Tummy Tuck (Abdominoplasty)

Conveniently located to serve Washington DC, Arlington, Bethesda

What is an abdominoplasty?

An abdominoplasty is a procedure to improve the aesthetic of your abdomen. It is also called a tummy tuck. This is most commonly performed after childbearing or major weight loss.  Major improvements are possible and results are generally permanent as long as there are no major weight swings or pregnancies after surgery. The surgeons at District Plastic Surgery are regarded as expert providers of tummy tucks in Washington, DC.

Who is a candidate?

Anyone who is healthy and desires improvement of their abdominal appearance can be a candidate.  Patients with loose skin, muscle bulging/diastasis, and excess fatty tissue can have significant aesthetic improvement.  In patients who are planning on having more children, we recommend waiting until childbearing is complete for best results.

How should I prepare for a tummy tuck?

Stop smoking for at least four to six weeks before surgery to limit the risk of complications during and after; studies have shown that patients may decrease their chances of wound complications by 50% by doing so. Alcohol consumption should cease starting 48 hours before surgery.

In the days leading up to surgery, stay hydrated; fluids containing electrolytes are ideal. Avoid processed, salty carbohydrates, as they promote inflammation. Carbonated beverages and processed sugar can cause gas and bloating and should also be limited or avoided. Patients are encouraged to eat low-fat, protein-rich meals instead.

Follow all instructions for fasting; generally, patients should not eat or drink for 12 hours before surgery. If oral medications are taken on the day of surgery, only a sip or two of water is advised if possible. It is essential to keep your surgeon aware of any changes in the use or addition of prescription and non-prescription medications, whether taken on the day of surgery or not.

Bring loose, comfortable clothing that is easy to put on and remove, taking into account that you will be fitted with a compression garment and may have drainage tubes afterwards.

Arrange for transportation home in advance from a friend or family member. Prepare your bedroom for recovery, gathering bandages, gauze, and other healing aids as directed.

How is the procedure performed?

Dr. Ramineni includes liposuction as part of his abdominoplasty surgeries for best aesthetic results.  Some surgeons just remove skin, leaving extra fat in the back and flank area causing “muffin topping” or disproportion between your abdomen and back area.

In surgery, the first step is performing liposuction of the bra line, love handles, upper and lower back, mons pubis area and the upper abdomen where the skin is not exised.  Once this is complete, the belly button is separated from the skin to be removed and left attached to its blood supply and to the abdominal muscles.  The bikini line incision is made and the skin is lifted to the level of the ribs from underneath.  The muscle separation/diastasis is repaired in multiple layers to flatten the abdomen and pull in the waist line. A long acting local anesthetic is injected into the muscle for post operative pain relief.  The surgical bed is then put into a “beachchair” position and the extra skin is marked off and excised.  The incision is closed in multiple layers over 2 drains and a small hole is made for pulling the belly button through.  The incision is dressed and compression dressings are placed and you are discharged home after a few hours in recovery.

Recovery 

Abdominoplasty recovery is a little longer  than other aesthetic surgical procedures, however the dramatic results make it worthwhile.  Patients are generally home from work for 2 weeks, can start early gym activities at 3-4 weeks and full activity including core exercises/yoga at 6 weeks.  You will be sized and placed in a surgical compression garment to help with swelling and shaping. This is worn 23 hours a day for 4-6 weeks.  Scar care is started when the steri strips are removed. Drains are removed 10-14 days after the surgery.

Risks

1. Bleeding – some blood loss happens in every surgery, with abdominoplasty the blood loss is generally low, but in some patients this may be moderate.  We will check blood counts prior to surgery and although very rare, 1% or less of patients may require a transfusion or overnight stay in the hospital for observation
2. Wound healing problems – A tummy tuck lifts the skin off the muscle and temporarily decreases its blood supply, some patients can have slow healing in the belly button area or lower abdominal area and in rare cases some skin loss that may require further surgery or lead to wider scars
3. Infection – infection is uncommon, but drainage or antibiotics could be needed
4. Revision – revisional surgery may be needed, most would be minor and could be performed as a small touch up in the office
5. Pain – the muscle repair does cause pain, we will give you pain medication, however there are times that the pain can last longer than a few weeks
6. Nerve injury – there is a small risk of injury to a sensory nerve to the outside of the thigh, this can cause numbness or pain. We fully expect some numbness of the abdomen to last 1 year or sometimes longer. 
7. Deep venous thrombosis/pulmonary embolism – We treat all patients with sequential compression devices, blood thinner shots prior to surgery and early walking.  In very rare cases a patient can have a blood clot which may require several months on blood thinners and in very rare cases this can be life threatening
8. Poor scarring – most patients get very fine line scars, however some patients are genetically predisposed to keloids or thick scars.  Scars may need revision and in some cases can “ride up” leading to visible scars in bathing suits/underwear
9. Liposuction complications – see liposuction
10. Abdominal tightness – because the muscles are tightened, it is not uncommon to feel full easily or have some heartburn, this generally resolves by itself within a few weeks/months
11. Suboptimal cosmetic results – abdominoplasty can only address fat/skin issues above the muscle. Patients with intraabdominal fat may not get as flat as those without.  For best result, you should be close to your ideal body weight prior to surgery

Schedule a consultation today

Arrange a consultation to learn more about tummy tucks in Washington, DC, today. The surgical experts at District Plastic Surgery are eager to help you learn more about the benefits of abdominoplasty.

Before & After