Cosmetic procedures to restore a youthful figure
The tummy tuck is a really powerful cosmetic procedure because it does multiple things; It removes fat and skin from the lower abdomen that's really just not responsive to diet and exercise.
Two common tummy tuck patient types
A delightful patient population I love are patients who have lost a lot of weight. It's very frustrating for them because you've put in so much work to achieve weight loss, but the excess skin just does not go away and a tummy tuck can be a really powerful tool to get that lower abdomen contoured.
Another group of patients who get an abdominoplasty in Columbus Ohio are postpartum women. During pregnancy, women have skin expansion from carrying a baby, for example, and it often just does not go away, no matter how much you exercise.
Basic Criteria for Patients ready for a Tummy Tuck
Before working with a patient, I first have them come in for an exam to assess the patient:
Is the patient in general good health? - We need to make sure they are healthy enough as this is an intensive surgery.
Do we have excess skin in the lower abdomen that needs removal? - This is something easily identifiable.
Does this patient have any hernias? - Hernias can be very dangerous and is something we often encounter. If a patient has one, do we actually need to do this procedure in combination with a general surgeon who can do a hernia repair at the same time?
Performing a Tummy Tuck
How our abdominoplasty is performed is we mark the patient in a standing position. If they have one, I will use an existing C-section scar but usually, we look at the natural crease where the skin might be folding over the mom’s pubis in the lower section of the abdomen. The abdominoplasty incision is a little on the long side and usually does go up to the hip area.
Once we start the surgery, we very, very carefully lift the skin and the fat from the abdominal wall which is a muscle layer. We often make an incision around the navel, the umbilicus or the belly button, so the belly button falls down in remains attached to an abdominal wall while we still continue to lift the skin all the way to the bottom of the chest. In most patients, it’s a pretty big dissection.
Repairing a Diastasis - the widening of your abs
Once that abdomen flap is lifted, I look at the abdominal wall and see if there's something called a diastasis. A lot of times in postpartum women or patients who've lost a lot of weight, the pressure of the intra-abdominal contents pushing out on the six-pack muscles, or the rectus abdominus muscles, makes these six-pack muscles split apart. They're not in the middle as they should be when they're actually outside.
There's a band of tissue that keeps the abdominal contents in but they are widened. If there's a bulge of the intra-abdominal tissue that shows up, no amount of crunches or any kind of physical therapy can reduce that. If there is a diastasis, what I do is I actually very carefully take some sutures that can hold the muscles together, where we actually reposition the six-pack muscles that are on the side and push them towards the middle of the abdomen. This dramatically changes the contour of the abdomen.
Finishing up the tummy tuck
Once that is done, the patient is actually repositioned on the operating room table, so the back of the operating table goes up, and the knees go up. So now the patient looks like they're sitting in a recliner. While they're still under anesthesia. That takes a lot of the tension off the lower abdomen.
Once position here, I can actually remove more skin than if some patient is patient is laying down completely flat. We remove a wedge of excess skin and fatty tissue from the lower of the abdomen and suture the patient closed, often leaving a couple of drains in as well, which will remove any fluid while the patient's healing.
Finally, we have to remake a new belly button or call it an umbilicoplasty. A new opening is made on the newly positioned abdominal wall and that is sutured to the umbilicus to recreate an “innie” belly button.
The tummy tuck procedure does take several hours, between two and a half to three and a half hours, or longer if it's performed in combination with other procedures. But this is a really powerful surgery that can make patients happy.
Good candidates for a tummy tuck
The best candidates are those who have a lot of excess skin that may look deflated, rather than thick, fatty tissue. This typically means you've already reached a weight loss goal, you're at your goal weight, and your BMI is under 30, but you still have excess skin hanging from the bottom. We make sure you’re not planning to lose any more weight and for women, you're not planning on future pregnancy.
This is a little stricter side of BMI numbers but I always have the patient’s overall health in mind first, in addition to patient safety because after all, this is an intensive surgery.
Tummy Tuck + ? = Mommy Makeover
It's important for patients to know that mommy makeover is a little bit of a marketing term rather than a surgical term and it is not a one-size-fits-all procedure. A mommy makeover implies a combination of surgeries in postpartum women that works on their torso.
When I talk with patients about a mommy makeover, it usually involves combining a tummy tuck with something else. A lot of times the changes that happen for a mom with pregnancy, breastfeeding, weight gain, weight loss, or just simply age, it's usually breast tissue and the torso or trunk.
Mommy Makeover surgery combinations
I've had patients who requested that they would like to have one of the many combinations of mommy makeover surgeries:
breast lift and a tummy tuck
breast augmentation and a mini tummy tuck
an abdominoplasty paired with a little liposuction
All of those can be considered a mommy makeover.
There are limitations to these combinations of surgeries and I always think about patient safety, that's really paramount. The main limit is operative time; I don't want to put a patient under for more than four or five hours.
If a patient comes in and says, “Hey, I would like a breast lift, a thigh lift, and an abdominoplasty” at the same time, that's really just not feasible to do in a safe amount of operatory time under anesthesia. In a situation like that, I usually counsel patients and ask “what's the most important part for you?” That way we can identify the patient’s goals and what’s most important to them and we can see what procedure makes sense to perform in conjunction during that safe operative time window.
Conclusion
If you have any questions about a procedure or are interested in getting a tummy tuck or mommy makeover in Columbus Ohio, please reach out to us and we’ll be more than happy to schedule you for a consultation. We can do virtual appointments as well but we’d prefer to see you in the office.