correct with diet and exercise alone. In addition to skin changes, the body stores extra fat in the breast and abdominal area. This is very common and happens to most women. The confusion comes when women decide how to address these changes. Every case is different and depends on the severity and the cosmetic goals of the patient. General Anesthesia is not required for even the most aggressive treatments. The risks of general anesthesia are well know and should be avoided in elective surgery.
The choices for treatment, in order of complexity and down time, are as follows:
- Tummy Tuck (abdominoplasty) –This is necessary if there are severe skin changes and skin laxity. It is important to note that upper abdominal liposuction has to be minimal to allow good healing of the lower abdominal incision.
- Laser Liposuction — This is the best option for mild to moderate skin laxity. This is a popular option because downtime is only a few days and there is no need for a large inscision. Also, you can be more aggressive with liposuction of the flanks and upper abdomen.
- Traditional Liposuction–This is a good if there are no skin issues but areas of unwanted fat needs to be removed from the abdomen and flanks.
- Breast Augmentation and Full Breast Lift (Keyhole incision)
- Breast Augmentation and Partial Breast Lift (Nipple Lift incision)
- Breast Reduction with liposuction and Full Breast Lift
- Breast Reduction with liposuction and Partial Breast Lift
- Breast Augmentation with Fat Transfer with Partial Breast Lift
- Breast Augmentation with Implants
- Breast Augmentation with Fat Transfer
For some women the so-called “keyhole” incision is a necessary and worthwhile trade off to have the breasts lifted.
What if I have more children and desire to breast feed?
The lesser invasive procedures like liposuction and breast augmentation with fat transfer or implants can be a great option for the undecided mom. The breast lift and tummy tuck are better suited if the patient is certain she does not want more children. Breast augmentation does not affect your ability to breast feed, whereas breast lifting procedures can limit breast feeding.
What is the down time?
This varies based on the patient and the procedure perfomed and should be discussed at consultation.
How long will the results last?
All the treatments are permanent however gravity and skin changes are progressive. After surgery, good diet and exercise will help maintain the body’s shape.
As described above there are many choices for a Mommy Makeover, Dr. Ewing will gladly meet with you to discuss the best treatment option for you.