Everything You Wanted to Know About Tummy Tucks …& Didn’t Know to Ask!
Did you know?
The first tummy tuck was called a dermolipectomy and it was performed in 1890 by doctors Demars and Marx in France.
The first abdominoplasty in the United States took place at John’s Hopkins in Baltimore, Maryland. A gynecologic surgeon named Kelly called the procedure a transverse abdominal lipectomy, but the transverse (horizontal) nature of the incisions followed by the complete removal of the abdominal pannus caused the patient to lose their belly button (YIKES). By 1905 back in France, doctors succeeded in the first abdominal lipectomy that preserved the belly button (YEAH). In 1909, a doctor Weinhold in Germany made use of vertical and horizontal flap incisions to completely avoid removal of the belly button during the tummy tuck procedure.
Today, the modern tummy tuck utilizes scars as low as possible, removes poor c-section scars (sometimes tattoos!), tightens the abdominal muscles, removes excess abdominal skin and places the belly button exactly where it should be.
More Good stuff to know:
- There is more than one tummy tuck procedure. A mini-tummy tuck focuses on the lower abdomen only to tighten loose skin and bulging below the bellow button. The standard procedure removes much more excess skin and tightens underlying muscles, from the ribs to the pubic area, while the extended tummy tuck targets loose skin around the back sides as well. Dr. Stagnone will help explain which procedure will be best for you following your exam.
- Your recovery from a tummy tuck will last several weeks. A tummy tuck is an extensive procedure that requires more recovery time than many other cosmetic surgeries, perhaps up to three weeks. (If you’ve had a C-section before, your recovery from a standard tummy tuck will probably be comparable.) Depending on the extent of the surgery you undergo, you may need assistance at home for up to five days. You’ll be on pain medication, possible a pain pump for a while and need to rest while your body recovers.
- A tummy tuck is not a weight loss measure. You should lose weight before a tummy tuck and be as close to your “ideal” weight as possible, and not rely on the surgery to resolve any long-standing weight loss issues. Additionally, if you’ve already lost a dramatic amount of weight—good for you!—you should postpone an abdominoplasty for six months to a year, to be sure your new weight is stable. More on BMI (body mass index to come).
- The results of a tummy tuck are technically permanent. This is good news! But to maintain your results over time, you should avoid big fluctuations in your weight. An encouraging January 2013 report from the American Society of Plastic Surgeons stated that many subjects in a post-abdominoplasty study sustained long-lasting weight loss after the procedure.
- Tummy tucks are for men, too. Though tummy tucks are popular with women who have had multiple pregnancies, they are also offered for those who have lost a significant amount of weight. Men can also suffer from loose muscles and sagging skin that aren’t improved by exercise or diet—it’s not just a girl thing!
Let’s Discuss BMI
- BMI is your Body Mass
- Q: Why is my BMI important:
- A: Elective surgery is recommended for people within a “healthy” BMI range for safety reasons.
- Q: What is a “normal” BMI?
- A: 18.5 – 24.9 is “healthy”, while 25 – 29.9 is overweight & 30 – 34.9 is considered obese
- Q: Can I have “safe” surgery with a higher BMI?
- A: Yes, under certain circumstances Dr. Stagnone may proceed & recommend surgery despite a high BMI , but only if it makes sense and your expectations are realistic.
- Click here for a BMI Calculator: http://www.mayoclinic.org/bmi-calculator/itt-20084938
What is a tummy tuck?
A tummy tuck, or abdominoplasty, removes excess fat and skin, and in most cases restores weakened or separated muscles, creating an abdominal profile that is smoother and firmer.
A flat and well-toned abdomen is something many of us strive for through exercise and weight control. Sometimes these methods cannot achieve our goals.
Even individuals of otherwise normal body weight and proportion can develop an abdomen that protrudes or is loose and sagging. The most common causes of this include:
- Significant fluctuations in weight
- Prior surgery
What a tummy tuck won’t do:
Tummy tucks are not a substitute for weight loss or an appropriate exercise program. They certainly don’t remove the “belly fat” deep inside your abdomen. Also, tummy tuck operations cannot correct all of your stretch marks. Most of those beneath your belly button can be removed, but the ones above it will still be there. (However, the good news is they’re usually a lot lighter after the skin is tightened up!)
