Tummy tuck (abdominoplasty) is an aesthetic, surgical procedure aimed at removing skin and muscle laxity in the abdomen, which occurs due to factors such as post-pregnancy, weight loss, and aging.
More relaxation of the abdominal wall is expected in multiple pregnancies. All causes aside, genetic predisposition determines the rate of deformation.
Abdominal stretching surgeries have started to be combined with liposuction in recent years. Removing the subcutaneous adipose tissue alone may not create sufficient indentation or curvature in the lumbar region. Additional liposuction, especially in the lateral areas, both reduces the formation of potholes at the end of the incision and optimizes the aesthetic appearance.
Before the operation, skin elasticity (resilience decreases with age), laxity of the abdominal muscles and the degree of diastasis (separation), the presence of striae (vertical skin cracks that occur mostly during pregnancy), the amount of subcutaneous adipose tissue and their localization are evaluated. Again, the patient’s smoking and aspirin use are factors that directly affect the surgical plan. It is preferred by many surgeons, including myself, to quit smoking at least one month before and not to have surgery if this cannot be done. Advanced age can increase the risk of surgery. Further investigations should be performed in patients with coagulation or bleeding problems. Additional procedures such as thigh stretching or butt lift can be added to the tummy tuck after excessive weight loss.
The surgery takes about 3 hours. Liposuction or additional procedures prolong this period. Depending on the size of the incision, we can divide tummy tuck into three main categories:
mini tummy tuck (mini abdominoplasty): involves removing skin only from the lower part without changing the location of the belly button. It is applied in mild skin, subcutaneous excess. Additional muscle tightening can be done.
full tummy tuck (full abdominoplasty): It is the most frequently applied method. It is preferred in moderate skin, subcutaneous and muscle laxity. It is necessary to re-create the belly button. Muscle separation is interfered with and diastasis is repaired.
circumferential tummy tuck (belt abdominoplasty): It is preferred in the repair of severe sagging and loose abdominal wall. The scar formed after the operation turns all around the waist region. The formation of potholes at the end of the incision in the abdomen with severe sagging makes the patient extremely uncomfortable and the result to be obtained is not aesthetically satisfactory. For this reason, it is preferred to all-around scars, potency and insufficient aesthetic appearance. It is mostly preferred after bariatric surgery.
panniculectomy: only the skin and subcutaneous tissue that causes sagging in the abdomen is amputated. Aesthetic appearance is of secondary importance. The aim is to reduce the burden of the patient so that he can move more easily. It is applied by keeping expectations low in case of advanced sagging that cannot withstand a long operation time.
The drain is usually placed and removed when it falls below 30 cc (3 to 5 days). Frequently, subcutaneous sutures are made. The navel and security stitches are removed on the 7th day. The corset, which will be used for about 1 month, is put on immediately at the end of the surgery. This both reduces tension pain and accelerates subcutaneous adhesion. Bending the knees while lying down and placing a few pillows under them will reduce tension pain.
Although rare, complications such as seroma (subcutaneous fluid accumulation), hematoma (subcutaneous hemorrhage), infection, potholes at the end of the incision, asymmetry, wound dehiscence, swelling in the wound (hypertrophic scar), fat necrosis can be seen after the surgery, albeit rare.
The scar that will form after tummy tuck surgery will remain under the underwear. If weight is not regained, the success of the surgery will be long-term.
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