Metropolitan Plastic Surgery

Tummy Tuck (Abdominoplasty)

Tummy Tuck Virginia

Sometimes, after multiple pregnancies or large fluctuations in weight, the tissues of the abdominal wall loose their elasticity and natural turgor, becoming lax and flaccid. The person may have localized accumulations of fat in the abdomen that have persisted despite exercise. Striae (stretch marks) from pregnancies may cover the skin of the lower abdomen and occasionally go as far as the mid-abdominal area. The purpose of abdominoplasty (tummy tuck) is to eliminate many of these deformities and to give the abdomen a tighter, firmer, and more pleasing contour.
   
Abdominoplasty is not just an operation for women. Men who have had large amounts of weight loss or who have localized fat in the stomach area may also benefit from this tummy tuck surgery. It must be remembered that a tummy tuck is not a substitute for more conventional methods of weight loss, such as dieting and exercise. However, in certain individuals, accumulations of fat in these areas do not respond to normal measures, and for these individuals a Virginia tummy tuck can provide a means to achieve this goal.

A tummy tuck is best thought of as a spectrum of surgical procedures that can be tailored to your specific need. In other words, not every person requires an extensive procedure and, depending on the situation, the patient may be able to get by with doing less. Often a Virginia tummy tuck procedure is done in conjunction with liposuction (fat removal), which enables the surgeon to enhance the end result of surgery and to put finishing touches where necessary.

The tummy tuck operation is done using general anesthesia or regional anesthesia and sedation. Depending on the extent of skin laxity or excess, the incision may be long or short, but is almost always hidden in the “bikini” area. Today, we have the ability to perform a Virginia tummy tuck with short scars, if the patient has a relatively small degree of skin laxity. This is called the partial tummy tuck or short scar abdominoplasty. If the skin that needs to be removed distorts the naval, it may be necessary to reposition this structure so that its ultimate location is as it was before. Muscle and facial layers under the skin can be tightened to make the abdomen firmer and flatter. Such maneuvers under the skin help contour the shape of the abdomen and can sometimes result in a narrower waist and give an hourglass appearance to the female patient.

Unless there is a clear indication for postoperative observation in a hospital, you may go home after tummy tuck surgery. You will have a moderate degree of discomfort in the first few days after tummy tuck surgery that is easily controlled with oral pain medication. Swelling and discoloration from the tummy tuck surgery will depend on the extent of the procedure, but generally most of it will be gone in a week or two. You will be able to return to most usual activities by the end of the first week and resume strenuous exercise in a few weeks. A support garment is recommended for approximately 2 months to ensure proper healing. Minor changes in sensation are not unusual for a short period after tummy tuck surgery.

What is a Tummy Tuck (Abdominoplasty)?

Abdominoplasty is a procedure that is designed to improve the shape of the abdomen and mid-body of both men and women. It is commonly called “tummy tuck.”

What does a Tummy Tuck (Abdominoplasty) accomplish?

With abdominoplasty, you can dramatically improve your mid-body shape. A Virginia tummy tuck can permanently remove fat, tighten loose muscles, and trim excess skin. There are different kinds of abdominoplasty, ranging from a complete tummy tuck to minimal incision operations that address specific problems in the abdomen.

What happens during the first consultation for Tummy Tuck in Virgnina?

In the first consultation, you will have a chance to discuss your concerns with our patient care coordinators and Dr. Marefat. We will explain what you need to know about the tummy tuck procedure and help to determine what is best for you. You will receive information booklets and pricing on the tummy tuck procedure.

How is a Tummy Tuck (Abdominoplasty) done?

A tummy tuck is done by first liposuctioning the abdomen, if necessary. This suctioning is limited to a safe amount, so as not to jeopardize the viability of the abdominal skin. The tumescent solution used in liposuction is also used for abdominoplasty. This significantly reduces blood loss and the need for hospitalization. The muscles above and below the belly button are then plicated. This makes a big difference in the protrusion of the abdomen that is seen in women after pregnancy. It also gives the abdomen a more defined hourglass shape . Finally, the excess skin is trimmed from the lower part of the abdomen.

What are some of the complications of a Tummy Tuck (Abdominoplasty)?