A tummy tuck is usually done through a horizontal incision made low on the abdomen either in, or just above, the pubic region. If you already have a “C-section” scar it can typically be done through the same incision (and often improves the existing scar). The length and shape of the incision is based on your anatomy. The resulting scar can be very fine but is permanent, yet may be hidden under many swimsuits and undergarments (sometimes even teeny ones). A smaller second incision is made around the navel, so that excess skin in this area can be pulled downward and removed. The position of your navel will not be changed and a new opening will be made for your belly button with the standard or “full” version. The underlying muscles are also addressed, and are tightened by suturing the muscles together in the middle, flattening the abdominal wall and recontouring your tummy and waistline. The lower abdominal skin is removed (including stretch marks). Stretch marks on the upper abdomen (above the belly button) are less noticeable since they are now lower and more taut. The end result is a stomach that is firmer and flatter. The resulting scars, although permanent, will fade over time. Ask us about “scar therapy”.
I’m confused…which is the right kind of Tummy Tuck for me? It’s not one kind fits all!
The Traditional or Standard Tummy Tuck
The traditional tummy tuck is ideal for men and women who are in good physical health, and who have a sizable portion of loose skin to remove from their midsection. Oftentimes, traditional tummy tuck patients have recently lost a great deal of weight, or are women who have excess flab and/or weak abdominal muscles post pregnancy. Again, this procedure is for patients with damaged tissues who couldn’t reduce their tummy troubles through diet and exercise alone.
For the traditional tummy tuck, the surgical incision runs in a curved line between the hip bones. Because the standard tummy tuck involves a larger portion of skin being removed, the belly button must be correctly repositioned as one of the last steps. Since this procedure is a bit more extensive than the “true” mini or extended mini, traditional tummy tuck patients may require a bit more help from a caretaker following surgery . The average recovery time for traditional tummy tuck is from two weeks for return to sedentary work to 6 weeks for fully unrestricted activities and working out. Early on, stronger pain medication is provided to minimize unnecessary pain or discomfort. We also recommend a PAIN PUMP (more later) to help during those first few days.
“True” Mini Tummy Tuck
The baby of the bunch is the true mini tummy tuck, sometimes known as the “scarless” tummy tuck. At The Plastic Surgery Center of Dallas, we don’t do very many true “minis” since they are only a beneficial procedure for a small, small percentage of women. The true mini tummy tuck is used only to tighten the lower abdominal muscles (no skin removal, but maybe an improvement of your c-section scar); hence the small incision. The true mini tummy tuck is great for generally healthy, fit patients who want to be rid of that “pooch“ hampering their otherwise slender physique. It is NOT however “scarless”. The mini (or Extended Mini) tummy tuck also just tightens the muscles below the belly button but takes out enough skin to smooth out and tighten up BELOW the belly button. The longer the scar, the more skin can be tightened. Dr. Stagnone likes to draw the pattern on all of this patients so they can see how much skin needs to be removed to get the results they’re after! It is the perfect solution for women who need more than a mini-tummy tuck but do not need a full tummy tuck
Extended Tummy Tuck
For patients with a greater amount of loose, sagging skin on their abdomen, as well as on their hips and on the sides of their lower back, the extended tummy tuck is the most appropriate procedure choice. Extended tummy tuck patients also usually have excess fat in these body regions that need to be removed along with the extra skin. Many major weight-loss patients require an extended abdominoplasty to reduce the excess skin caused by extensive weight loss which is more extensive than the visual changes from pregnancy along.
In extended tummy tuck surgery, a longer incision is made in the abdominal area that reaches around the hips towards the lower back. Dr. Stagnone tightens muscles in the abdomen as well as removing any unnecessary loose skin before suturing the incision. Like with the traditional tummy tuck, the belly button must be repositioned to correspond with the patient’s newly transformed body shape. Daily activities that don’t require much physical exertion may often be resumed within a couple of weeks of surgery. Swelling may persist a little longer.
Let’s talk about Abdominoplasty and Weight Loss Patients (& possibly other body contouring procedures)
Body contouring after major weight loss improves the shape and tone of your underlying tissue and removes excess sagging fat and skin. Most women’s (men too) biggest concern is the excess, possibly hanging skin of the abdomen. If there are other areas of concern, they may be combined as a surgical procedure, or they may be staged in multiple surgeries for best results and safety. It is recommended to have the weight off and stable for about 12 months prior to seeking surgery. Surgical body contouring following major weight loss improves your shape and tone and removes excess sagging skin and often areas of underlying fat.
The result is a more normal appearance to the body, with smoother contours. This is, in essence, the final phase of your total weight loss experience.
