Body Contouring is the family of procedures which can dramatically alter the shape and contours of the trunk, abdominal, flank, thigh and hip areas. These procedures include liposuction (“lipo”), ultrasound-assisted liposuction, and abdominoplasty (“tummy tuck”).
Liposuction is the surgical procedure that uses small incisions to remove smaller deposits of fat. The areas that typically respond well to liposuction are the abdominal wall, flanks (“love handles”), hips (“saddle bags”) and thighs. No skin is removed and the underlying muscles are not tightened.
Ultrasound-assisted liposuction is similar to liposuction, but it uses an ultrasound device to break up the fatty deposits prior to removal. Ultrasound-assisted liposuction has several beneficial effects. These include greater tightening of the skin, more precise fat removal, and less bruising and swelling. Dr. Zemmel will advise you whether ultrasound-assisted liposuction is right for you.
Abdominoplasty is the surgical procedure to remove excess skin and fat from the middle and lower abdomen and to tighten the muscles of the abdominal wall. The procedure can dramatically reduce the appearance of a protruding abdomen. Depending on how much excess skin and fatty tissue need removal, and how much the muscles need tightening, a smaller or larger incision can be used.
The small incision procedure is common known as the mini-abdominoplasty and extends just above the pubic area much like a Caesarian Section (C-section) Scar. The full-abdominoplasty procedure uses an incision that extends along the entire length of the lower abdomen. Both procedures will leave permanent scars, but usually heal well.
Dr. Zemmel will make every attempt at placing the incision in an area under the bikini line so it is well hidden even while wearing revealing clothing.
If you’re considering abdominoplasty, this page will give you a basic understanding of the procedure: when it can help, how it’s performed, and what results you can expect.
Dr. Zemmel will answer all of your questions during your initial consultation.
The Best Candidates For Abdominoplasty
Optimal 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 and exercise. Abdominoplasty is particularly helpful to:
- Women who have had multiple pregnancies and have stretched their abdominal muscles and skin beyond the point where they can return to normal even with diet and exercise.
- Men and woman who have undergone massive weight loss which has resulted in excess skin around the trunk, abdomen, thighs, and arms.
Patients who intend to lose a significant amount of weight should postpone the surgery until after their weight has stabilized. Women who plan future pregnancies should also wait to enjoy the full benefits of the procedure.
Abdominoplasty can enhance your appearance and your self-confidence. Before you decide to have surgery, think carefully about your expectations and discuss them with Dr. Zemmel.
Planning Your Surgery
During your initial consultation, Dr. Zemmel will evaluate your health and fully examine the body region you are concerned with. Dr. Zemmel will assess:
- Your height and weight
- The proportion of your trunk to your abdomen to your waist
- The shape of your arms and legs
- The abdominal wall muscle tone
- The quality of your skin
- The size and shape of your umbilicus (belly-button)
Dr. Zemmel will then give you a recommendation whether a full abdominoplasty, a mini abdominoplasty, or liposuction will give you the best results.
For example, if your fat deposits are limited to the area below the navel, you may require mini-abdominoplasty. If your excess skin and loose muscles extend the entire length of the abdominal wall you may benefit from a full abdominoplasty. In other cases isolated fat deposits of the flanks and hips may be present. These may be treated with liposuction alone or in combination with an abdominoplasty.
During the consultation, Dr. Zemmel will explain the anesthesia that he will use, the type of facility where the surgery will be performed, and the costs involved.
Be sure to tell Dr. Zemmel if you smoke, and if you’re taking any medications, vitamins, or other drugs.
Be frank in discussing your expectations with Dr. Zemmel and he will be equally frank with you, describing your alternatives and the risks and limitations of the surgery
In most cases, health insurance policies do not cover the cost of abdominoplasty, but you should check your policy to be sure. Some health insurances policies will cover the cost if the excess skin results from massive weight loss following gastric bypass surgery. Dr. Zemmel can assist you in obtaining the pre-approval.
Preparing For Your Surgery
Dr. Zemmel will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins, and medications.
