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Orange County, Newport Beach Tummy Tuck

 

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Tummy Tuck Surgery – Orange County

 

What is Tummy Tuck Surgery?


Everyone would like to have a tummy that is tight, firm, flat, and well-contoured. As we age, that goal may not be achievable by weight loss or exercise alone. People of normal weight can still develop an abdomen that protrudes or is loose and sagging.

Tummy Tuck in Newport Beach CA, when you desire a flat and well toned abdomen.

 

Everyone would like to have a tummy that is tight, firm, flat, and well-contoured. As we age, that goal may not be achievable by weight loss or exercise alone. People of normal weight can still develop an abdomen that protrudes or is loose and sagging.

 

The combined effects of aging, gravity, fluctuations in weight, pregnancy, gastric bypass surgery, and loss of skin elasticity can all contribute to lax abdominal muscles and soft tissue. Pregnancy and weight gain stretch and separate the two main abdominal muscles that are responsible for the six-pack look (the rectus abdominus muscles). These muscles form two vertical bands down the abdomen that are joined at the midline by connective tissue. The abdominal skin may be stretched beyond its biomechanical capability and result in breakage of the deeper dermal layer of skin. After childbirth or significant weight loss, the stretched skin is now unable to spring back and contract. The degree of deeper skin damage, visible as stretch marks, determines the ability of the skin to retract to its initial elastic form. Excess skin and fatty tissue as well as laxity of the abdominal wall muscles are commonly the result.There is often extra skin and underlying fat in both the upper and lower abdomen. The most significant changes after pregnancy or weight gain are visible around and below the belly button, where excess skin and fat can hang over the groin area. Development of excess skin and fat around the flanks (love handles) is also a common problem.

 

A flat and well-toned abdomen is something many of us strive for through exercise and weight control. But when stretched beyond the capacity to return to normal, abdominal tissue doesn’t respond to exercise and diet programs. In such cases, abdominoplasty, also known as a tummy tuck, may provide a highly effective, immediate solution in the treatment of stubborn abdominal areas. Abdominoplasty is a surgical procedure to remove excess abdominal skin and fat from the abdomen and to tighten the underlying muscles of the abdominal wall. As an added benefit of the tummy tuck, not only will the abdominal region be firmer and flatter, but the waist will be smaller. While the degree of improvement varies significantly depending on the extent of the abdominoplasty surgery, other factors contribute to the surgical outcome, such as the patient’s skin tone, body build, and the individual healing process. The Newport Beach tummy tuck operation is done on men and women alike. Following tummy tuck surgery, many patients experience an immediate improvement in self-esteem and discover greater self-confidence. In addition, many people enjoy shopping for new form-fitting clothes and are less self-conscious at the gym, around the pool, or at the beach.

 

Abdominoplasty is a very popular procedure when it comes to plastic surgery in Orange County and can produce satisfactory results for many people. According to the American Society for Aesthetic Plastic Surgery’s 2004 Cosmetic Surgery National Data Bank, the number of abdominoplasty procedures performed has increased 344% in the last seven years.

 

Abdominoplasty is frequently combined with liposuction in the form of the new technique of lipoabdominoplasty. It may also be performed after another surgery, such as a hysterectomy or other gynecologic surgery. A pre-existing C-section scar on the lower abdomen can often be removed during an abdominoplasty performed by Dr. Agha, a Board Certified Plastic Surgeon in Orange County, California, specifically Newport Beach.

 

Although the results of an abdominoplasty are considered long-lasting, weight fluctuations after surgery can cause the abdomen to protrude again. Patients who intend to lose a lot of weight should postpone the surgery until they have reached their weight goals. Also, women who plan future pregnancies should wait until they are finished having children so the results of an abdominoplasty are not undone.

 

Because smoking can increase the risk of complications and delay healing, smokers should quit at least three weeks before surgery and remain smoke-free for three weeks after surgery.

 

Various Tummy Tuck Options in Newport Beach

There are many types of abdominoplasty that Orange County cosmetic surgeon Dr. Agha performs routinely. In addition to these, Dr. Agha has developed his own signature abdominoplasty that he calls the Abdominoplasty™ since it refines the three-dimensional “hourglass” body contour.

 

Mini Tummy Tuck or Mini-Abdominoplasty

This procedure is performed through a smaller incision and is therefore useful if you only have a small amount of excess skin and fat above the pubic area.

 

Full Tummy Tuck or Full Abdominoplasty

With this technique, an incision is made from one hip bone to another. Unlike many surgeons, Orange County plastic surgeon Dr. Agha places his incision very low, so that it is well hidden by underwear or a bikini. Southern California cosmetic surgeon Dr. Agha is able to remove most of the excess abdominal skin and fat from the pubic hairline all the way to the belly button in most patients. He then tightens the loose abdominal muscles as needed.

 

High-Definition Tummy Tuck™

This body shaping procedure was developed by Orange County cosmetic surgeon Dr. Agha and is his signature High-Definition Tummy Tuck. Dr. Agha will recreate an hour-glass contour of your abdomen, applying many of the aesthetic features of the ideal abdomen: a defined rectus abdominus silhouette with oblique lateral indentation and depressions and a vertically-oriented navel in a narrow, midline depression. The High-Definition Tummy Tuck™ procedure also uses liposuction to sculpt the upper abdomen and flanks.

 

Extended Abdominoplasty

This abdominoplasty surgery technique is reserved for patients with excess fat and skin in the hip areas. In addition to the steps performed in a full abdominoplasty, Dr. Agha extends the abdominoplasty incisions around the hip area on each side and removes skin and fat from these regions. This procedure results in a more concave hour-glass contour of the hips and also lifts the outer aspect of the thigh on each side.

 

Circumferential Abdominoplasty

Also known as “belt abdominoplasty,” this tummy tuck procedure is reserved for patients who present with lower body laxity. This typically occurs after significant weight loss or aging. The typical belt abdominoplasty patient is unhappy with the looseness of her/his abdomen, thighs, and buttocks. The circumferential abdominoplasty creates incisions that go all the way across the patient’s lower back. Through these incisions, the excess abdominal, hip, and lower back tissue are removed. The buttocks and outer thighs are elevated followed by completion of the abdominoplasty procedure. This procedure is often performed as part of a lower body lift.

 

Inverted-T or Fleur-de-Lis Abdominoplasty

This tummy tuck surgery procedure is best suited for those rare patients who have lost significant weight and need a substantial quantity of skin and tissue removed. The patients often present with both vertical and circumferential abdominal tissue laxity and lose their hour-glass look due to fullness of their sides. Fleur-de-lis abdominoplasty combines the use of a horizontal incision over the lower abdomen with a vertical incision on the abdomen, forming an “inverted-T” pattern.

Reverse Abdominoplasty

A reverse abdominoplasty removes excess skin and fat in the area above the navel. It is a relatively uncommon procedure that can be used in conjunction with a breast reduction or mastopexy (breast lift) or an upper body lift. In this tummy tuck procedure, the incision is made along the crease underneath the breasts, and the skin is pulled upward.

