Dr. vanVliet | Abdominoplasty

Abdominoplasty, also referred to as tummy tuck surgery, is conducted to remove excess skin and fat from the lower and middle abdominal region. The procedure may also involve tightening lax or spread abdominal muscles. The length of the procedure varies anywhere from 2-5 hours and this coincides with the extent of the work to be done. Each procedure is tailored to a patient's specific wishes and unique physiology and shape and will be thoroughly reviewed in consultation with Dr. vanVliet.

Abdominoplasty surgery is conducted under general anesthetic and requires an overnight stay in hospital. Most commonly a long incision extends from hip bone to hip bone just above the pubic area. The length of this horizontal scar correlates directly with the amount of excess skin that needs to be removed. Therefore, it may be short with more limited procedures and extended around to the back if necessary in more extensive body lift procedures. The length of the anticipated scars will be thoroughly reviewed prior to surgery. A second incision is often made around the navel and excess skin is removed from around it. The abdominal muscles are tightened as required to improve subsequent abdominal contour.

During and after surgery, patients will wear specialized pneumatic compression stockings on their calves to reduce the potential for blood clots. An abdominal binder will be worn to support the incisions and there will be drains utilized to reduce post-operative swelling.

Abdominoplasty surgery is helpful for women who are bothered by a protruding abdomen or loose skin that has not responded to proper diet and exercise. These waistline issues are often the result of pregnancy, massive weight loss or age. The abdominoplasty procedure is designed to create a flatter, tighter and improved belly contour.

Abdominoplasty surgery is a safe procedure for healthy, fit and weight appropriate patients if the procedure is conducted by a board certified qualified Plastic Surgeon. The procedure, howevere, carries elevated risk in the obese patient and the smoker. Dr. vanVliet will often defer surgical plans until these correctable risk factors are attended to. Smoking, in particular, can cause severe wound healing issues and potential tissue death in abdominoplasty surgery. Protracted and poor wound healing often results in poor quality scars and esthetic outcomes.

Following surgery, the patient will have an overnight stay in hospital. Nursing staff will encourage early ambulation and patient mobility during their hospital stay. These manouvers, in combination with specialized compression stockings to be worn, serve to reduce the potential for bloodclots. An abdominal binder will be worn to support the incisions and dressings and there will be two drains to reduce swelling. The patients will have a personalized pain pump to help manage discomfort in the early post-operative period. Dr. vanVliet personally assesses all her patients prior to their discharge home the morning after surgery. Patients will then be discharged with a prescription for pain medications and antibiotics, as well as simple instructions regarding drain care. The patient will be seen in the office within a week of surgery and at that time the dressings and drains are removed. After that, the patient is instructed regarding washing and no further dressings are usually required. The abdominal binder will be worn 24/7 for the first month and it can be worn underneath clothing.

Early on, patients experience tightness, swelling and discomfort of their abdomen. At first, it may feel difficult to walk upright but this in fact is encouraged as soon as is comfortable. The first week is a time for convalescing, although gently walking is encouraged. Patients are asked to refrain from crossing their legs in this early post-operative period. Normal, sedentary activities can generally be resumed within two weeks of surgery. It usually takes 3-6 weeks to start getting normal energy levels back and therefore patients will have to guage their time away from work accordingly. The average range is 2-4 weeks away from work. Exertional activity and sports are discouraged until 4-6 weeks following surgery.

Early on, the scars may appear red, puckered and thick. The first month is critical to creating good scars in the long run. This is the time where a tension closure may become spread or disrupted if the patient is too active and does not refrain from physical exertion and heavy lifting. The protective binder provides an additional important element to the wound healing well. Significant improvement in swelling and incision healing can be anticipated in the first few months and then more subtle improvements with ongoing softening and lightening will occur for up to a year.

Operative risks related to abdominoplasty surgery is significantly reduced when conducted by a qualified Plastic Surgeon trained in body contouring. Nevertheless, like any surgical procedure, there are some inherent risks to be aware of. Post-operative complications may include a low risk for bleeding or infection. Bleeding may necessitate re-operating but the requirement for blood transfusions is very low. Infection can be treated with antibiotics and rarely requires further surgery. The potential for bloodclots is rare and is significantly reduced by the use of specialized compression stockings and early patient mobilization. Patients are encouraged to walk as soon as possible after surgery and to refrain from crossing their legs.

There will be a permanent scar, the extent of which will be outlined to the patient prior to surgery, correlating with the extent of skin excision. The majority of these scars are of excellent quality and are easily covered by most under-garments and bathing suits. The potential for poor quality of scarring is reduced by closely adhering to the pre- and post-operative instructions provided. In particular, cessation from smoking is critical as is limiting exertion in the first month after surgery.