Most women want to change something about their appearance, and it’s usually their stomach. For men, the desire for a firmer, flatter stomach is also common, as it is frequently cited as one of the key features contributing to the attractive male form. However, this area tends to be particularly vulnerable to the effects of weight fluctuations, aging, and pregnancy. It is not unusual for loose skin, weak muscles and excess fat in the abdominal and waist area to develop more easily than in other areas, and they simply cannot be eliminated as effectively with exercise, a healthy diet, and even pharmaceuticals. To date, tummy tuck surgery, also known as abdominoplasty, is the only solution that can achieve the dramatic improvement you desire.
Medical informationGet a Flatter Stomach and Contoured Waistline
How to get a flatter, firmer stomach and contoured waistline
- A tummy tuck is a cosmetic surgical procedure that removes excess fat and skin while correcting muscle separation, if necessary.
In the study, Measuring outcomes in plastic surgery: body image and quality of life in abdominoplasty patients, abdominoplasty patients experienced significant improvements in their body image and evaluations of their overall appearance.
Abdominoplasty enables you to
- Banish the “muffin top”, so you can feel confident wearing pants without worrying about undesirable bulging.
- Revamp your wardrobe, doing away with clothes that camouflage your figure. Instead, you’ll be able to wear a wider range of clothing, including form-fitting tops, pants and dresses to show off your improved body contour.
- Eliminate saggy skin that diminishes the desirable effects of your massive weight loss.
- Feel much better about yourself, because you know you look good.
- Have the flatter, firmer stomach you had before pregnancy.
- Create a cinched-in waist that gives you an hourglass figure.
No matter how much you go to the gym or you try to modify your diet, there’s only so much the gym can do. You reach a point where you're at a plateau and this is where you need help.
The Edelstein Cosmetic difference
We have developed an abdominoplasty technique for patients who qualify that is less invasive and for which the incision is dramatically shortened, allowing optimal results to appear more quickly. Known as floating abdominoplasty, or FAB, You’ll also be able to experience all the benefits of a tummy tuck but with a scar that doesn’t extend from hip bone to hip bone as it usually does, and doesn’t require an incision around the belly button. Rather, the incision will be far shorter and less visible.
We use an “invisible suture technique” for the long tummy tuck incision, which means that all the suturing is internal. You won’t see any stitches and you won’t have to come back to get them removed, either, as they are dissolvable. In addition, we do not use staples. Staples used in cosmetic surgery are typically made from some type of metal, often stainless steel, and are used by some surgeons to close incisions because it is faster than applying sutures. Unfortunately, while your actual surgery time may be shorter, you’ll be left with a less than ideal result. Your scarring will be uneven and more visible—kind of like train tracks with extra puncture holes on either side of the incision line where the staples enter the skin. Plus, you’ll have to schedule yet another appointment in a week or so to get your staples removed. Several studies suggest that there is a higher chance you’ll experience significantly more pain when your incisions are closed with staples rather than sutures. Sutures achieve a superior aesthetic result than staples.
The use of the advanced progressive tension suture (PTS) approach has made tummy tucks an even better option for qualified patients who are unhappy with their appearance. Our surgeons leverage their extensive knowledge of traditional abdominoplasty with experience in cutting-edge surgical techniques to make the procedure safer and easier to recover from than ever before with the no drain method.
PTS has helped resolve one of the lingering problems associated with recovery: the use of surgical drains. After the traditional form of abdominoplasty is complete, patients are typically fitted with small, thin tubes that pass through the skin. For about one to two weeks following surgery, these tubes are used to drain any of the excess fluid that accumulates in the potential space between the skin / fat and the muscle left behind by the surgery and ensures a safe, speedy recovery. Without drains, the fluid that naturally collects in the wound can stop the underlying fat and muscle tissues from coming together and properly healing. The use of drains can lead to certain problems, though. Patients often report irritation and discomfort with the drain itself, annoyance regarding limitations on movement, and the need to empty the drains two to three times per day. Drains also carry the risk of creating infections, making unnecessary scars, and can also technically malfunction.
A drainless tummy tuck, or drain-free abdominoplasty, avoids these problems by using the progressive tension suture technique. The first part of surgery remains the same: creating a horizontal abdominal incision, strengthening the weakened or separated internal muscles, removing excess skin, liposuction and repositioning the remaining tissue. Then, PTS bypasses what would usually be the next step: placing drainage tubes. At this point in the procedure, we instead administer a series of carefully placed stitches that close the cavity usually left open and tended with drains. These tissues are then able to heal without any significant amount of fluid accumulation interfering with the process.