All patients must stop smoking at least 4 weeks before and after abdominoplasty surgery. Numerous medical studies have shown that smoking causes significant delays in healing which raise the risks of scaring, infection, blood clots, and respiratory problems.
Safety is Dr. Zemmel’s number one concern, and he strives to provide the safest environment for all patients. He will give you a complete list of instructions for before and after surgery at the time of your initial consultation.
Avoid overexposure to the sun before surgery, especially to your abdomen, and do not go on a stringent diet, as both can inhibit your ability to heal.
Whether your surgery is done on an outpatient or inpatient basis, you should arrange for someone to drive you home after your surgery, and to help you out for a day or two after surgery.
Types Of Anesthesia
Depending on the length of the surgery and the preferences of the patient, Dr. Zemmel may select general anesthesia or deep sedation. Both types of anesthesia will allow you to sleep through the entire operation. You will unaware of the procedure and completely pain free.
A full abdominoplasty usually takes two to three hours, depending on the extent of work required. A mini-abdominoplasty may take one to two hours, and liposuction can take one to three hours.
For a full abdominoplasty Dr. Zemmel will make a long incision from hip to hip, just above the pubic area. A second incision is made to free the navel from surrounding tissue. With partial abdominoplasty, the incision is much shorter and the navel may not be moved.
Next, the skin is lifted from the abdominal wall all the way up to your ribs. This reveals the vertical muscles of your abdominal wall. These muscles are then tightened by pulling them close together and stitching them into a new position. This provides a firmer abdominal wall and narrows the waistline.
The skin flap is then stretched down and the extra skin is removed. A new hole is cut for your navel, which is then stitched in place. Dr. Zemmel spends time tailoring the navel to provide a sexy natural appearing navel in female patients. The new navel can even be pierced if the patient desires. Finally, the incisions will be stitched with absorbable sutures and the dressings will be applied. A small tube is inserted under the skin to drain excess fluid from the surgical site. Dr. Zemmel removes them 5 to 7 days after surgery.
In a mini-abdominoplasty, the skin is separated only between the incision line and the navel. The muscles below the navel are tightened. The skin flap is stretched down, the excess is removed, and the flap is stitched back into place.
Thousands of body contouring procedures 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 healing time. You can minimize the risk of blood clots by moving around as soon after the surgery as possible. Dr. Zemmel will take specific precautions before, during, and after surgery to prevent blood clots.
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 Dr. Zemmel’s instructions before and after the surgery, especially with regard to when and how you should resume physical activity.
For the first few days, your abdomen will probably be swollen and you’re likely to feel some pain and discomfort, which can be controlled by medication. Patients typically go home the same day of surgery. Dr. Zemmel prescribes all patients will excellent pain medicine and muscle relaxants after surgery.
Dr. Zemmel will give you full instructions for showering and changing your dressings. And though you may not be able to stand straight at first, you should start walking as soon as possible.
Most sutures used are absorbable, and only a few will be removed seven days after surgery. The drainage tube will also be removed at this time. Patients will then wear a light compression garment after surgery for 2 to 4 weeks time.
Getting Back To Normal
It may several weeks to feel normal after surgery. If you go into surgery in top physical condition with strong abdominal muscles, recovery from abdominoplasty will be much faster. Some people return to work after one week, while others take two or three weeks to rest and recuperate.
Exercise will help you heal better. Even people who have never exercised before should begin an exercise program to reduce swelling, lower the chance of blood clots, and tone muscles. Vigorous exercise, however, should be avoided until you can do it comfortably. Dr. Zemmel will advise you on the time and intensity of exercise.
Your scars will initially be slightly raised and red and may widen initially. Over 6 to 12 months time the scar will soften and fade dramatically. At 18 to 24 months time many patients are only left with a fine soft white line. While scars never disappear completely, abdominal scars will not show under most clothing, even under bathing suits.
Your New Look
Abdominoplasty, whether mini- or full-, produces excellent results for patients with weakened abdominal muscles or excess skin. In most cases the results are long lasting if you follow a balanced diet and exercise regularly.
If you’re realistic in your expectations and prepared for the consequences of a permanent scar and a lengthy recovery period, abdominoplasty may be just the answer for you.