Before you focus on the complications of a Virginia tummy tuck procedure, first consider how best to digest these bits and pieces of information. Reading about complications can be quite scary. Many people cannot comfortably sit through a consultation session without having some real doubts about surgery. But it is different when you have these complications explained to you by a doctor. Dr. Marefat can put them in perspective for you and tell you the likelihood of such complications occurring. Most complications are very rare. Some are less rare and need to be explained to you in more detail so that you know how we would tackle these problems if they occurred. The purpose of explaining risks and complications is for you to know what steps we would take to treat you and put you back on the road to recovery. Remember that every surgeon has his or her own way of treating problems. You must go over these potential risks with your surgeon to gain better insight and understanding.

  • Bleeding. This is very uncommon with liposuction because we are generally not cutting tissues but using a blunt-tipped cannula to remove the fat. However, there have been some reports in the literature of bleeding as a complication. There are those who are at higher risk of bleeding. The use of some medications, such as aspirin or coumadin (a blood thinner), could put you at higher risk of bleeding. If you are contemplating tummy tuck surgery, you should refrain from using aspirin- containing products from 2 weeks before surgery until 2 weeks after surgery. Some people with a history of uncontrolled hypertension can be at higher risk of bleeding after the surgery. There are some individuals who are unaware of problems with their coagulation system and who, consequently, have had bleeding after surgery. If you have bleeding after surgery, it may entail returning to the operating room to stop it.
  • Infection. It is very uncommon to get an infection with the tummy tuck procedure. We usually give all our patients antibiotics both before and after surgery. If infection occurs, however, we will treat it very aggressively with stronger antibiotics.
  • Skin discoloration. This can occur in any surgery. It is due to blood metabolites and is usually temporary and self-limiting. Sometimes these blood pigments stay in the subcutaneous tissues permanently. These are very rare and generally occur in patients with darker skin complexions. If this occurs, we may need to treat your skin with certain bleaching agents, which could help ameliorate the problem.
  • Discomfort and pain. This is easily controlled with oral pain medications. With the use of the tumescent technique and the use of local anesthetics in the tissues, both the pain and the discomfort should be minimized.    
  • Temporary numbness associated with the surgery.  This numbness usually persists for several weeks, and it depends on the extent of surgery performed. Most of this numbness subsides after 7-10 days. However, it is not unusual to see persistent numbness even after 4-6 weeks have passed.
  • Minor lumps and irregularities. These irregularities are related to accumulations of fluid in certain areas of the subcutaneous fatty layer of the skin, as a result of either infiltration of the fluid or as a result of the trauma associated with surgery. Irregularities even out after the first 2 or 3 weeks after the tummy tuck surgery.
  • Minor asymmetry. Minor asymmetry between the two sides of the body can be seen after the liposuctioning. This, too, is related to accumulations of fluid or trauma related to the operation. These asymmetries usually resolve within 2-3 weeks.
  • Permanent scars. Scars are present whenever there is any incision. Almost all operations will involve some scarring. The extent of the scar will depend on the nature of the problem and the extent of surgery. Liposuction puncture wounds made during surgery are minute and in 2-3 months they heal so well that they are barely visible. Abdominoplasty operations may have more extensive incisions and thus more scarring. The nature and extent of the scar also depends on the location of the incision, as well as the genetic ability of the patient to heal scars. Dr. Marefat rarely sees cases in which the scar has become a major problem. However, if scars do become prominent and visible, he can usually improve them with scar revision procedures. It is more prudent to wait approximately 1 year before attempting scar revision.
  • Excessive skin. In certain individuals, the skin has lost its ability to contract after having been stretched. One of the indications for abdominoplasty is specifically this problem. Nevertheless, after surgery the patient may be left with an excessive roll of skin in the area of surgery that does not go away. At times, the ends of the incisions may have too much tissue. These are called “dog ears.” In such cases, it is necessary to remove this excessive roll of skin directly. This will result in having a permanent scar in the area of excision.
  • Waviness and surface irregularities. This is a problem that is perhaps one of the most undesirable side effects of liposuctioning. It is unpredictable, and we will not know which patient will have surface irregularities, but it seems to occur more in people with poor skin turgor and patients who have cellulite. One way that Dr. Marefat has avoided waviness and irregularities is to use very small gauge cannulas and to take his time removing the fat. Nevertheless, there is still a chance that you may develop some irregularity, and if this occurs, we can usually fix the problem in a touch-up procedure. This touch-up procedure is done in a second stage approximately 3 months after the initial liposuctioning.
  • Persistent edema. This problem is very rare, but if it occurs it can be bothersome and may last for many weeks after surgery. Generally, this is not a permanent problem. The literature on the subject only reports a few cases in which people have experienced persistent edema. To avoid persistent edema, we encourage the use of compression garments after surgery .  Should there be continued edema, we would encourage the use of compression garments until the problem is resolved.  
  • Altered areas of sensation. On rare occasions, it is possible to have an area remain permanently numb or experience paresthesia. Usually, these problems are seen in cases where a skin resection is being performed at the same time as the liposuction . The liposuction can, however, injure nerves in the area, and these injured nerves can later develop permanent scarring and problems related to nerve conduction. Usually, the surrounding nerves are able to cover the area of impaired sensation, and after 4 or 5 weeks the area is reenervated by these nerves. However, if this does not happen, the patient is left with an area that has permanent numbness or altered sensation. This may or may not be a correctable problem. Often, the impaired sensory area is not much larger than a half dollar or a quarter in size, and most patients are not bothered by it.
  • Surgical shock and pulmonary complications. There are certain uncommon risks and complications that can also occur. These include shock, which might require a transfusion. This is a very uncommon problem, and one that Dr. Marefat has not seen in any of his patients, but it is occasionally reported in the literature. The need for autologous blood has been virtually eliminated because of the tumescent technique.  
  • Seromas and hematomas. These are collections of fluid or blood under the skin. If this occurs, it will need to be drained. This is usually done with the use of a syringe. It will entail more frequent office visits for the patient after surgery until the problem is resolved. Usually, these problems do not cause any permanent damage.
  • Skin loss. This has been seen in a few cases with major skin undermining. Usually, this problem occurs in people who are smokers or have some underlying problem with circulation. If you smoke, you are strongly encouraged to quit smoking 2 weeks prior to surgery and to refrain from smoking until 2 weeks after surgery.
  • Fat embolism. In a few cases, the literature has noted cases of pulmonary fat embolism as a result of liposuctioning. This problem is very uncommon, and there is no clear explanation for why it occurs. It may be related to the entrance of fat into the blood vessels during the operation. These could travel to the lung and obstruct the pulmonary vessels. If this occurs as a result of the operation, and the problem is severe, there is no question that the patient would need to be admitted to the hospital.
  • Life threatening conditions. It is very uncommon to see severe complications with cosmetic surgery. However, should such a condition arise for any reason, you would be immediately admitted to the hospital.