 

Lipoabdominoplasty

This is a newer technique that was described by Brazilian plastic surgeon, Dr. Saldengo, several years ago. Lipoabdominoplasty employs liposuction in conjunction with abdominoplasty called tummy tuck liposuction. This body contouring procedure involves the use of liposuction to sculpt the upper abdomen and flanks. Liposuction is followed by tightening of the abdominal muscles and removing the loose lower abdominal skin and tissue. The lipoabdominoplasty procedure should be performed only by plastic surgeons who have experience in this technique. Lipoabdominoplasty and contoured abdominoplasty are the two main types of tummy tucks performed by Newport Beach, Orange County plastic surgeon Dr. Agha.

 

Plastic Surgery Body Contouring Center is conveniently located in Corona Del Mar, Newport Beach, California and services patients throughout the Southern California area. Dr. Agha has treated patients throughout Orange County, including Irvine, Costa Mesa and Yorba Linda, as well as Los Angeles, San Diego and Riverside counties.

 

Full Tummy Tuck

What is tummy tuck?
A tummy tuck, also known as an abdominoplasty, is a popular procedure for patients who have excessive abdominal skin and tissue with or without abdominal muscle laxity. Over the years, surgeons have made significant advancements to the original tummy tuck procedure in order to meet the aesthetic needs of their patients. Today, there are several types of tummy tucks to serve mild to severe cases of abdominal tissue laxity. The typical tummy tuck is the process of surgically removing the extra abdominal tissue and skin between the navel and the pubic area while tightening the abdominal muscles to restore the feminine hour-glass figure.

 

Who can benefit from tummy tuck surgery?
Typical candidates for this procedure are patients that have excess tummy skin, are unable to tighten their abdominal wall with diet or exercise, or has lost their skin quality due to aging. In most cases, these changes result after pregnancy or weight loss. Although the effects of childbearing differ from patient to patient, the majority of patients will experience some degree of laxity of their abdominal skin and muscle post-pregnancy. During pregnancy, the abdominal skin and muscles are stretched out significantly, with breakage of skin collagen layer, which presents as stretch marks. This stretched out skin does not always retract back to its original form. Also, the divergence between the separated abdominal muscles often remains despite abdominal crunches and exercise. A tummy tuck is the only way to remove the stretched out abdominal skin and to tighten the abdominal muscles at the present time.

 

What is involved in a tummy tuck procedure?
A tummy tuck procedure includes several components. These include: removal of excess skin of lower abdomen, removal of waist fat by liposuction if necessary, muscle tightening to repair the separated abdominal muscles, and reshaping and repositioning of the belly button.

 

Tummy tuck procedures available at our Newport Beach Office?
There are several types of tummy tuck variant available to suit different patients and their abdominal tissue excess. These variant include:

  • Mini tummy tuck

  • Full tummy tuck

  • Liposuction Tummy Tuck (lipo-abdominoplasty)

  • Extended tummy tuck

  • Circumferential tummy tuck (Belt Lipectomy)

  • Reverse tummy tuck

 

What is the most typical tummy tuck procedure?
Although there are several different tummy tuck types, most patients benefit from the full tummy tuck surgery. During a full tummy tuck, your plastic surgeon will make an incision from hip to hip in the lowest part of the abdomen. The incision is then extended through a layer of fat under the skin as far as the abdominal muscles. Next, an incision is made around the belly button to release it from the abdominal skin. The location for the upper incision is then checked and modified if needed. The excess skin and underlying fat in between the lower incision and the upper incision is then excised, revealing the abdominal muscles. The upper abdominal skin and fat are then elevated over the abdominal muscles. The muscle laxity is then gauged at this point and marked for correction. Stitches are then placed in the two main abdominal muscles (rectus abdominus) to approximate the left and right muscle bundles. The upper abdominal skin and fatty layer are then pulled down as far as the lower incision. A new opening of the navel is then marked on the abdominal skin. Some surgeons prefer to create a new opening in the shape of a “shield”. At our practice we create a vertically oriented elliptical navel according to studies that have shown this shape as the most aesthetically pleasing belly button form. The opening is then cut and the navel brought through. If the flanks are full, the love-handle fat is then liposuctioned at this stage. Your plastic surgeon will place a drain on each side before reattaching the belly button, and this drain will typically stay in place for about 5 days post-operatively. The incision is then closed with 3-layers of suturing at our practice. This includes approximation of the fatty layer first, followed by the layer below the skin, and finally the skin itself. The patient will then have surgical tape placed on their incision and be wrapped in an abdominal binder to help reduce swelling.

 

Where will my tummy tuck surgery be performed at?
For most patients, a tummy tuck is performed under general anesthesia in an ambulatory surgical care facility or in the hospital. Patients can typically go home or to a recovery care on the same day as their surgery. We can recommend Newport Beach recovery facilities or home care if you would like additional private post-operative care in the days following surgery.

 

How long does tummy tuck plastic surgery take?
As with other plastic surgery procedures, a tummy tuck is highly individualized for the patient’s needs or desires. However, The procedure may take anywhere from 2-5 hours, depending on the severity of the case and the type of tummy tuck planned.

 

What happens after the tummy tuck surgery?
The incisions are covered with light dressings. After the tummy tuck, patients may feel like they are so tightly sutured that their incisions may pop. The sutures are tightly placed to ensure that the patient gets the best results once the skin starts to relax weeks following their procedure. The first two weeks patients will not be able to fully stand straight up, but this is normal and will only be temporary. Initial discomfort subsides daily and can be controlled with oral medication.

 

When can I return to work and regular activities after tummy tuck?
Some bruising and swelling may be present within the first two weeks after tummy tuck surgery. Patients typically return to work when all discomfort has subsided.

 

What restrictions will I have after the tummy tuck surgery?
It is important that the patient refrains from any vigorous or strenuous activity as this could lead to breakage of the internal or external sutures. Walking for 100 yards is recommended several times a day to prevent development of blood clots. Patients should refrain from any strenuous activity for 4-6 weeks after surgery.

 

Can I combine a tummy tuck with other procedures?
Tummy tuck procedure can also be combined with any other plastic surgery procedure to reduce the amount of time a patient will have to undergo surgery. Some patients opt to have an extended tummy tuck procedure while others combine their tummy tuck with a Brazilian butt lift or breast enhancement surgery.

 

What is a mommy makeover?
A mommy makeover is a procedure designed to repair and recontour a woman’s body after pregnancy. The physical effects that come with childbearing can seem impossible to correct without plastic surgery. Some of the anatomical changes that occur are deflated breasts, increase in flank size, excess skin in the abdominal area, deflated buttocks, and separated abdominal muscles, which in turn leaves a weakened abdominal wall. A mommy makeover can be customized to meet all of these effects or only some of them, as all bodies differ post-pregnancy. The procedures that are typically included in a mommy makeover are a tummy tuck, breast lift, breast augmentation, breast reduction, liposuction, and Brazilian butt lift.

 

Does a tummy tuck procedure correct for mons pubis laxity?
The pubic mons often becomes loose and sags after weight loss, normal ageing, and/or pregnancy. Monsplasty is a surgical procedure that reduces and lifts the mons pubis to its original position. In our plastic surgery body contouring practice, a monsplasty is performed in combination with our tummy tuck surgeries to enhance the overall outcome and improve appearance of both the tummy and the pubic mons.

