Tummy Tuck (Abdominoplasty)

Some women and men start thinking about a tummy tuck (abdominoplasty) when they develop loose tissue around the midline. This extra tissue can make it difficult to find clothing and may even hang over the waistband. There are many factors that can contribute to this condition including: weight loss, weight gain, pregnancy, and (quite simply) changes over time.

A tummy tuck can also be considered in certain situations to remove large areas of stretch marks or surgical scars.

During an abdominal evaluation, Dr. John M. Sarbak assesses the amount and quality of the patient’s skin (is there too much? How elastic is it? Does it have stretch marks? Are there scars?) He will evaluate the thickness and distribution of the fatty layer (how much is the fatty layer contributing to the overall condition? Is there too much in one area?). Dr. Sarbak will also look at the location and tone of the abdominal wall muscles (have the muscles been stretched or weakened? Have they separated with pregnancy or weight gain?)

One final factor that Dr. Sarbak looks at is the amount of tissue inside the abdomen. This is the tissue that is beneath the muscles around the intestines. Many people are surprised to hear that individuals can have fatty buildup around the intestines (in some people this can be quite significant). Unfortunately this tissue cannot be addressed surgically. Having said that, it can still significantly influence the shape of the abdomen even after a tummy tuck (it pushes against the muscle tightening portion of the procedure from the inside out). The reduction of this area is up to each patient and a weight loss program.

This overall analysis helps Dr. Sarbak formulate a treatment plan that may involve skin excision, liposuction, or abdominal muscle tightening or any combination thereof. Sometimes his recommendation may involve weight loss before the procedure can be scheduled.

Recent improvements in the tummy tuck technique allow Dr. Sarbak to avoid the use of drains in the vast majority of cases. This seems to improve patient comfort postoperatively.

Dr. Sarbak’s approach also allows additional tightening of the upper abdomen. The upper abdominal area was not particularly well addressed by the traditional abdominoplasty operation. For that reason, he finds that many of our patients have had tummy tuck surgery in the past but are having another one with us because their upper abdomen is still too loose.

Every once in a while we may find an unexpected hernia that can be addressed during the surgery.

When muscle tightening is required – and the vast majority of patients require this – the muscles will let the patient know that they have been tightened. They tend to be sore for seven to ten days. Patients may still feel some intermittent (every once in a while) discomfort for up to six weeks. Most of our patients can return to work within two to three weeks and resume rigorous activities by six weeks.

Breast lift techniques can also address asymmetries with a patient’s nipple sizes and/or positions. They can provide significant benefit both for woman with developmental differences and surgically created differences such as after breast cancer surgery.

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