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.