While using PTS to create a drainless tummy tuck may take the surgeon slightly longer to perform, the benefits of the approach are well worth it. Not having drains in place makes the recovery process more comfortable, cost effective, and less painful. There is also a greatly lessened risk of infection, additional scarring, and healing complications. When PTS is used, the tummy tuck heals more quickly and recovery isn’t as difficult for the patient. Progressive tension sutures: a technique to reduce local complications in abdominoplasty, a study published in the Plastic Reconstructive Surgery medical journal has firmly established that the PTS approach offers ” a very effective and satisfactory procedure” that decreases complications and speeds recovery.
There is no additional fee for liposuction accompanying abdominoplasty in the abdominal area. This is because we believe that lipoabdominoplasty is a superior technique to traditional abdominoplasty for the appropriate patients.
The surgical skill of our surgeons is admired internationally; patients have come to us from not just across Canada, but also the Caribbean, Europe and the Middle East. Our patients also include celebrities and socialites.
96% of the men and women who had a tummy tuck voted that the procedure was worth it on the popular consumer website Realself.com.
Full tummy tuck
When it comes to a full tummy tuck, it’s all about abdominal wall deformities. Abdominal wall deformities consist of three components:
- The presence of wrinkly or loose skin with stretch marks. Most patients suffer from these issues as they age, following pregnancy or after rapid weight loss.
- Excess fatty tissue. This accumulated tissue is usually most prominent in the lower abdomen and the “love handles”.
- Rectus muscle diastasis. This condition results from the separation of the anterior abdominal muscles. Patients affected by rectus muscle diastasis cannot improve the condition with exercise because once the abdominal muscles have relaxed and separated, the stomach will continue to noticeably bulge.
A full tummy tuck works to address all three components, treating conditions related to the skin, fat and stomach muscles. The procedure repairs weakened abdominal muscles while also removing excessive skin/fat through tightening, surgical removal and, often, liposuction. Patients frequently lose a number of inches from their waist size as well.
There are a number of significant advantages to undergoing a full tummy tuck. The primary benefits come from resolving the persistent components of abdominal wall deformity discussed above. A full tummy tuck leads to the permanent removal of stretch marks and excessive lower abdominal skin. Barring the patient gaining a significant amount of weight or giving birth to a child, the treatment also leads to permanent tightening of the abdominal wall, an improved waistline and improvement of the belly button’s contour.
The main disadvantage associated with treatment is the presence of an extended horizontal scar (as well as a small scar around the navel). Though tummy tuck scars fade dramatically with time, patients who have undergone a full tummy tuck will have a permanent scar along their lower abdomen.
Mini tummy tuck
A mini tummy tuck or partial abdominoplasty is best suited for those who cannot reduce the bulging beneath their navels or who have stretched, lax skin. Stubborn bulging in the lower abdomen is usually the result of weakened and stretched muscles from fluctuating weight, pregnancy and aging. This is for a male or female who has a slim midsection and only desires to change the shape of their tummy by reducing a limited amount of bulging or saggy skin.
Floating abdominoplasty or FAB
The FAB procedure is an excellent choice for those who have remained in adequate shape but struggle with their tummies and want to take the extra step towards enhancing their physical beauty.
Anyone with significant stretching and weakness of their abdominal muscles after one or more pregnancies is a good candidate. If there is a moderate amount of excess skin and fat, but with little to no stretch marks, the FAB procedure is a great option. This new technique would remove the extra skin and fat through an incision slightly longer than that of a C-section.
The ever expanding field of cosmetic surgery now offers a procedure that uses the techniques of the classic tummy tuck and liposuction of the abdomen referred to as lipoabdominoplasty. This combination can now be effectively performed without the unfortunate complications that tended to go hand and hand with the original tummy tuck operation, such as tissue loss and bleeding.
There are multiple benefits associated with lipoabdominoplasty including a better end result that compliments the silhouette with more fat removal, closure of the musculature, and less loose skin. It is all done safely alongside liposuction with a shorter recovery period.