 

Is tummy tuck plastic surgery typically covered by insurance?
The tummy tuck procedure is unlikely to be covered by insurance. However, a panniculectomy may be covered by certain insurance policies when medical necessity is met.

 

What are the potential risks of the tummy tuck surgery?
The most common complaints following surgery include swelling, bruising, numbness in the abdominal region, and some discomfort. However, potential complications after a tummy tuck surgery include infection, bleeding, blood clot formation, fluid collection, partial loss of abdominal skin, wound separation, poor healing, poor scarring, loss of umbilicus, temporary or long-lasting loss of skin sensation, as well as unforeseen risks.

 

How soon can I walk after my tummy tuck?
Every patient’s post-operative journey is different as people heal at different rates. However, after your surgery, you should walk about 200 yards or so every 3 hours throughout the day. This improves blood circulations and prevents blood clot formation in your legs.

 

Are pain pumps for tummy tuck worth the extra cost?
Every surgeon differs in what type of medications they want their patients on after undergoing any type of procedure. In the Plastic Surgery Body Contouring Center, we recommend the pain pump for the first 2-3 days of your tummy tuck recovery. Most patients have been very happy with the additional help, as these initial days are the most painful and difficult period following surgery.

 

Mini Tummy Tuck

A mini tummy tuck, also known as partial abdominoplasty, is another options available to patients who have limited abdominal skin laxity and desire to smooth out their lower abdominal area. This body contouring procedure is designed for those patients whose needs are not extensive enough for the standard full tummy tuck, but could benefit from some abdominal skin removal. The mini tummy tuck procedure is often customized according to the need of the patient

 

The ideal candidates for a mini tummy tuck are those who have a mild degree of lower abdominal skin laxity with minimal abdominal muscle separation. In these patients, the upper abdominal region, from belly button above, has minimal skin laxity. Most of the skin laxity is below the belly button and is limited to the lower abdomen.

 

This procedure may be performed under general or local anesthesia in about two hours or less, depending on the severity of the case. The incision of a mini tummy tuck is made above the pubic area. This allows for the surgeon to excise some of the excess skin, as well as remove fat. Some muscle repair may be done to complete the abdominoplasty, but if it requires complete muscle repair, then a full tummy tuck is recommended. Liposuction is used to remove any additional fat lying above the muscle and to sculpt the abdominal area. Unlike the standard tummy tuck, the belly button is not affected and will not need repositioning. The mini tummy tuck surgery typically requires less recovery than the full tummy tuck.

 

Mini tummy tucks carry a lower risk of potential complications compared to the more extensivetummy tuck procedures. Patients can often return to normal activity within a week after surgery.

 

Liposuction Tummy Tuck

Liposuction tummy tuck, also referred to as lipo-abdominoplasty, is a relatively new technique. It is popular among patients who need a tummy tuck procedure to remove the excess loose abdominal skin and liposuction to reduce the thickness of the abdominal tissue and fat that reside under the skin layer.

 

Liposuction tummy tuck is typically performed under general anesthesia in an outpatient facility. The procedure is initiated by removal of the abdominal fat through liposuction. This is then followed by excision of the loose abdominal skin through a full tummy tuck incision. The procedure uses a blunt liposuction cannula to remove the majority of the superficial and deep fat in the abdomen. This process reduces damage done to blood vessels, nerves, arteries, and lymphatic vessels. These intact vessels and arteries then ensure that oxygen reaches the tummy tuck surgical site to assist in the wound healing process. The fascia is also retained during a liposuction tummy tuck. This layer of fibrous connective tissue in the abdomen helps to absorb many of the additional fluids that normally accumulate.

 

In a standard tummy tuck, your plastic surgeon is only able to use liposuction in the hips and on the waist due to the risk of damage to underlying blood vessels of the abdomen. This can in turn complicate the healing process at the site of the tummy tuck incision. However, during liposuction tummy tuck, aggressive liposuction of the abdomen, hips, and love-handles can be performed without impeding the healing process. This is because the technique of abdominal skin resection differs in the liposuction tummy tuck surgery and the majority of the blood vessels to the surgical site are preserved.

 

Patients who have liposuction tummy tuck are pleased with having not only a flat abdominal contour, but also one that is artfully sculpted.

 

Extended Tummy Tuck

An extended tummy tuck is a procedure that best serves those patients that have significant laxity of their abdominal skin as well as their love-handles and waists. Typical candidates for this procedure are those who have lost a significant amount of weight or have had multiple pregnancies. An extended tummy tuck is essentially a full tummy tuck that extends past the waists in order to better shape the mid-region of the body. The extended tummy tuck procedure has all the regular components of a full tummy tuck, which are muscle tightening of the abdominal wall, abdominal skin excision and liposuction, but the incision and fat removal extends around both waists to remove the extra skin from the waist, hips and love handles. Thus the procedure is more elaborate that the standard full tummy tuck but less extensive than a circumferential tummy tuck.

 

Like the standard tummy tuck, the extended tummy tuck procedure is performed under general anesthesia in an outpatient surgical facility. The procedure can take anywhere from 3-5 hours, depending on the severity of the case. After the incision is made from the outer hip through the lower abdominal area and to the opposite outer hip, the incision is extended to the abdominal muscle surface. The length of an extended tummy tuck incision is customized for each patient’s needs. Similar to the standard tummy tuck, an incision is then made around the belly button in order to release it. The abdominal skin is then pulled back to allow your plastic surgeon to tighten the separated abdominal wall with sutures. Fat is then removed with a liposuction cannula around the flanks and hips. The excess skin of lower abdomen and waists is then removed through an upper incision at the level of the belly button. The upper abdominal skin is then pulled down as far as the lower incision. At this level, the incision is then sutured and closed in 3 layers. Drains are inserted under the incision to allow excess fluid to flow out of the body for the week following surgery. The belly button is next repositioned. Bandages, an abdominal binder and compression garment are placed to help reduce swelling. It is essential for patients to follow their post-operative instructions to reduce the risk of potential complications.

 

Circumferential Tummy Tuck

The circumferential tummy tuck, also known as a belt lipectomy, was developed to address the loose hanging skin of the abdomen, waists, lower back, and buttock regions. This is usually due to extreme weight loss from having bariatric surgery or through diet and exercise. Although some plastic surgeons use the terms circumferential tummy tuck and a lower body lift interchangeably, the lower body lift is often a far more complex procedure when performed properly.

 

The circumferential tummy tuck procedure is not appropriate for most individuals as it is much more invasive than a standard tummy tuck. The incision is made around the entire lower abdomen and lower back region. This incision allows for your plastic surgeon to remove the excess fat and skin of abdomen, waists, and lower back through an incision that extends circumferentially like a belt around your lower back. from the rib cage all the way down to the knees. As with a traditional tummy tuck the muscles will be repaired as well.

