![]() Many patients believe that this procedure is extremely painful but, in fact, it is not the case. All of my patients stay overnight in the hospital and are discharged the following day. A pain pump is provided, which allows the patient to press a button when pain medicine is needed, making sure they are kept comfortable postoperatively. Patients are admitted to a private room in the hospital on a floor that is very familiar in taking care of patients who have just undergone abdominoplasty surgery. I perform all my abdominoplasty procedures in a hospital setting, most commonly Morristown Medical Center. The procedure is performed under general anesthesia and typically takes between three to four hours to complete. Where is the abdominoplasty procedure performed? ![]() This scar typically goes on to heal very well and fade over time. If this is likely to occur, I advise my patients preoperatively and make them very aware of it. ![]() In this case, the area needs to be closed primarily, producing a small vertical scar very low on the abdomen, close to the incision. Occasionally not all of the skin can be removed which includes the prior site of the belly button. This means that most patients do in fact also have a scar right around their belly button at the completion of an abdominoplasty procedure. The belly button stays attached to the patient’s abdominal wall on this stalk and when the excess skin is resected and excised I feel underneath the flap where the belly button is located, mark that spot and make a new hole in the skin for the belly button to be brought through. This leaves a hole in the overlying abdominal skin flap where the belly button used to be. When the skin and soft tissues are being raised, once the level of the umbilicus is reached, the structure is circumferentially incised and separated as a stalk attaching to the abdominal wall itself. Many people are very curious about what happens to the belly button or umbilicus. Your natural abdominal contours and belly button will be preserved. Most patients go on to lose a good amount of weight after surgery, on average, 8 to 10 pounds. As a matter of fact, most of the time patients are tightened so much that there is less room inside the abdominal wall cavity for the stomach to expand after eating and often eat much less after surgery. The fascia is then aggressively tightened along the midline, creating an internal corset effect which greatly enhances the patient’s overall shape and contour. Therefore, the muscles themselves are not actually tightened it is this overlying layer of fascia which is tightened which brings the muscles along with it. The abdominal wall tissue consists of a very strong layer called fascia, which is the layer that sits just along the top portion of the muscle and is attached to the underlying muscles. Correction of the rectus diastasis is arguably the most important part of obtaining an outstanding contour as part of the final result. This commonly manifests as bulging in the central portion of the abdomen creating a protuberant appearing abdomen. Most patients who have an abdominoplasty procedure are found to have a rectus diastasis, a stretching out of the abdominal wall which causes laxity. Next the entire abdominal wall and muscle layer is exposed and evaluated. At this point, the skin and soft tissue is peeled off of the patient’s abdominal wall all the way up to the middle portion of the ribs, called the xiphoid process. The incision extends through the skin and underlying soft tissue until the abdominal wall is reached. The scar is quite long however, it is kept very low at the level of the pubic hairline. The scar extends out to the sides reaching just about hip to hip in most people. An abdominoplasty begins with an incision that is very low on the abdomen, most commonly just at the edge of the pubic hairline. I am very straightforward with my patients when describing this procedure and the correct and more formal term is abdominoplasty. I dislike the term “tummy tuck” as this gives the patient an impression that the operation is small, which it is not. Results should last at least ten to fifteen years and the procedure may never need to be repeated during the course of the patient’s lifetime. It is not a procedure that needs to be repeated every so often and, in fact, it is quite rare to perform a secondary abdominoplasty surgery in my practice. In addition, abdominoplasty surgery is long lasting.
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