In a study performed by JR Kanjoor, AK Singh published in the Indian Journal of Plastic Surgery, the results of a group of patients who underwent the lipoabdominoplasty procedure were documented. The average patient age was 43 with the youngest being 29 and the oldest 72. Out of the group, 94% were of normal weight. An astounding 94% of the patients achieved satisfactory results from surgery. As a result, it was determined that tummy tuck with liposuction (specifically liposuction combined with a limited dissection method in typical abdominoplasty) consistently yielded safe, reliable and positive aesthetic results, including a faster recovery with fewer complications.
The benefits of choosing a lipoabdominoplasty over a traditional abdominoplasty are vast and varied and include:
- Better shaping of the abdomen: combining liposuction with a tummy tuck can achieve a more uniform contour of the treated area.
- Less postoperative complications: precise surgical technique allows for the preservation of at least 80% of the abdominal wall’s blood supply due to fewer blood vessels affected, and the majority of lymphatic vessels are also preserved.
- Reduced chance of postoperative numbness: less trauma to the targeted area and less disruption in blood supply mean that the risk of numbness is reduced.
- Smaller scar: while abdominoplasty alone tends to require a large incision, the length of the scar can often be shortened to some degree by applying liposuction. Liposuction only requires an incision just large enough for a cannula, typically just a few millimetres in length. Through this incision the removal of fat is possible without more extensive incisions, minimizing scarring.
- Minimal bruising, pain and swelling with an overall quicker recovery time.
Diastasis recti: abdominal muscle separation
Diastasis recti is a condition that is common in women who have had one or more pregnancies. It involves the separation of the left and right side of the rectus abdominis muscle (a muscle that covers the front surface of the stomach area).
The growth of a uterus during pregnancy creates so much pressure on the internal abdomen that the rectus muscles stretch, migrating outwards and separating in the centre. Often, women who have been pregnant multiple times will develop diastasis recti due to repeated stretching of these muscles.
The condition is characterized by a ridge-like presence that runs from the bottom of the breastbone to the middle of the stomach area (near the belly button), and can continue down towards the pubic area. It increases with muscle strain (for example, during a crunch) and is evident around the navel (umbilicus) or the area above. The width of muscle separation is usually between two to five centimetres and can be felt while lying flat.
Although diastasis recti is usually described as muscle separation, the main issue involves a tough band of tissue, called fascia, that holds the muscles together. This tissue, when stretched, is similar to garbage bag material, that is, it can shrink back a little, but is usually permanently stretched. This is the reason that even if you do a tremendous amount of abdominal exercises, you will not get rid of diastasis recti. The problem really involves the fascia, not the actual muscle.
Diastasis recti is thought to be the result of the accumulated effects of maternal hormones (which relax the abdominal muscles and soften connective tissues) and the repeated, biomechanical abdominal wall stretching that occurs during pregnancy. It has also been linked to dramatic weight gain.
Up to 60 percent of all pregnant women experience some extent of muscle separation in their third trimester or in the immediate postpartum period. This is natural and usually resolves itself spontaneously. The permanent form of diastasis is far less frequent (affecting 10 to 15 percent of women) and is usually found in women who have been pregnant three or more times or have carried larger babies.
Women who are older than 25, have a multiple pregnancy, repeated pregnancies or deliver a baby with a high birth weight are more likely to develop diastasis recti. Aggressive abdominal exercise during the first trimester may also contribute to its development.
All of the abdominal muscles are connected (in the fibrous midline), meaning that the widening that occurs with diastasis recti can lead to diminished core strength and a reduction in overall muscle performance. Many women are most concerned with the interference it plays in regaining pre-pregnancy stomach muscle tone. Despite performing daily core strengthening exercises (eg. sit-ups and planks), diastasis recti does prevent muscle improvement. The weakened abdominal wall also tends to noticeably bulge. In extreme cases a pseudohernia may develop, most noticeable by the abdominal contents becoming visible through a significant protrusion during sit-ups.
Aside from the toll diastasis recti may take on a patient’s appearance and self-esteem, the condition can also lead to physical problems. Without surgical repositioning and tightening, diastasis recti can lead to the formation of hernias, impaired posture, lower back pain and stomach protrusion.