 

A circumferential tummy tuck may take 4 to 5 hours to perform. During the procedure, the patient is placed on the operating table on his/her stomach. The lower back excision is performed first. The upper and lower incisions of the lower back excision are made from waist to waist. The incision is then closed in 3 layers using sutures. During this stage, several other procedures can be performed through the same incision. These include:

  • Buttock Lift

  • Buttock Augmentation with lower back fat

  • Outer thigh lift

 

Once the lower back incision is closed, the patient is turned on the operating room table and placed on his/her back. Surgery is then commenced on the abdominal region. Just like the standard tummy tuck, the abdominal wall is tightened, and in some cases the outer abdominal muscles are tightened. Liposuction is used throughout the abdominal area, flanks, hips, lower back, upper back to give the patient a figure-8 look. Drains will be placed in the abdominal area and thighs. These will be removed after 5 to 10 days from your surgery date.

 

A circumferential tummy tuck procedure requires a 1-2 night overnight stay at a recovery center. The recovery time for this procedure is typically between 4 to 6 weeks.

 

Monsplasty

Monsplasty, also known as pubic lift, is a surgical procedure used to reduce and lift the Mons Pubis. Monsplasty is performed for both cosmetic and functional reasons to return the mons pubis to its original position.

 

The pubic mons often becomes overly large with weight gain or pregnancy. After significant weight loss, childbirth, or normal aging, the mons pubis can loose its connective tissue attachments and sag. When severe, this can interfere with getting clothes to fit, urination stream, and/or sexual relations. Monsplasty procedure reduces the sagging skin and tightens the mons tissue to create an improved appearance and restore normal function. The procedure involves excision of the pubic skin and fat horizontally at the upper edge of the pubic region. Through this incision, excess fat is removed, pubic mons is sculpted or liposuctioned, and the mons is lifted. The outcome is a smaller, more natural looking Pubic Mons.

 

Panniculectomy

Panniculectomy is a procedure done to correct an overhanging pannus, which is usually caused by losing an excessive amount of weight. This procedure is done to tighten the lower part of the abdomen, but usually will not give a patient the full correction they need unless it is combined with either a standard tummy tuck, extended tummy tuck, or a circumferential tummy tuck. Since the idea patient seeking to have a panniculectomy is suffering with panniculitis, which means one who has an overhanging pannus, the standard combination will be an extended tummy tuck, and for severe cases a circumferential tummy tuck will be suggested.

 

Patients suffering with panniculitis may also have rashes and infections caused by the excessive level of skin laxity in the lower abdominal area. Before seeking plastic surgery, a patient must go see their primary care physician in order to address these concerns and the majority of the time, a physician may recommend a visit with a board certified plastic surgeon that specializes in body contouring. Most patients will take antibiotics or use topical creams to decrease the development of these symptoms, but if this does not fix their problem then consulting with a plastic surgeon about panniculectomy surgery is the next step.

In some cases patients may have their panniculectomy covered by their insurance, but insurance plans differ and are based on medical necessity.

 

Tummy Tuck Insurance Coverage

Although the Tummy tuck surgery is excluded under most insurance policies, a panniculectomy may receive coverage when medically necessary. A panniculectomy is an effective procedure that removes the redundant pannus of skin and subcutaneous fat located in the lower abdominal area. Panniculectomy is covered by insurance when performed to correct for structural defects of the abdominal wall (such as a hernia) or to relieve abdominal skin disorders such as:

  • Skin infection such as cellulitis and abscess

  • Contact dermatitis

  • Eczema

  • Skin moisture and malodor

  • Hypertrophic and atrophic conditions of skin

  • Persistent ulcer

  • Skin inflammation

  • Persistent local skin irritations

  • Painful inflammation of the tissue

  • Hernia repair

  • Interference with activities of daily living

 

Most insurance companies will request:

  • Dated photographs of the pannus hanging over the pubis and of the pannus elevated to expose the chronic, persistent, and refractory skin infection or irritation.

  • Office notes from the treating primary care physician that reflect the chronic, persistent, and refractory skin infection or irritation that persists despite optimal medical care over a six-month period.

  • A list of the medications that were prescribed during a six-month period and the length of time the agents were used.

 

Reverse Tummy Tuck

Most people have heard of a tummy tuck procedure, and most people can also assume that a tummy tuck can address all laxity in the abdominal area. Unfortunately this is not true, as upper skin laxity issues can only be corrected by having a reverse tummy tuck. Essentially this procedure is a tummy tuck done upside down, with the incision line falling in the inframammary fold and across the chest.

 

Not everyone is a candidate for this procedure, so it is essential to see a board certified plastic surgeon specializing in body contouring before preceding in your plastic surgery journey. Typically patients that are post-pregnancy, or that have lost a significant amount of weight, either by natural weight-loss or by bariatric surgery, will tend to fit the description of a reverse tummy tuck candidate.

 

This procedure involves the removal of excess skin of the abdomen and securing it vertically upwards towards the breasts. Some patients combine this procedure with a breast lift, leaving no scarring in the lower abdominal area, unless a mini-tummy tuck is necessary to address the lower abdominal laxity as well. This makes it easier to conceal any scarring while wearing a bikini, which is a desire for many patients after losing significant amounts of weight.

 

Mommy Makeover Surgery

Childbirth is one of the most enjoyable and memorable experiences of a woman’s life. However, pregnancy can take a toll on your body and physique, especially on the breasts and abdominal areas. On average, most women will gain anywhere from 25 to 35 pounds during their pregnancy. This weight is stored as fatty tissue in the breasts, abdomen, flanks (love-handles), hips, lower back, buttocks, and thighs. The breasts also enlarge due to weight gain and glandular growth in preparation for nursing. As the baby grows, expansion of the abdominal girth often results in weakening and separation of the abdominal muscles and stretching of the abdominal skin. The latter can result in breakage of the skin collagen, presenting as stretch marks. These are purple-red in color and concentrated around the belly button and the lower abdomen.

 

Mommy Makeover in Orange County, Newport Beach California, designed to conunteract the physical effects of childbearing and to restore and enjance your contour and apprearance.

Following childbirth and nursing, the lasting effects of pregnancy on your body may become more apparent. Much of the gained weight is gradually lost over the course of the first 12 months or so. Unfortunately, the weight loss is not proportional to the amount of fatty tissue that you may have in a given area. That means, for some, more weight may be lost from the breasts or buttocks than the abdomen and waist. The results are smaller breasts despite fullness of the waist and abdomen. Once breastfeeding is complete, the breasts deflate even more as the glandular tissue is lost. The deflated breasts lack form and begin to sag. The weak abdominal muscles and the excess abdominal fat appear as fullness and bulging of the belly.

 

A Mommy Makeover is designed to counteract the physical effects of childbearing and to restore and enhance your contour and appearance. Depending on the patients wishes and needs, sagging or deflated breasts, flank fullness, weakened abdominal muscles, excess abdominal skin, and deflated buttocks can all be addressed. A mommy makeover is an individualized surgical plan geared towards meeting the goals of many women who have had children and want to rejuvenate their bodies.