Following weight reduction surgery, or any substantial amount of weight loss, the skin and tissues often lack elasticity and cannot conform to the reduced body size. As a result, skin that has been severely stretched now is unsupported:
- Upper arms may sag and appear loose and “wiggle” when you move
- Breasts may flatten and hang with nipples pointed downward
- Abdominal sagging may extend around the sides and into the lower back area, resulting in an apron-like overhang possibly requiring an extended tummy tuck
- Buttocks, groin and thighs can sag and cause hanging pockets of skin too
Ok, How Much is this Going to Cost?
As you’re learned, there are several variables to a tummy tuck. Your quote is based on the kind of tummy tuck needed, the size of the patient, and the calculated time for your procedure, etc. In addition to the surgical fee, you will have fees for operating room (read about our accredited OR later), anesthesia (we only use Board Certified MD Anesthiogists), compression garments, post-operative prescriptions and possibly pre-operative lab work. At The Plastic Surgery Center of Dallas, we try to remain highly competitive with our neighboring surgeons, while offering you the benefit of Dr. Stagnone’s creative talents and experience of over 22 years. Tummy tucks are one of the top 4 procedures he performs! In any artistic endeavor, whether it is sculpting, painting, photography, composing, or architecture, it is often the incorporation of subtle details, along with a fresh perspective and creative interpretation which distinguishes work that is ordinary from that which is exceptional. Plastic surgery is unique among surgical specialties in that it blends both science and art, revealing a surgeon’s knowledge of operative techniques and his own unique style and vision of the desired result translated to the body.
- A Standard Tummy Tuck (the majority of the tummy tucks preformed) is typically in the range of $7500 – $9000
- A “True” Mini Tummy Tuck is less than a standard, typically closer to $4500 – $5000 range
- A Mini or Extended Mini runs $5500 – $6500 range
- An Extended Tummy Tuck (has the most variables) will typically be – $10,000 +
Do you take payments?
We are pleased to offer financing through Care Credit (including 6 mo. no interest) or payments over an extended timeframe. You will find more information on Care Credit as well as a link to get pre-approved on our website. If you have questions on fees or on financing, please feel free to call the office (we can even apply for Care Credit for you).
Misc and Other stuff:
Recovery – The recovery from a full + tummy tuck is not fun for the first few days (why sugarcoat it?). We offer pain pumps following surgery to help you during the most uncomfortable time. For the first 48-72 hours you will need/want a caretaker to help you. After that, you will be able to get around (slowly) and not need constant care. You should be able to drive yourself after about 2 weeks (whenever you feel that you do not have reduced reaction time and are off all prescription pain relievers). We’ve had some patients rent or borrow a walker to help in the first few days – whatever works!
Pain Pumps – A pain pump following surgery is optional, but we strongly recommend it as it will make those first few days more comfortable. A pain pump delivers local anesthetic (a strong “numbing” medication) under the skin directly to the abdominal (surgical) area. After surgery a pain pump can help you get up earlier and easier (important!), allow you to sleep better, minimize your need for strong pain pills and get your normal appetite back so you feel better faster.
Scar Management – We want our patients to be pro-active (not reactive) in regards to your tummy tuck scar. Following surgery we recommend using a medical grade silicone gel sheeting. It helps flatten & smoothes scars for the best possible end result. We’ll tell you when to get started.
What’s an “Inverted T” – Sometimes (not often) especially if your belly button is high, there can be a small round opening (where the old belly button once was) that doesn’t quite reach the incision area. That “hole” needs to be closed with a small vertical incision (looking like an “inverted t”). This is only necessary when the patient has less skin laxity below the belly button and/or if the position of your belly button is relatively very high. This is easy to understand during your consultation when Dr. Stagnone draws your surgery on your own skin.
Will I have Drains? – Probably yes, this is to help collect any fluid from accumulating under your skin. Based on the amount of drainage they typically come out in 7 -9 days. A “drainless tummy tuck”, while not for everyone, may be an option for you too. Dr. Stagnone will help you decide.
What’s a Mommy Make-Over? – There is not a single procedure known as “mommy make-over”, it is typically a combined tummy tuck and breast enhancement (implants, sometimes lift). Please feel free to call or ask us about this. The better question is “what does this mommy need” to make her happy!
What’s YOUR Mommy Makeover Look Like?