A tummy tuck corrects diastasis recti
If diastasis is present, we use permanent stitches to bring the muscles back together, returning the muscles to their proper anatomic location so that they are able to function in their most biomechanically correct position. If the abdominal wall remains lax after the muscles have been stitched, we tighten the lateral aspects of the wall using corset sutures—a technique that also reduces the patient’s waist size and improves body definition.
Eliminating stretchmarks with a tummy tuck
Stretch marks are a common problem that many think are impossible to resolve. Many patients ask us how to remove stretch marks that negatively affect their body. Fortunately, tummy tucks can drastically reduce the appearance of some stretch marks.
The location of the stretch marks (also known as striae) and the patient’s individual circumstance dictate whether or not a tummy tuck is an appropriate procedure for their treatment. If the stretch marks are localized in the area of the skin that will be treated during the tummy tuck, they will be entirely removed. Stretch marks that are present outside of the area to be removed will be stretched further in the direction they’re oriented.
When a patient’s stretch marks are located on the lower part of the stomach (below and directly above the belly button) a tummy tuck can be performed to minimize or eliminate them. The procedure removes the skin from this area and, as a part of the surgery, removes the stretch marks as well. The most difficult location to treat is above the belly button and on the patient’s sides, above the hips. Although a tummy tuck will not remove stretch marks in this area or on a patient’s middle to upper abdomen, the procedure can shift them lower.
Full tummy tucks involve the creation of an incision that runs from hip to hip. Any stretch marks located in this area can be removed.
Stretch marks that are present on loose skin tend to have a raised appearance. This, along with their tendency to vary in colour, makes them more noticeable. Tummy tucks that stretch the striae along their longer axis are helpful in these cases. This type of stretching generally camouflages the marks to a much greater extent than they would in other cases. Generally, striae can be pulled and stretched in order to reduce their appearance. White stretch mark removal: This is most beneficial in treating those that are white in colour.
Women who have developed stretch marks and extra skin on the sides of their abdomen and/or on their back following pregnancy and massive weight loss will benefit from a more extensive body lift procedure than a basic tummy tuck.
Aside from tummy tucks, any other form of surgery that excises skin afflicted with stretch marks may also lead to improvement. Stretch mark sufferers should discuss their condition and intended results with us in order to best determine whether or not a surgical stretch mark removal procedure will help them remove stretch marks and achieve their skin improvement goals.
Shed the muffin top and the embarrassment that comes with it. Call (416) 256-5614 to book your professional medical consultation with us for abdominoplasty.
Are you a candidate?
Understanding your goals is very important to achieving a customized procedure, which is why our board certified plastic surgeons will take the time during your consultation to find out what your expectations are and answer all your questions and concerns about a tummy tuck.
A tummy tuck is designed for men and women who are seeking improvement, rather than perfection, in their appearance. You may be a good candidate for the procedure if you’re physically healthy and emotionally stable.
If you are a woman who’s just had a baby, it’s important to wait for at least six months after giving birth before scheduling a tummy tuck. During this time, you can improve the results of their surgery by working toward returning to their ideal body weight.
Women who may wish to have more children in the future should not undergo a tummy tuck. The benefits of the procedure can be maintained after further pregnancies, but the same bodily changes that caused an altered appearance in the first place may return in many cases. For this reason it’s a good idea to delay undergoing a tummy tuck until you no longer plans to have any more children.
Tummy tucks also require a period of recovery wherein you won’t be able to lift anything heavy (including children) for approximately two to three weeks following the procedure.
A tummy tuck, just like every surgical procedure, is associated with certain risks and complications. These are, for the most part, specific to individuals and can vary drastically. The potential side effects of a tummy tuck may include swelling, scarring, numbness, bruising and discomfort.
Some patients may experience complications due to problems that occur during the procedure or while recovering. Along with unexpected anaesthetic reactions, these rare dangers of a tummy tuck include the following:
Infection: Patients are given antibiotics during surgery and a prescription for antibiotics that is to be taken after treatment. These work to reduce the chance of developing an infection.
Haematoma: A haematoma involves bleeding under the skin. This condition may require surgery to correct. If blood cannot be adequately drained from the area affected by the haematoma, excessive bleeding may need to be treated through a blood transfusion or surgery. The most common form of haematoma is far less severe, however. The problem is usually treated through aspiration or the placement of a drain that targets the localized blood collection.
The risk of developing a haematoma is minimized when you follow pre- and post-operation instructions. Avoid taking any blood thinners (aspirin, anti-inflammatories or vitamin E) in the time before and after surgery.
