TUMMY TUCK

SEATTLE

You've done the work. Loose skin and a stomach that won't flatten aren't a personal failing — they're anatomy, and surgery is often the only thing that actually changes it.

WHAT IS A TUMMY TUCK?

A Tummy Tuck, or an Abdominoplasty, is a cosmetic procedure performed by a Plastic Surgeon to remove loose, stretched out abdominal skin, reshape and tighten the waist, and remove stubborn abdominal fat. As we age, with pregnancy, or with weight loss and weight gain, the skin of the abdominal wall stretches out but rarely re-tightens. In addition, we tend to gain that extra, stubborn “fluff” around the abdomen over time. While diet and exercise are important for a healthy routine, they often do little to tighten the skin, decrease stretch marks or shrink the waist. An Abdominoplasty is a 3-Dimensional procedure aimed at restoring the aesthetics of all the layers of the abdomen. The innermost “core” can be reconstructed by moving the Rectus Muscles (vertical ab muscles) back to their midline position. This is called a Diastasis Repair. The intervening fat layer can be liposuctioned, and the outermost skin is removed and tightened.

A CLOSER LOOK

A careful evaluation of the trunk as a whole must be done in order to assess which areas will need to be addressed during surgery. During your seattle plastic surgery consultation, Dr. Megan will examine the amount and location of loose skin, the location and extent of fat deposits and the position of the rectus muscles and presence of a rectus diastasis. There are multiple variations of a Tummy Tuck that can be tailored to meet each individual patient’s anatomy and goals.

COMBINING LIPOSUCTION WITH A TUMMY TUCK:

Liposuction is a common cosmetic procedure performed simultaneously with a tummy tuck. Common areas of liposuction include the waist, mons region (above the pubic bone), and posterior flanks (aka "muffin top"). There is also a variation of tummy tuck referred to as a Lipoabdominoplasty. This technique combines a the skin excision of a Traditional Tummy Tuck with Liposuction to not only remove extra skin but also thin out the fat layer on the front of the abdomen. All loose skin below the belly button is removed and the incision is placed just above the pubic bone, where it can be hidden by a bikini or underwear. The belly button remains attached to the underlying muscle layer but a new hole must be made for it once the skin has been redraped. This procedure is best performed in patients who have a significant fat layer throughout the abdomen, including the skin just above the belly button.

THE PROCEDURE:

An Abdominoplasty is safely performed as an outpatient procedure in our AAAASF Ambulatory Surgery Center, located on the 16th floor of the Nordstrom Medical Tower in downtown Seattle. The procedure requires a general anesthesia to perform, and can be completed in under 3 hours. It is often combined with other procedures such as Liposuction or Breast Surgery as is often the case in a Mommy Makeover.

The patient will be marked for a tummy tuck the morning of surgery for the areas of fat to be removed and the excess skin to be excised. Once asleep in the operating room, any Liposuction indicated is performed first. An incision is then made around the belly button and horizontally above the pubic bone. The length of the lower incision is dependent on how much skin will need to be removed. The more skin, the longer the incision. The abdominal skin is then elevated so it can be optimally redraped. The incision is then closed with multiple layers of absorbable stitches for strength. Surgery drains are commonly and will be removed when the drain output reaches a threshold of less than 30ml/day. The final part of the procedure is the inset of the belly button. The patient is then placed in a compression garment and will eventually be discharged home to recover.

TYPES OF TUMMY TUCKS

STANDARD TUMMY TUCK

A “Traditional” Tummy Tuck is best suited for patients whose main issue is the loose, stretched out skin of the upper and lower abdomen. All loose skin below the belly button is removed, and the skin above the belly button is pulled down to an incision placed just above the pubic bone, where it can be hidden by a bikini or underwear. The belly button remains attached to the underlying muscle layer but a new hole must be made for it once the skin has been redraped.

Liposuction of the waist can be performed simultaneously, as can a rectus diastasis repair.

MINI TUMMY TUCK

This procedure uses a shorter scar just above the pubic bone to remove loose skin of the LOWER abdomen only. It does not tighten skin above the level of the belly button and is best suited for patients who have isolated skin laxity and stretch marks below the belly button.

Liposuction can be added for additional sculpting and the Rectus muscles below the belly button can be tightened in a partial rectus diastasis repair.