 

In general, an orange county mommy makeover may include:

 

Breast augmentationBreast liftTummy tuck (abdominoplasty)Brazilian Buttock liftLiposuction

With regard to the breasts, some patients simply need a breast augmentation procedure to refill “deflated” breasts, while others may need implants in combination with a breast lift (mastopexy) to correct the loss of breast volume and shape. Still, for some women, the increased breast size persists long after child birth and nursing. For these patients, a breast reduction with a mastopexy is a viable option to achieve more youthful breasts. In the abdominal area, most patients need a fulltummy tuck (abdominoplasty) with tightening of the muscle layer as well as removal of the excess skin and fat.

 

Orange County, Newport Beach plastic surgeon Dr. Agha performs his signature AbdominoplastyT which includes liposuction of the flanks and abdomen as needed. For certain patients, a mini-abdominoplasty may be all that is needed. The breast and tummy procedures are most commonly requested by mothers after their last childbirth. The breast and tummy procedures are most commonly requested after the last childbirth. According to data provided by the American Society for Aesthetic Plastic Surgery, more than 200,000 tummy tucks, breast augmentations and breast lifts were performed in 2008 on women ages 19 to 34. For many patients, Dr. Agha is able to perform the breast augmentation through the tummy tuck incision (Trans-abdominal breast augmentation). In addition to breast augmentation and tummy tuck procedures, liposuction can also be employed to sculpt and remove unwanted fat of the back, waists, hips, and thighs in order to lengthen the appearance of the torso area.

 

Finally, an increasing number of patients have been requesting buttock lipoaugmentation, more commonly known as a Brazilian butt lift, to accentuate their contour and curves. Knowing your options is the first step in determining what you want to change. Use the links at the top of this page to explore the cosmetic surgery options available. All of the plastic surgery procedures described on this site can be integrated into your own individualized Mommy Makeover at our Plastic Surgery Body Contouring Center. Although the Mommy Makeover procedures involve major surgery, the advantage of this approach is the dramatic improvement of your post-pregnancy body with only one trip to the operating room and a single recovery period. There are few surgeries that provide this level of immediate cosmetic improvement, and Orange County, Newport Beach (Southern California) patients are usually thrilled that they can once again feel comfortable wearing a bikini.

 

Plastic Surgery Body Contouring Center is conveniently located in Corona Del Mar, Newport Beach, California and services patients throughout the Southern California area. Dr. Agha has treated patients throughout Orange County, including Irvine, Costa Mesa and Yorba Linda, as well as Los Angeles, San Diego and Riverside counties.

 

Trans-Abdominal Breast Augmentation

After losing a great deal of weight or following pregnancy, a tummy tuck may be necessary to tighten the abdominal wall muscles, remove excess skin and contour the body for improved smoothness and aesthetic appeal. A tummy tuck can return a certain youthfulness to the abdominal region of someone who has lost excessive weight or endured pregnancy. This plastic surgery procedure can also remove or reduce stretch marks in the region of the lower abdomen and waist and can even correct the mons (pubic) laxity that develops with natural birth.

 

Most candidates of tummy tuck undergo this procedure to remove excess abdominal skin and tissue and to improve their abdominal contour. Because those physical changes tend to wreak havoc on the body, tummy tuck is a long-lasting, surgical fix for what diet and exercise cannot improve.

 

Along with negative changes to the abdomen during weight loss and pregnancy, there are changes that affect the breasts. Following pregnancy, nursing or weight loss, breasts may appear deflated. They often gain an appearance of hanging loosely and flat against the chest, having lost volume and skin tightness, as the rest of the body did. Unfortunately, these breast changes cannot be alleviated through diet and exercise, either. Breast tissue is largely unaffected by such measures of fitness and the best approach for long-lasting rejuvenation and youthful appeal of the breasts is through breast enhancement for the lost volume by breast augmentation.
 

How Is Trans-Abdominal Breast Augmentation Performed During Tummy Tuck?

For women undergoing tummy tuck, trans-abdominal breast augmentation is a very effective means of placing breast implants without creating any breast incisions. In fact, trans-abdominal breast augmentation during tummy tuck ensures that there will be no scars on the breasts at all. The results are incredibly natural and appealing, as the breasts do not appear to have been surgically altered due to absence of scars.

 

Either silicone or saline breast implants may be used as part of trans-abdominal breast augmentation during tummy tuck. Which ones are preferred and most suitable for your body will be determined in your initial consultation with Orange County plastic surgeon Dr. Siamak Agha, the board certified plastic surgeon of Plastic Surgery Body Contouring Center in Orange County and Los Angeles.

 

For implant placement, Dr. Agha will utilize the tummy tuck incision. Dr. Agha’s training in trans-umbilical breast augmentation, enables him to place the breast implants sub-glandularly (over the muscle) or sub-muscularly (under the muscle) depending on the patient’s needs and desires. This technique is superior to any other breast augmentation approaches since there are no incisions on the breasts. No one needs to know that you have enhanced your breasts but you.
 

Who Is a Good Candidate for Breast Augmentation During Tummy Tuck?

Trans-abdominal breast augmentation during tummy tuck is best suited for women who are having a tummy tuck and need added volume to their breasts, but do not have excessive drooping requiring a breast lift. If only an implant is necessary to restore youthful appearance to the breasts, then a trans-abdominal breast augmentation during tummy tuck will provide excellent results.

 

The Initial Consultation for Trans-Abdominal Breast Augmentation During Tummy Tuck

If you are considering a tummy tuck procedure at Plastic Surgery Body Contouring Center in Los Angeles or Orange County with board certified plastic surgeon Dr. Siamak Agha, you can discuss your breast augmentation options with him during your initial consultation.

 

During this initial consultation, Dr. Agha will perform a physical examination to assess whether you are a good candidate for tummy tuck. He will review your medical history, ask you questions regarding your health and expectations for this plastic surgery and will offer you insight about the procedure and recovery expectations. You will also be able to ask him any questions you may have regarding trans-abdominal breast augmentation during tummy tuck.
 

Tummy Tuck Insurance Coverage

Although the Tummy tuck surgery is excluded under most insurance policies, a panniculectomy may receive coverage when medically necessary. A panniculectomy is an effective procedure that removes the redundant pannus of skin and subcutaneous fat located in the lower abdominal area. Panniculectomy is covered by insurance when performed to correct for structural defects of the abdominal wall (such as a hernia) or to relieve abdominal skin disorders such as:

  • Skin infection such as cellulitis and abscess

  • Contact dermatitis

  • Eczema

  • Skin moisture and malodor

  • Hypertrophic and atrophic conditions of skin

  • Persistent ulcer

  • Skin inflammation

  • Persistent local skin irritations

  • Painful inflammation of the tissue

  • Hernia repair

  • Interference with activities of daily living

 

Most insurance companies will request:

  • Dated photographs of the pannus hanging over the pubis and of the pannus elevated to expose the chronic, persistent, and refractory skin infection or irritation.

  • Office notes from the treating primary care physician that reflect the chronic, persistent, and refractory skin infection or irritation that persists despite optimal medical care over a six-month period.

  • A list of the medications that were prescribed during a six-month period and the length of time the agents were used.