Seroma: A seroma is a collection of fluid around the operational site. Patients who develop a seroma can be easily treated through a routine draining procedure.
Numbness and skin irritation: Numbness is usually very noticeable immediately after surgery, especially below the belly button in the midline. Over time, however, enough feeling returns that patients don’t pay attention to it any longer. This usually takes somewhere between three to eight months. Be careful when applying heat to numb areas, as even the minimal heat of a hot water bottle may damage or burn the skin if not carefully used.
Unusually red or raised scars: Unusually red or raised scarring can take several months to fade. In other cases, bad scarring or the formation of keloid or hypertrophic scars can occur. This is usually the fault of a genetic predisposition towards improper scarring, something that can affect patients of all skin colours (and not just those of darker skin as previously believed).
Blood clots: Blood clots (deep vein thrombosis or cardiac and pulmonary complications) can result from lengthy surgeries where the patient is immobilized. The main concern associated with the formation of (or increase in) blood clots in the veins of the legs is their ability to travel to other parts of the body. Blood clots that travel to the lungs, for example, can cause pulmonary embolism—a life threatening and, in some cases, fatal condition.
We commonly use compression stockings on the legs, and a very small dose of a blood thinner immediately before surgery, to help prevent clotting. The risk of developing blood clots can be reduced by moving as soon as possible after the surgery is complete.
Patients are also urged to discuss their medical history with us. Any history of blood clots, swollen legs or the use of estrogen or birth control pills can contribute to blood clotting and must be disclosed during your consultation. Patients who experience an irregular heartbeat, chest pain or shortness of breath after treatment should immediately contact their physician and receive medical attention. In some cases, additional procedures and hospitalization may be required.
Fat necrosis: During the body’s recovery process some of the deeper skin fat may die while other tissue heals. While fat necrosis is usually benign, patients who notice irregular body contours or areas of unusual firmness should contact us.
The chance of developing any of these complications is usually less than five to eight percent.
The consultation process is extremely important toward ensuring a successful tummy tuck. Patients should be prepared to discuss their complete medical history, sharing information on the medications they take and any medical conditions they may have. During the consultation with your surgeon, the price for a tummy tuck will also be discussed.
Please note that the decision to take either a traditional or drainless approach to the abdominoplasty is made by your surgeon during your consultation. Not everyone is a candidate for it. For example, thinner patients may benefit more from the use of drains than others. When progressive tension sutures are used, thinner patients are at a higher risk for developing permanently dimpled skin due to the stitching technique inherent to the no drain approach. Consequently, it is necessary for every patient to be carefully assessed during their consultation. We will always ensure that you receive the safest and most convenient form of abdominoplasty by performing a careful examination and planning a surgical approach based on your unique physiology. Whether this entails a drainless or traditional tummy tuck depends on factors inherent to your body.
Four weeks before surgery: Cigarettes, cigars, tobacco chew, and pipes should all be avoided from this period onward. Nicotine use interferes with circulation and puts patients at higher risk of experiencing complications during tummy tuck recovery or while receiving anaesthesia.
Three weeks before surgery: Any of the pre-operative tests that your surgeon has scheduled (usually EKG and/or laboratory testing) should be taken. The results of these tests must be sent to Edelstein Cosmetic at least one full week before surgery. If these tests reveal the patient may be pregnant, the tummy tuck must be cancelled.
During this period of time patients should reduce their salt intake. Since it leads to swelling and bloating, consuming too much salt can lead to unnecessary post-operative swelling. Water consumption should be increased at this time as well. Drinking more water flushes out toxins, helping prepare the body to heal and ward off illness during the recovery period.
Two weeks before surgery: All alcohol (even a single drink) must be avoided from this point onward as well. Alcohol decreases the strength of the immune system and increases the risk of post-operative infection. It can also increase the risk of bleeding. Aspirin and ibuprofen products also cannot be taken starting two weeks prior to the tummy tuck. Because these medications are blood thinners, they can lead to surgical complications like excess bleeding and recovery problems such as incision wounds healing too slowly due to blood that cannot clot. Tylenol has a different formulation and may be taken safely.
Vitamins should be taken to help encourage healing processes. Multivitamins containing iron, minerals and vitamin C/E are advised. It’s important not to take “extra” vitamin E.
