Abdominoplasty

What Is Abdominoplasty?

Abdominoplasty, also known as a tummy tuck, is a surgical procedure that entails removing excess skin around the abdomen and, in some cases, tightening the rectus abdominis muscles. This body contouring procedure is often beneficial for those who have sagging tissue as a result of major weight loss or pregnancy. Liposuction is often combined with abdominoplasty to further sculpt the midsection, removing isolated pockets of fat for a smoother contour.

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. Our board-certified plastic surgeon, Dr. Neil J. Zemmel, will answer all of your questions during your initial consultation.

• Mini vs. Full Abdominoplasty
• Abdominoplasty Candidates
• Abdominoplasty Consultation
• Preparing for Abdominoplasty
• Abdominoplasty Procedure
• Abdominoplasty Recovery
• Abdominoplasty Scars
• Abdominoplasty Results
• Abdominoplasty Cost
• Abdominoplasty Insurance Coverage

Mini vs. Full Abdominoplasty

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 commonly known as the mini (or partial) abdominoplasty and extends just above the pubic area much like a caesarian section (c-section) scar. If your fat deposits are limited to the area below the navel, you may require mini abdominoplasty. 

The full abdominoplasty procedure uses an incision that extends along the entire length of the lower abdomen. If your excess skin and loose muscles extend the entire length of the abdominal wall, you may benefit from a full abdominoplasty.

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.

Am I a Good Candidate for Abdominoplasty?

Optimal candidates for abdominoplasty are those at or near their goal weight, in generally good health, and want to improve loose abdominal skin and/or stretched abdominal muscles. The procedure is ideal for those who can relate to the following:

• Women who have had multiple pregnancies in the past that have led to their skin and abdominal muscles stretching beyond the point of returning to normal.
• Men and women who have undergone massive weight loss that has resulted in excess skin around the body, such as around the abdomen.

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 abdominoplasty.

What Does the Abdominoplasty Consultation Involve?

During your initial consultation, Dr. Zemmel will evaluate your health and fully examine the body region you are concerned with. He 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 (bellybutton)

Based on this information, Dr. Zemmel will then give you a recommendation whether full abdominoplasty or mini abdominoplasty can give you the best results. In cases where isolated fat deposits of the flanks and hips are present, liposuction may be recommended either alone or in combination with abdominoplasty.

During your consultation, Dr. Zemmel will explain the anesthesia he will use, the type of facility where the surgery will be performed, and the costs involved. Be sure to tell him 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 honest with you, describing your alternatives and the risks and limitations of abdominoplasty.

How Should I Prepare for Abdominoplasty?

Once your surgery has been scheduled, Dr. Zemmel will provide you with personalized instructions on how to best prepare for your abdominoplasty. This will include guidelines on your diet, when to stop smoking, and certain vitamins and medications you should take or avoid. Some general recommendations are: 

• Smoking: 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.
• Sun Exposure: Avoid excess sun exposure before and after surgery, especially to your abdominal area, as this can affect your ability to heal properly.
• Diet: Maintain a healthy healthy diet full of nutritious foods, but make sure to avoid any restrictive diets, as these can impede your healing.
• Arrange for Help After Surgery: You will need someone to drive you home after abdominoplasty, as well as assist you in the first couple days of your recovery.

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.

What Does the Abdominoplasty Procedure Entail?

The full abdominoplasty procedure takes about two to three hours, while a mini abdominoplasty may take one to two hours. Depending on the length of the surgery and your preference, Dr. Zemmel may select general anesthesia or deep sedation. Both types of anesthesia will allow you to sleep through the entire operation. You will be unaware throughout the procedure, not feeling any discomfort.

• Full Abdominoplasty: During full abdominoplasty, a long incision will be made above the pubic area from one hip to the other. Another incision is then made to reposition the navel. Stretched or torn abdominal muscles are then repaired, if necessary, by tightening and stitching them together. Excess skin is removed, while the remaining tissue is tightened. The navel is then repositioned to a new, more appropriate location on the abdomen. Dr. Zemmel spends time tailoring the navel to provide the most natural appearance. The new navel can even be pierced if the patient desires. 
• Mini Abdominoplasty: Mini abdominoplasty involves much shorter incisions compared to the full procedure. The muscles below the navel may be tightened. Excess skin is then removed and the surrounding tissue is pulled taut. 

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. Patients typically go home the same day of surgery.

What Can I Expect in My Recovery from Abdominoplasty?

For the first few days after abdominoplasty, your abdomen may be swollen, and you are likely to feel some pain and discomfort, which can be controlled by medication. Dr. Zemmel prescribes pain medicine and muscle relaxants after surgery to help you remain comfortable. He will give you full instructions for showering and changing your dressings. 

Though you may not be able to stand straight at first, you should start walking as soon as possible. Mild exercise will aid in the healing process, reducing swelling and lowering your risk of blood clots. You should avoid more strenuous exercise for several weeks, which Dr. Zemmel will advise you on. 

Most sutures used are absorbable, and only a few will be removed 7 days after surgery. The drainage tube will also be removed at this time. A light compression garment will then need to be worn for 2 to 4 weeks. 

Most patients feel ready to return to work after their first week of recovery, but some individuals may want to wait two to three weeks, depending on the demands of their job.

What Will My Abdominoplasty Scars Look Like?

The scars from your abdominoplasty may look red and be raised, widening at first. Over the course of the first 6 months to a year, you can expect these lines to gradually soften and fade in color. Since Dr. Zemmel ensures incisions are made in easy-to-conceal areas, your abdominal scars should not be visible with most clothing and bathing suits.

How Long Will My Abdominoplasty Results Last?

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 are prepared for the associated scarring and recovery period, abdominoplasty may be just the answer for you.

How Much Does Abdominoplasty Cost?

Abdominoplasty costs approximately $10,000 to $15,000 in Richmond for the surgeon’s fee and all other associated costs. Your total procedure cost will depend on the details of your surgical plan and will also include other fees, such as from your anesthesia and surgical facility. Our team will provide you with a personalized quote at the end of your consultation to help you budget for your procedure.

Is Abdominoplasty Covered by Insurance?

In most cases, health insurance policies do not cover the cost of abdominoplasty, but you should check your policy to be sure. Some health insurance 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.