 

Abdominal Hernia Repair

Combine tummy tuck and abdominal hernia repair surgery at plastic surgery body contouring center

Struggling with a hernia can be painful. Many people struggle with abdominal hernias due to issues like pregnancy, obesity, straining during bowel movements, and more. Hernias can also be both prevented and repaired, but often going through surgery simply to repair a hernia is not on everyone’s top priority list.

 
In addition, the number of safe tummy tuck procedures is on the rise. We are based in Newport Beach in Orange County, serving all of Southern California, and we have seen tummy tucks increase a great deal as the procedure becomes more well known and the results more public.

 

Repair your abdominal hernia while having a tummy tuck

Hernias can be very problematic. They are often painful, possibly dangerous, and recurring. They can also be caused by (or lead to) a weakening of the abdominal wall, which is one of the reasons that hernias continue to come back and plague you even after you have lost weight or had a baby.

 
Though unrelated to hernias, a tummy tuck incision can provide a great, hidden, and low incision that can provide a great access to an abdominal hernia. Instead of having an incision on the central abdomen, the tummy tuck incision can be used by a qualified plastic surgeon to expose the abdominal wall, the abdominal hernia, and the defect location. The hernia is then repaired through this incision and the rest of the tummy tuck is completed.

 

At Plastic Surgery Newport Beach, Dr. Agha is not only one of the top rated tummy tuck specialists in Orange County – he is also trained in abdominal hernia repair. That is why we are proud to offer a combination tummy tuck/abdominal hernia repair service, so that you can avoid having two surgeries and address two separate issues.

 

Types of Abdominal Hernias

There is more than one type of hernia. Dr. Agha at Plastic Surgery Body Contouring Center can repair many different types of abdominal hernias, including:

  • Para-umbilical Hernias

  • Umbilical Hernias

  • Incisional Hernias

  • Ventral Hernias

 

Both abdominoplasty and abdominal hernia repair are major surgeries, so it’s important to note that hernia repair can affect the recovery time after the surgery. Incisional hernia repair, for example, are known to affect the recovery time of the tummy tuck, so make sure you talk to Orange County plastic surgeon Dr. Siamak Agha about the concerns you have regarding the abdominal hernia and tummy tuck combination procedure, as well as what your complete health history.

 

Working on Your Physical and Emotional Health

Many patients who elect to have a tummy tuck may also have an abdominal hernia. If you are considering both procedures at any point in time, it may be in your best interests to combine them into one procedure so that you can avoid multiple trips to the surgeon.

 
If you’re interested in learning more about tummy tucks and hernia repair, or you’d like more information on the combination procedures and Dr. Agha’s training and expertise in both plastic and reconstructive surgery in Newport Beach, Orange County, and the rest of Southern California, contact us today at 949-407-5482.
 

Tummy Tuck Typical Patients

Abdominoplasty can be performed on adults of any age who are in good health, close to their ideal weight, in good physical and psychological health, and not severely overweight. Often, these men and women have managed to control their weight through nutrition and exercise but still have excess skin or fat on their abdomen. Other Southern California body contouring patients have lost skin elasticity in their abdomens after one or more pregnancies.

 

There are certain people for whom a tummy tuck is not an ideal choice. If you are planning on becoming pregnant in the future or are trying to lose a large amount of weight, it may be best to wait until later to undergo abdominoplasty surgery in Newport Beach. In both cases, the benefits of a tummy tuck may be undone by changes in skin and muscle tone due to pregnancy or weight loss.

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Before

This mother presented to Dr. Agha for a Mommy Makeover, including a tummy tuck, a breast augmentation, and a breast lift.


Before

This patient presented to Dr. Agha for a tummy tuck after multiple pregnancies.


Before

This patient presented to Dr. Agha for a lipoabdominoplasty and body contouring surgery.


Before

This patient presented to Dr. Agha after gastric bypass surgery for a circumferential abdominoplasty and lower body lift.

 

Tummy Tuck Details

Tummy tuck surgery usually takes two to five hours, depending on which type of abdominoplasty is being performed and how much correction of the abdominal contour is desired and practical. A mini-abdominoplasty takes one to two hours, and a full abdominoplasty or a Abdominoplasty™ takes two or three hours, depending on the extent of work required. After you have changed into a gown and had your intravenous line started, Orange County plastic surgeon Dr. Agha will mark certain landmarks on your abdomen and flanks in the pre-operative area. The location, length, and direction of these incision lines will be dictated by the type of abdominoplasty being performed. This ensures proper planning for the site of the abdominoplasty incision and liposuction. He will also review the entire operative plan with you including potential complications. You will then be given a dose of intravenous antibiotics as a precautionary measure.

 

What happens during tummy tuck surgery?

Step 1 – Anesthesia

Abdominoplasty is usually performed under general anesthesia. After initiation of anesthesia in the operating room, Dr. Agha will inject a solution of local anesthetics known as “tumescent solution” at the intended incision site, the surgical site, and sites marked for liposuction. The injection solution consists of a low concentration of lidocaine and epinephrine. The lidocaine will numb the surgical site, and the epinephrine causes constriction of the blood vessels at the surgical site, reducing the potential for bleeding and bruising.

 

Step 2 – The incision

Dr. Agha will next make the necessary incisions for the removal of excess skin and fat. He will place your incisions low so that they can be well-hidden in a two-piece bathing suit. For a mini-tummy tuck, the incision will be limited to the width of the pubic hairline. For the full or Tummy Tuck™, the incision may extend all the way from hipbone to hipbone. The shape and length of the incision will be determined by the degree of correction necessary. A second incision is made to free the navel from its surrounding tissue (see figure below). After the incision has been made, Dr. Agha elevates the skin and fat off the underlying muscles of the abdominal wall. These muscles are then tightened by pulling them close together with stitches in a seam down the center of the abdomen (see figure below). This provides a firmer abdominal wall and narrows the waistline. Excess fat, tissue, and skin are removed, and the remaining abdominal tissue is re-draped over the underlying muscles. A new opening is then created for your belly button. Your belly button is then pulled through and sutured in its correct position.

Step 3 – Closing the incisions

The incisions are carefully closed to minimize scarring. Southern California cosmetic surgeon Dr. Agha places all his sutures beneath the skin where they are gradually absorbed by the body. Not having to undergo suture removal has improved patient comfort and satisfaction. One or more drains may be placed beneath the incision. These slender, rubber tubes assist in draining any fluid that may accumulate beneath the incision and delay your healing.

 

Step 4 – Dressings

A sterile dressing is applied to the incisions, and a compression garment or abdominal binder is placed over your abdomen. This compression garment or binder helps support your abdominal wall during healing, decreases post-operative swelling, and helps decrease any bruising that may occur.

 

Tummy Tuck Consultation

During your initial consultation, board certified plastic surgeon Dr. Agha will inquire about your general physical and mental health status, pre-existing health conditions, prior surgeries, your medications, allergies, and smoking habits.
Relevant questions include:

  • Pregnancies and their effects on the abdomen

  • Previous surgical procedures (including laparoscopic procedures)

  • History and method of weight gain and loss

  • Future plans for pregnancy

  • A detailed history of current medical and psychological problems, e.g. heart disease, diabetes, a history of thromboembolic disease, connective tissue disorders, and wound healing problems

It is important that you be thorough when providing the requested information as this will allow Dr. Agha and staff to proactively address medical and psychological concerns.