One week before surgery: Patients should continue to refrain from nicotine, alcohol and ibuprofen products. All laboratory test results and blood work must be sent to Edelstein Cosmetic by this point as well.
The day before surgery: Fasting is required in order to guarantee a safe surgery and effective anaesthesia. Patients must not eat or drink (including water or gum) after midnight. If regular medication must be taken it can be swallowed with a small sip of water on the morning of the appointment.
The day of surgery: Patients may shower and shampoo their hair on the morning of surgery, but must not wear make-up or use hair sprays/gels or nail polish. Acrylic nails can stay on while other jewelry should not be worn or brought to the appointment. Tampons cannot be worn (a feminine napkin can be used instead), and patients should dress in loose-fitting clothes.
By the day of surgery all post-operative arrangements (planning a ride home, scheduling for help around the house for the first 24 hours, and grocery shopping) should be made and confirmed.
General or local anesthetic will be administered.
What happens during your surgery depends on the type of tummy tuck performed.
Full tummy tuck
You surgeon will first outline the area of the body where skin and fat are to be removed. A horizontal incision, just above the pubic hairline, is then made in order to allow for the removal of unwanted tissue and skin. Consideration is paid to creating an area of skin (above the operational area) that can be pulled down and sutured closed at the end of the procedure. The shape and length of this incision is determined by the degree of correction required. A second incision, located around the navel, is made in order to be able to remove the excess skin and close the incision.
Excess fat above the belly button is removed with liposuction while the skin and fat from the belly button to pubic area is removed by excision. We then place permanent, internal stitches that tighten loose fascia/muscle (by up to five inches) from the rib cage to the pubic bone.
The upper adnominal skin and remaining fat from above the surgical site are then pulled down. We close the lower abdominal incisions with absorbable, internal stitches without having to place external stitches. After the procedure is complete, the patient’s belly button will be oriented vertically to give it a more youthful appearance.
Mini tummy tuck
The mini tummy tuck is not as complicated or as invasive as a full tuck. You can consider this a small tummy tuck, because rather than cutting around the navel and then again across the lower abdomen, a much smaller incision that does not require detachment of the belly button is made instead. The rectus muscles, better known as the ‘six pack’, are tightened with permanent sutures and the extra skin, tissue and fat are removed through the incision. To remove excess fat, liposuction is frequently used to achieve the desired result. Finally, sutures are placed to close the incision and drains may be inserted in the area to aid in the prevention of fluid retention.
Although the belly button is not surgically targeted at all, its appearance is often improved because the skin is pulled downward to make it taut, thereby creating a more pleasing shape.
Floating abdominoplasty or FAB
Using a small incision in the lower abdomen, this new tummy tuck surgery technique allows the tummy to be tightened and shaped with optimal results. Also referred to as an extended mini abdominoplasty, this procedure is an excellent option without the telltale signs as there is no incision around the belly button. Excess skin is removed through the incision; the belly button is temporarily detached and ‘floats’ above the muscles. This allows the muscles to become tightened and reshaped from sternum to pubic area, that is, along the entire length of the abdomen, as opposed to a typical mini tummy tuck where the muscles are only tightened below the belly button. The skin on the abdomen is then made smooth and firm, and the belly button is reattached from the inside with the option of moving it down one or two cm if necessary. To sculpt to an even greater degree, liposuction is performed, resulting in beautiful tight abs with a scar that is minimal and discreet.
Following your surgery
When you awake from your surgery you will be in the recovery room. Your incision will be well hidden in the low bikini line and groin. You will have your support garment on, and if one or two drains have been placed, they will be exiting from the pubic area. You may feel some incisional pain and discomfort, but this is generally well controlled by pain medications.
If you are not staying overnight, you will be able to go home when you have fully recovered from the sedation.
The greatest discomfort you will experience during recovery will be within the first 24 to 48 hours following surgery. This can be alleviated by taking your prescribed pain medication. To avoid nausea, take this medication with liquids, crackers, soup or toast. Constipation is a common side effect of pain medication, but over the counter stool softeners (like Docusate or Colace) will help to relieve the problem or stop it from developing.