We get daily calls for a “mommy makeover” and daily we ask the caller “what does that mean to you? – What’s YOUR mommy makeover look like” That’s typically followed by a minute of silence… So, we ask “what is it that YOU want from the procedure?” A mommy makeover is NOT a procedure or the same for all mommies; but rather a personalized combination of procedures designed to help you look and feel your best after pregnancy.
In addition to your new (or older) bundle of joy, pregnancy can bring with it many undesired physical changes to your body. From weight gain to sagging or excess skin, your body may seem foreign to you after your children. A growing number of moms (new or not-so-new) are choosing to combat these changes and undergo cosmetic surgery to regain their “pre-baby” bodies. It can help restore or improve your body (and spirits) so you can enjoy your body as much as your growing family. Typically, it’s going to include surgery for the tummy and the breast; although we’ve talked with women who’ve discussed their knees, even their faces or noses while inquiring about a mommy makeover (so for that mommy, it’s going to be unique and different!).
As your weight yo-yo’s during your pregnancies, your skin can become lose and despite getting back into the gym or diets, you may be unable to regain your pre-baby body. Often during pregnancy your abdominal muscles become separated (called diastases) which, no matter how much you exercise, can’t be brought back together without surgical help. You may also have a lost volume to your breasts (deflated), or end up with breasts that now are droopy or saggy. Indeed, some mom’s now have breasts larger and heavier than before. Needless to say, most moms’ look in the mirror longing for their pre-baby bodies; so the good news, a mommy makeover can help get that back for you!
More good news is that a mommy makeover can improve several areas of the body with one surgery (AND, one recovery time!) It can help restore youthfulness, reduce excess fat, tighten loose skin and enhance breast volume or “perkiness”. All in all, a thorough mommy makeover can help restore self confidence by making you comfortable again in your own skin!
So, what’s your mommy makeover look like? A full tummy tuck and breast implants (augmentation)? An extended mini tummytuck with some liposuction and breast lift?
Maybe, tummy and hip liposuction with a modified breast lift and new implants? The possibilities are as varied as the kids in a mommy playgroup! One key thing to remember about mommy makeover surgery is that it’s particularly important to find an experience, qualified surgery when combining procedures. Dr. Stagnone is a Board Certified Plastic Surgeon with over 25 years experience and uses only Board Certified Anesthesiologists for your comfort and safety. The Plastic Surgery Center of Dallas has its own accredited surgery center and recovery facility conveniently located in North Dallas.
About Our On-Site Surgery Center/OR
- About Our Surgery Center The Plastic Surgery Center of Dallas, office of Dr. Gregory Stagnone, has a beautiful onsite surgical suite including a state-of-the-art operating room and extremely comfortable recovery facility. We have been fully licensed and accredited as an AAAASF facility since 1995. One of our staff will be happy to provide you with a tour of our facility in non-operating times.
- It is the mission of the American Association for Accreditation of Ambulatory Surgery Facilities, Inc. (AAAASF) to develop and implement standards of excellence to ensure the highest quality of patient safety through an accreditation program. Accredited facilities must meet 100% of the standards set by AAAASF for accreditation through regular on-site inspections. Many office based surgical facilities are not accredited, legally operating independently of any peer review and inspection process. In AAAASF accredited facilities, assuring patient safety is the first and utmost priority. The Plastic Surgery Center of Dallas has achieved both National and Global Accreditation.
- Why is This a Benefit to You? Dr. Stagnone spends nearly as much time at The Plastic Surgery Center of Dallas as he does at home. It is his highest priority to provide a comfortable and safe environment with a non-hospital feel and the most personalized care, never compromising on quality or the well being of his patients. Many doctors operate in a number of different surgery centers and some even in office exam rooms. Facilities designed for multiple physicians (orthopedic surgery, ocular surgery, urology, etc) are not specifically designed for cosmetic surgery and do not have the benefit of a customized layout and design for your utmost privacy and comfort. At these facilities, the surgeon often does not know which staff will be assigned to his room. We feel that the full control we have over our surgery center eliminates many variables and is better for our patients from the moment of arrival through the final visit. Your convenience and privacy are further assured by our plentiful private parking and our discrete covered pickup at the surgery center door, just steps away from our surgical entrance.
- Your Overall Experience We will use all of our skills, talents and technical capabilities to help you reach your goals. In addition, we strive to provide unparalleled follow-up services to help you realize your optimal recovery with safety and peace of mind. We are always available for any of your questions or concerns.
Click here to learn more about our innovative simulator tool, Vectra 3D, to further assist you and the doctor during your consultation.