When asked about medications, be sure to include any diet pills, vitamin or herbal preparations because some vitamins and herbal medications can affect your blood pressure and clotting ability. Honesty regarding your smoking and alcohol use is also very important as these will have a profound impact on your recovery period and your ability to heal.

 

After reviewing your medical history, Dr. Agha will discuss your concerns, priorities, and motivations for pursuing plastic surgery. Orange County plastic surgeon Dr. Agha will then examine you and assess your abdominal tissue laxity. He will assess multiple factors, including the degree of abdominal muscle weakness and separation, excess abdominal tissue, skin laxity and damage, and distribution of excess fat in the flanks and upper abdominal regions. The locations of all scars are noted and the presence of an abdominal hernia is ruled out.

 

Each of these components will determine which procedure is best for you. With only mild excess fat and good skin elasticity, you may be benefit best from liposuction alone. For mild tissue and skin excess confined to the lower abdominal region, you may be a candidate for a mini-abdominoplasty with or without liposuction. For more pronounced excess skin and fat as well as muscle weakness or laxity, you will most likely require a full abdominoplasty or Abdominoplasty™ to achieve the best results.

 

Dr. Agha will subsequently provide you with information on different options, explaining the advantages and disadvantages of the each procedure. You will be provided with information regarding the potential risks and complications of each surgery. Finally, considering your input, Dr. Agha will plan an appropriate procedure to best suit your anatomy as well as meet your desires and expectations.

 

At the completion of your consultation, you will be given a written estimate of the cost of your procedure. At this time, you will also have the option to schedule your procedure. You are encouraged to bring your spouse, significant other, family member, or a friend to your consultation. Prior to surgery, you may be asked to obtain specific lab tests and a medical evaluation.

 

The cornerstone of Dr. Agha’s approach is the customization of treatment to suit your specific needs and circumstances, ensuring that you have an adequate understanding of the procedure so that you are able to make an informed decision. This will help you achieve the appearance you desire with the least invasive procedure available.

 

Tummy Tuck Recovery

Tummy tuck surgery may be performed as an outpatient procedure, or you may choose to stay in the hospital overnight. If you choose to go home, you will spend one or two hours in the recovery room prior to being released in the company of a friend or family member. We also have a private duty nurse available to care for you in the comfort and privacy of your own home if you so choose. Some tummy tuck patients may need to stay overnight in the hospital. This will depend on many factors, including how extensive the tummy tuck operation is.

 

Day of Surgery- When you wake up from your tummy tuck procedure, you will be in the recovery room and will be wearing an abdominal binder. You should plan to wear the abdominal binder or compression garment for four weeks following surgery.

 

Caregiver- When tummy tuck patients leave the surgery facility to go home, they are usually groggy for about 12 hours or overnight. It is very important to have someone who can assist you with getting around and taking your medications for at least the first 24 hours.

 

Nausea- Most people are nauseated during the first 24-48 hours. To reduce this, we suggest that you take your nausea pill one hour before taking your pain medication or antibiotics.

 

Sleep- During the first week after abdominoplasty, attempt to sleep on several pillows on your back. Also, keep your legs slightly bent at the hips. This ensures that the tension on your incision is minimized, reducing pain and resulting in a thinner scar.

 

Painkillers- You’re likely to feel sore for a few days, but you should be up and around in 24 hours. Most of your discomfort can be controlled by the prescribed painkillers.

 

Q-Pain Pump- Alternatively, you may also be a candidate for a revolutionary new product for the management of post-operative pain called the On-Q Post-Operative Pain Pump. Be sure to ask Orange County plastic surgeon Dr. Agha about this during your consultation if you think you might be a good candidate for this system.

 

Shower- Remove your dressing, sponges, and gauze pads on the third post-operative day. You may now take a shower. After showering, simply pat your incisions dry and replace your abdominal binder.

 

First Post-operative Visit- Dr. Agha prefers to see you on Day 5 for your first post-operative visit. At this time, he will remove the drainage tubes.

 

Swelling- Any swelling in your abdomen and flanks may take three to five weeks to subside.

 

Driving- It is not safe to drive a car within twenty-four hours of taking pain medication, as your reflexes and alertness may be altered. It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing. Walking- You will probably be unable to stand fully upright for 7 to 10 days after a full or Abdominoplasty™. Even if you can’t stand straight, it is still important to start walking as soon as possible, usually the evening of surgery. This is the best way to reduce the chance of blood clotting in the legs.

 

Light Exercise- Dr. Agha recommends light exercise to reduce swelling and prevent clotting. Light exercise includes walking, stretching, as well as moving your arms and legs while sitting. If you should feel pain or pulling at the incision site, cease the movement.

 

Activities- During the first week after surgery, avoid activities that raise your blood pressure. This could cause bleeding at the operative site, which could result in a hematoma (collection of blood). Walking is the safest exercise, especially during the first week. Avoid exercises which directly stress the area of your surgery for a full four weeks. After this period, cardiovascular activities, such as riding a stationary bicycle or brisk walking, can be initiated. Running at this point may be premature.Avoid heavy lifting, contact sports, and jogging for up to six weeks. Six weeks after surgery, you will be nearing your pre-operative state. Avoid pulling at the surgical area to maximize healing and minimize scarring. During the early phase of healing, one must avoid irritation around the operative site as this can worsen swelling and fluid accumulation. This could cause development of a seroma (fluid collection) or cause problems with the wound (dehiscence or opening of the suture line or widening of the scar). Even though the skin is closed, there are many activities taking place beneath the skin.

 

Healing- You will need a few weeks to recover and heal from a tummy tuck procedure. The typical healing time is at least one to two weeks before returning to work.

 

Scarring- Every person’s body is different, and many factors contribute to scar healing. Your scars will be firm and pink for about six weeks. Non-smokers and those who follow the Enhanced Recovery Nutritional Supplements routine have a better chance of rapid healing and thinner scarring. Expect to wait at least nine months before your scars lighten in color and become as flat as the rest of your skin. Although they will never disappear completely, abdominal scars will not show under most clothing, even bathing suits.

 

Follow-ups- Regular check-ups protect against complications.

 

Emergencies- Some discomfort is expected following surgery.
Be sure to tell us if:

  • There is an increase in swelling, pain, redness, drainage, or bleeding in the surgical area.

  • You develop fever, dizziness, nausea or vomiting, or a general ill feeling.

  • If you experience shortness of breath, chest pains, or unusual heartbeats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.

 

Tummy Tuck Results

You will notice an improvement in your abdominal contour immediately. A tummy tuck with Southern California plastic surgeon Dr. Agha will result in a flatter, firmer abdominal contour that is proportionate with your body type and weight. The final results may be initially obscured by swelling and your inability to stand fully upright until internal healing is complete. Within a week or two, you should be standing tall and confident with your new, slimmer, contoured profile.

 

For most patients, the long-term results associated with the tummy tuck procedure are excellent. However, long-term results of tummy tuck surgery are dependent on keeping one’s weight relatively constant, eating a healthy diet, and exercising regularly.