FLEUR DE LIS TUMMY TUCK

A fleur de lis tummy tuck involves removing abdominal skin both horizontally and vertically, leaving a traditional tummy tuck scar low on the abdomen and also a vertical midline scar. This type of tummy tuck is generally used for patients with significant loose abdominal tissue, such as after massive weight loss.

A rectus diastasis repair can be performed simultaneously and liposuction can be combined with this tummy tuck, although more judiciously.

AM I A GOOD CANDIDATE?

The ideal candidate for a Tummy Tuck is in good overall health and at a stable, healthy weight. If you're still in the middle of a weight loss journey, this procedure is best placed at the end of it, once your weight has leveled off. We also recommend women wait until they're done having children, since a future pregnancy can undo much of what surgery accomplishes.

Beyond the basics, your candidacy — and which type of Tummy Tuck fits you — comes down to a few specifics I evaluate in person during your consultation:

Where your loose skin is located. Skin laxity above versus below the belly button is what determines whether a Standard, Mini, or Fleur de Lis Tummy Tuck is the right fit for your anatomy. Any previous abdominal scars, including C-sections. C-section scars are common in my practice and can typically be removed and incorporated into your new incision during the same surgery.
Whether you have a hernia. Some hernias can be repaired at the same time as your Tummy Tuck; others need to be addressed beforehand. I check for this specifically during your exam.
Where your stretch marks are located. Stretch marks on the skin being removed go with it — stretch marks above the belly button or on the hips typically remain. I'll set realistic expectations with you about which is which before we ever schedule surgery.

Patients with a history of blood clots, or multiple risk factors for them, may need to take a blood thinner after surgery. We'll review your history carefully beforehand.

Dr. Megan far exceeded my expectations. She is extremely caring, talented, educated, and attentive. I am so thankful for her, she truly changed my life in the best way possible! I feel great knowing I 100% chose the right surgeon for my procedure.

SCHEDULE NOW

TUMMY TUCK RECOVERY

How long is recovery, really? It's one of the first questions almost every patient asks me, and it should be — recovery isn't something you fit around your life, it's something you plan for. The patients who heal best are the ones who plan ahead: meals prepped in the freezer, an extra set of hands lined up for the kids, a work calendar cleared further out than they think they need. Skipping that step is one of the most common reasons recovery drags on longer than it should, or results end up compromised.

Right after surgery, getting up and moving matters more than it sounds like it should — regular movement is what keeps blood clots from forming in your legs, and it's not optional. You'll go home in an abdominal binder or compression garment for extra support, and plan on needing help getting in and out of a chair or bed for the first couple of days. That's normal, not a sign something's wrong. I typically place one surgical drain, which stays in for about a week.

I see every Tummy Tuck patient back at one week. We change your dressings, remove the drain, and you'll stay in your abdominal binder. At three weeks, we start lifting activity restrictions and begin scar care — you should still expect some swelling at this point, and that's expected, not a setback. Around four weeks, you can start lifting more and adding in light activity and light exercise. Between four and eight weeks, you're rebuilding strength and stamina, gradually. By eight weeks, most patients are back to something close to normal activity.

Most patients take two weeks off work, though that depends on how physical your job is. I'll be honest with you: recovery is in a race, and cutting it short doesn't save you time. It costs you. Rushing back into activity too soon is one of the most common ways patients end up with complications, a longer recovery than they started with, or results that don't hold up the way they should.

SEATTLE TUMMY TUCK

FAQ

Will I Still Have My C-Section Scar After My Tummy Tuck?

Often, a C-Section scar is removed with a tummy tuck. Scars that are not limited to the pubic region may remain after your seattle tummy tuck.

Should I Combine My Breast Surgery With My Tummy Tuck?

Many patients find it convenient to combine a breast and abdominal surgery. The benefit is a single anesthesia cost and a single recovery. Surgical recover, however, will be slightly more difficult. Dr. Megan will help guide her patients during consultation to figure out the best approach.

What If I Gain Weight After My Tummy Tuck?

Gaining weight after your tummy tuck may affect your results.

Can I Still Have A Tummy Tuck If I'm Not At My Goal Weight?

There are many reasons a patient might seek a tummy tuck before reaching an ideal body weight. Dr. Megan will help guide patients through this process during consultation. Ultimately, the goal is to avoid revisions though, in some instances, the benefits of immediate tummy tuck outweigh the drawbacks of waiting.