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What is it Like to Have a Tummy Tuck?
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What is it Like to Have a Tummy Tuck?

Episode 12: What is it Like to Have a Tummy Tuck?

What is it like to have a tummy tuck? Well, a tummy tuck, or abdominoplasty, is one of the most powerful transformative operations that we perform in our practice. The goal of a tummy tuck or abdominoplasty is to improve the contour or shape of the abdomen. And while this procedure is very popular for women of many different ages and life stages, and similarly for men, it is most popular, we've found by looking at our patient population, in women that have finished having children.

That makes sense because childbearing and pregnancy stretches out the abdominal wall in terms of the abdominal muscles and it can create a rectus diastasis, which is a separation between the two rectus abdominis muscles, which are the vertical paired muscles that form the six pack. It stretches out the abdominal skin, and it can lead to changes in distribution of fat in the abdomen and around the waist. So an abdominoplasty, often combined with some liposuction, addresses all of these things.

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Will I have scars after a tummy tuck?

Now, the abdominoplasty procedure is real surgery, by which I mean it is an invasive procedure and significant incisions are required and they leave a significant scar. Specifically, there is a scar that generally goes almost from hip to hip, and there's also a small scar that goes around the belly button. Now, those scars do fade over time, but there always will be some scar present. So when someone elects to have an abdominoplasty, they are essentially saying that it's worth it to them to have these scars in order to have a really awesome abdominal shape. That's a very reasonable decision to make, especially because that long, horizontal scar that goes across the waist, can almost always be hidden below the underwear line or below the bikini line.

What is it like to have the surgery?

So that being said, an abdominoplasty is generally done under general anesthesia. That means that you're completely asleep. The process really begins about 12 hours before surgery. At that point, you can no longer eat or drink anything and then, when you arrive for surgery on the day of your procedure, you'll meet with an anesthesiologist.

In our practice we only work with board-certified anesthesiologists, and they'll start an IV to give you some medication that will get you relaxed. Then we'll move you into the operating room and you will drift off to sleep. The procedure itself takes approximately two-and-a-half to three-and-a-half hours, depending on the size of the procedure and the complexity of the individual case.

What is recovery like after abdominoplasty?

When you wake up, you may feel a little sore, but you really won't have much pain at this point as we give you a lot of very powerful numbing medication in the operating room. And in fact, we can even give you a medication that will make you almost completely numb for 48 to 72 hours. That's an option that we discuss with our patients before they have their procedure.

So when you do wake up, you'll initially feel tight in your abdomen, but not really having that much discomfort. You'll notice that you have two drains. We place them coming out of the horizontal, low incision, and you'll really wake up and become less drowsy over the next couple hours. At that point, you'll be evaluated by our medical staff.

And again, this scenario that we're describing here really only applies to how we do things in our practice and this will vary significantly from practice to practice, but in the case of how we perform our abdominoplasties or tummy tucks, you'll be evaluated and closely monitored in our recovery room.

Usually by about two hours or so, you're cleared to leave. If you live in the Manhattan area, you are allowed to go right home. We do require you to spend the evening with one of our nurses, and he or she is there to keep you comfortable and to get you used to having had a major surgery, and essentially to be my eyes and ears. I'm in communication with him or her throughout the night to make sure that everything is going fine.

If you do not live in Manhattan, I do require my patients to spend at least one night in Manhattan after the procedure. If you live nearby, you can then go home the following morning. However, if you're coming in from out of town, I do like my patients to stay in the New York City area for seven to 10 days after the procedure. But these are recommendations and guidelines that we really determine on a case-by-case basis.

In any event, when you do go home or to the hotel that you're staying in, you will find that you are up and walking right away. We do not like people to just lie in bed. The reason for this is we find that it's important to do these things to prevent several kinds of complications, most importantly, a venous thromboembolism, which is a blood clot that can form in the legs and go to the lungs and be fairly dangerous. And it also helps your lungs recover, so you can get back to breathing normally as rapidly as possible. It has several other health benefits as well.

You will be up and walking around, but you will be walking bent at the waist for the first week or so, because things will be quite tight and we don't want to put unnecessary tension on the abdominal repair. So you will be up and walking around and, during that first week, you really won't be doing much other than gently walking and resting. It's someone else's turn to do tasks around the home, so you can kind of enjoy that aspect of things.

Getting back to normal after tummy tuck

It is really during the second week where you start to more or less return to your baseline a little bit more, you start to stand up and walk straight and feel a bit more comfortable. The soreness really probably peaks for most folks at around three days after the procedure. That's when their swelling is peaking and it's when their pain medication is wearing off. But the discomfort is fairly manageable, especially with the medications that we're using, and this is something we have a lot of experience with, so we're able to make it quite comfortable for people.

The first two weeks are basically your initial recovery. After usually the first week, the first drain can come out and it usually takes an additional week for the second drain to come out. Those drains are there to drain any fluid that your body produces after the procedure, and we don't want that fluid to collect in the abdomen after the surgery, because it can theoretically get infected or cause what's called a seroma, which is a fluid collection, which if left untreated can change the shape of the abdominal contour.

So after those first two weeks, in general, your drains are out, you're walking straight up, but you're still not up to any major physical activity. Most of our patients, though, that have desk jobs are fairly comfortable to go back to work at the two week mark.

It's really not until four to six weeks after the procedure that we start to clear people to get back to their full regular exercise schedule. And again, this is something that we determine on a case-by-case basis. Now, you will notice a dramatic change in your appearance really right after the surgery, but it takes a good six months to a year to see the final result. That's because we have to wait for two things to happen.

One, your swelling has to go down and, two, your body has to adjust to its new shape. So while we've removed skin, and we've suctioned fat, and we've sewn the muscles together to repair any rectus diastasis that was present, your connective tissue will then actually contract and conform to your body's new shape. That process takes several months.

So while you'll see a really nice result right away, it just keeps getting better for the first six months to a year. While an abdominoplasty or tummy tuck is a significant surgical procedure, it's one that we work with our patients to prepare them for and get them set up to really do excellently and have a very smooth recovery. We remain in very close contact with them during the recovery process to make sure any and all of their needs are met and they are kept healthy and safe.

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  • Darren M. Smith MD
  • Darren M. Smith MD
  • Darren M. Smith MD

All photos are of models except before and after images.

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