Immediately after surgery, your skin will feel tight. For the first two to three days, you are encouraged to walk slightly bent forward to avoid pulling on the incision line, and to put pillows under your knees and your head when you’re reclining so you’re bent at the waist. You can also sleep on your side in a slight ‘fetal’ position (i.e. bent at the waist). You may find it difficult to rise from a lying position and it will be easier to turn on your side, allow your legs to hang over the side and slowly use your arms to raise yourself to a sitting position before rising. Avoid sitting up in a chair for the first week.
Hot or cold water bottles/compresses should not be used during recovery unless recommended by your surgeon. Because the tummy tuck temporarily minimizes your ability to properly sense or feel your abdomen, applying hot or cold to the treatment site can lead to frostbite or burns without you noticing.
On the third day after your surgery, you can take a shower (e.g. if your surgery was on a Thursday, you can shower on Sunday). Do not sit in a bath.
When taking a shower, remove the support garment and underlying dressing. The small white tapes (called steri-strips) over your incision should be left on.
You will need to hold the drains in your hand while you shower. You can wet and soap the tapes and your incision. Use mild soap such as Dove or Ivory. Pat yourself dry using a towel (do not rub) and put the dressing pad and support garment back on. This daily routine will help keep the incision and drain sites clean, and will promote wound healing.
Taking a bath will only be possible once the drains are out, the sutures around your belly button are out and the incisions are well on their way to being healed (approximately two weeks).
You must also wait until the incisions have had a chance to begin properly healing (approximately two weeks) before taking a bath. Swimming pools and whirlpools must also be avoided for at least one month.
Drains are used to remove any excess fluid or blood, preventing accumulations under the skin that would promote swelling after tummy tuck surgery. They are used for some patients. Both drains are usually removed within two weeks. Occasionally, they need to be left in longer.
Before you are discharged home, the nurse will show you how to empty your drains, but here are a few reminders:
- Remove the cap. Hold the bulb upright and measure the amount of blood and fluid in the bulb by reading the measurement levels. Record the amount for each drain.
- Turn the bulb upside down and squeeze out the blood and fluid into a garbage, toilet, or sink.
Turn the bulb upright again, squeeze the bulb so it crumples and expels all the air, then while holding it tightly squeezed replace the cap. Release the bulb, it should stay collapsed. (The bulb should not quickly re-expand or there is an air-leak)
- Measure and empty your drains two to three times per day. You may have to do this more often if the bulb becomes full quickly.
- Record the Drainage in following format:
DRAIN SITE AMOUNT (in cc’s)
Your compression garment
Your support garment should be worn day and night for three weeks, removing it only to shower or wash the garment. From three to six weeks, the garment should be worn during the day, but you can take it off at night. The garment must cover the incision.
There are three main reasons why a compression garment is used to help the body after surgery:
- Fluid absorption: The pressure of the compression garment helps control swelling, bruising and discomfort while the body heals from the effects of a tummy tuck. This pressure works to shift fluid balances in the affected area, “pushing” the fluid out of the tissues and encouraging the body to absorb them naturally. When the body is able to properly absorb these fluids, the bruising and swelling that is common to the recovery process is sped up.
- Scar healing: Compression garments also work to promote scar healing. The pressure applied by the garment works to provide patients with a smoother and more attractive scar while also minimizing the chance of developing keloid or hypertrophic scars. Compression garments are so effective in controlling scarring that they are also used in the treatment of burn patients (where they are worn for an entire year). Though the scarring that results from a tummy tuck is nowhere near as severe as those caused by burns, the application of a compression garment still works to help maximize healing and minimize problematic or unsightly scarring for abdominoplasty patients.
- Skin conforming: The pressure applied by a compression garment helps to conform the skin to its new position. Properly conformed skin helps patients to achieve a more aesthetically pleasing result.
Aside from the healing effects provided by compression garments, patients may also enjoy weight control benefits. Since abdominoplasty doesn’t replace healthy eating and exercise, it is important to maintain an ideal weight after the surgery. Surprisingly, compression garments help patients to feel fuller (because of the pressure around the stomach).
Either a binder or girdle compression garment recommended by your surgeon works well. As long as the garment puts pressure on the operating area it will help to provide the benefits listed above in recovery following tummy tuck.
Going back to work and exercising
You should plan to be off work for two to three weeks. During that time, you should take it easy; a little stroll as your tummy tuck exercises is okay but not much more. We encourage you not to spend all your time in bed. This will minimize the risk of deep clots in your leg veins.