 

Tummy Tuck Potential Risks

All surgical procedures, including the tummy tuck, have potential risks associated with their performance. The decision to have abdominoplasty or other body contouring surgeries is extremely personal, and you’ll have to decide if the procedure will achieve your goals and whether or not the risks and potential complications are acceptable.

 

In this section, you will find further information regarding the potential risks associated with various abdominoplasty procedures.

 

Possible risks of abdominoplasty include:

 

Surgical Anesthesia: On the day of surgery, your anesthesiologist will discuss the risks of both local and general anesthesia.

 

Unfavorable Scarring: If the sutured area doesn’t heal properly or takes too long to heal, the scars that are a result of the abdominoplasty may be thicker than normal. If the patient heals relatively quickly, minimal scarring will result. Scars will take years to fade, but they are long-lasting. Despite Dr.Agha’s best efforts, scar appearance and healing are not fully predictable. The scars may be uneven, excessively wide, and/or asymmetrical. Scars may be unattractive and of a different color than the surrounding skin. Excessive, hypertrophic, and keloid scarring are uncommon. Additional treatments, including surgery, may be necessary to treat abnormal scarring.

 

Bleeding/Hematoma: Bleeding may result if the sutured areas do not heal correctly or if there is improper coagulation after the tummy tuck procedure. A hematoma is a blood collection that can form under the skin and enlarges as a tender bulge. If a patient notices any unusual bleeding after an abdominoplasty, contact Orange County plastic surgeon Dr. Agha immediately. Do not take any aspirin or anti-inflammatory medications for ten days before surgery as this will increase the risk of bleeding. Non-prescription “herbs” and dietary supplements can also increase the risk of surgical bleeding.

 

Infection: Major infection with fever and large areas of red skin (cellulitis) is unusual after this type of surgery. Should a serious infection occur, treatment, including intravenous antibiotics or additional surgery to remove dead tissue and drain abscesses, may be necessary. Minor wound infections, accompanied by exposed and “spitting” sutures can occur and are usually easily dealt with by limited debridement, antibiotics, and dressing care. There is a greater risk of infection in smokers, those with diabetes, and with multiple procedures.

 

Fluid Accumulation (Seroma): Drains are often placed at the surgical site at the end of the operation to collect seepage of fluid. After their removal in about five to seven days, body fluids (serum) occasionally accumulate underneath the skin. Should this occur, it may require aspirations. If that fails to cure the seroma then the patient will need to be seen either in the office or the operating room for insertion of new drainage tubes and the removal of seroma cavities. This is very rarely necessarily.

 

Poor Wound Healing: Individuals that have a slower than average healing rate or smokers may find that they do not heal properly, that the sutured areas reopen easily, or that they are more prone to infection. Patients should avoid smoking three weeks prior to and after the procedure so that their body’s natural healing process is not hindered.

 

Wound Dehiscence: In general, your skin closure is in multiple layers. Separation of the superficial, deep and/or both layers may occur any time during your first post-operative month. Suture breakage, knots untying, sutures tearing through an excessively tight closure, too much movement or bending, and skin necrosis (death) are some of the recognized causes of dehiscence. Breakage of sutures in the superficial layer of skin may be sutured closed or allowed to heal secondarily at the judgment of Orange County plastic surgeon Dr. Agha.

 

Deep dehiscence may require a return trip to the operating room for closure under anesthesia. These healing problems may require frequent dressing changes, extra office visits and further surgery to remove the non-healed tissue. Open wounds may take weeks to heal or a secondary closure may be appropriate. Wounds allowed to heal on their own usually benefit from secondary scar revision. Smokers have a high risk of skin loss and wound healing complications. Do not smoke for three weeks before and after your surgery.

 

Suture Granuloma: Some surgical techniques use deep sutures. These items may be noticed by the patient following surgery. Sutures may spontaneously poke through the skin, be visible, or produce irritation that requires removal.

 

Numbness in Skin Sensation: Post-operative diminished (or loss of) skin sensation (numbness, pins and needles sensation, burning or itching), and/or pain in the lower torso may be temporary or very rarely long-lasting.

 

Contour Irregularities: Contour irregularities and depressions may occur after these procedures. Visible and palpable looseness and wrinkling of skin can also occur. On occasion, asymmetrical fullness, bulges, and depressions may be present.

 

Asymmetry in Scar Placement or Contour- On occasion, asymmetry may occur after a tummy tuck. Although this is not typical, it is a risk associated with the abdominoplasty procedure. Every body and every patient is different.

 

Pain that Persists: Chronic pain may occur very infrequently from nerves becoming trapped in scar tissue after surgery.

 

Nerve Damage: If improper healing occurs, the patient may have some nerve damage. The possibility of nerve damage should be discussed with the physician before the procedure. Nerve damage can result in over-sensitivity or it can result in a lack of sensitivity in certain areas where the abdominoplasty was performed.

 

Allergic Reactions: In rare cases, local allergies to tape, suture material, or topical preparations have been reported. More serious systemic reactions may occur in response to drugs used during surgery and prescription medicines. Allergic reactions may require additional treatment.

Loss of Umbilicus: Malposition, scarring, unacceptable appearance, or loss of the umbilicus (navel) may occur.

 

Residual Deformity- Despite the best efforts to obtain a tight abdominal contour, a small degree of residual deformity may persist or develop months after the surgery.
Need for Revisional Surgery: The practice of medicine and surgery is not an exact science. Should complications occur or some aesthetic expectations remain unmet, additional procedures or other treatments may be necessary. Other complications and risks can occur but are even more uncommon.

 

Suboptimal Aesthetic Result: You may be disappointed with the results of surgery. Under-treatment with residual laxity and looseness or over-treatment with excessive tightness of the skin can occur with the flattening of regional contours and the widening or thickening of scars. Considerable care is used to achieve the optimum shape, but for a variety of reasons, the ultimate results may be suboptimal. At times, it is desirable to perform additional procedures to improve your results.

 

Deep Vein Thrombosis (DVT) and Pulmonary Complications: Deep vein thrombosis is rare but worrisome complication of plastic surgery. It represents formation of blood clots in the deep veins of the legs during anesthesia and surgery. Although a sequential compression device will be used to reduce the risks, a few patients may still develop DVTs. Pulmonary complications may occur secondarily to the migration of the vein blood clots into the lungs (pulmonary emboli) or partial collapse of the lungs after general anesthesia. Should either of these complications occur, you may require hospitalization and additional treatment. Pulmonary emboli can be life-threatening or fatal in some circumstances.

 

Long Term Effects: Subsequent alterations in body contour may occur as the result of aging, weight loss or gain, pregnancy, or other circumstances unrelated to the above procedures.

 

Contraindications for Abdominoplasty Plastic Surgery

  • Severe comorbid conditions (heart disease, diabetes, morbid obesity, cigarette smoking, etc.)

  • Expecting future pregnancy

  • Thromboembolic disease (blood clotting disorders)

  • Morbid obesity (BMI >40)

  • Unrealistic patient expectations

  • Upper abdominal scars

  • Patients who tend to form keloids or hypertrophic scars


 

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