Avoid straining, lifting, and bending completely over. You may be able to begin cardio type physical activity at three to four weeks. Strenuous physical activity (like lifting weights, abdominal crunches) is not permitted until six weeks after surgery.
Full recovery can take several weeks or months, but you’ll heal faster if you originally had strong abdominal muscles. Exercise expedites healing by toning muscles, reducing swelling and minimizing the potential for blood clots forming.
Caring for your incisions
Most of the sutures that are used in the procedure are dissolvable. These are typically woven under the skin in order to avoid the development of “stitch marks.” Some of the sutures placed around the belly button are non-dissolvable, though, and must be removed two weeks after the surgery. You must not remove the white tape placed over the incisions (steri-strips) until it has begun to peel around the edges. Once this has occurred and the tape has been removed the incision site can heal on its own, without requiring any further dressing.
At this point, you can begin using a silicone scar cream such as Dermatix.
Dermatrix Silicone Gel is a transparent, self-drying gel that can be used after your tummy tuck scar(s) has fully healed and all surgical tape and/or bandaging has been removed. The gel is applied to the scar(s) daily and works to smooth, flatten and relieve itchiness of the incision lines. 76% of dermatologists rated the efficacy of Dermatrix as good to very good in a European case study. These physicians rated Dermatrix on its ability to reduce scar elevation, elasticity, itchiness, pain and redness. Dermatrix is effective in treating either new or mature scars.
We may also recommend the use of Retouch® Silicone Sheeting for Scars in order to improve and speed healing. Retouch® Silicone Sheets are adhesive, come in standard shapes (e.g. for tummy tucks or breast reductions), or can be cut to suit any shape and naturally conform to the contours of the affected areas of the body. They help by flattening and decreasing the visibility of your scars. Silicone sheets can be reused for months. They work on older scars and provide permanent results.
Avoid direct sunlight to the incision line as this may result in pigmentation changes. This is particularly true during the first year after the surgery. Never expose the incision to sunlight without sunblock. Always use SPF 30 or greater.
Scars will initially be red and a little raised, but over three to six months, they usually get lighter in colour and flatten out. They may appear to get worse before they get better.
Patients who have realistic expectations will be pleased with the results. To get the most out of your treatment, it’s important to preserve your results with a healthy diet and regular exercise.
Keeping fit after your tummy tuck
In order to maintain the results of a tummy tuck and for overall health, patients must be willing to work at controlling their weight. Once your surgeon has given the go ahead to begin exercising again, specific activities and nutritional guidelines can help to make the benefits of the procedure last well into the future.
The food you eat
Despite differing opinions on what constitutes the best possible weight maintenance regimen, all dieticians agree that a balanced diet can be achieved by dividing various foods into two distinct groups. These groups include important, everyday foods and others that should only be eaten occasionally. For example, everyday foods include whole grains, low-fat but high protein sources (e.g. eggs), vegetables and legumes. Vitamins and nutrients are abundant in vegetables (preferably fresh or steamed to preserve their dietary benefits), and because they’re low in calories and will keep you feeling satiated for a longer time, feel free to load up your plate with them.
Foods you should eat only occasionally include refined sugar and refined white flour. In fact, other than to perhaps satisfy a craving now and then, it’s probably better not to eat these at all as they facilitate weight gain (and can reverse the results of your tummy tuck).
While the minimum number of calories a person needs to healthily function varies depending on such factors as age, weight and lifestyle, the average person should aim to eat anywhere from 1600-2400 calories per day. Please speak to your doctor to find out what your ideal daily caloric intake is.
The physical activities you do
After your tummy tuck surgery, the goal of your exercise routine should be to maintain a healthy lifestyle, and this includes remaining physically active through exercises that promote cardiovascular fitness and the improvement of muscle tone.
Exercises tailored toward cardiovascular fitness include running, cycling and aerobics. Start off at a very easy pace after your surgeon gives you the green light to hit the gym. Increase intensity slowly with each session.
For strength training, it is imperative that you keep any abdominal exercises to a reasonable amount. Although many patients believe that these exercises will help keep their stomachs flat and firm, it can actually cause the opposite to occur. Over exerting abdominal muscles that have been treated during a tummy tuck can cause them to stretch apart, as they were before surgery. Perform any abdominal exercises with this in mind. For this reason, the majority of your workout routine should be “cardio”.
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