What can I expect after a Tummy Tuck (Abdominoplasty) in Virginia?

After tummy tuck surgery, you will have a moderate amount of drainage from the incisions. You may have drains under the skin to collect some of this extra fluid. You will need to rest for 2 or 3 days, but most people are up and about shortly after surgery. We generally recommend our patients take off 7-10 days from work. Heavy lifting and exercising should be avoided in the first 2-3 weeks. Your body will tell you when you are ready to get back into your regular exercise routine. Most people are able to return to their normal exercise level in 4-6 weeks.

When are the Tummy Tuck (Abdominoplasty) sutures removed?

The sutures in abdominoplasty come out in 10 days. Sometimes you may have absorbable sutures that do not need to come out.

How many visits do I have after a Tummy Tuck (Abdominoplasty) in Virginia?

We like to see our patients frequently after surgery. You are seen by the doctor or nurse within 2-3 days of tummy tuck surgery. Then the normal postoperative routine is 1 week, 1 month, 3 months, 6 months, and 12 months after surgery. Of course, if there is a need, you may be seen more often. After a year, we encourage our patients to come in for routine follow-up visits every 3-5 years.

When can I wear make-up?

You should be able to wear make-up if you have had abdominoplasty. However, we do not recommend putting make-up on your incisions. This may result in tattooing of the skin by the pigments in the make-up.

Am I a good candidate for a Tummy Tuck (Abdominoplasty)?

You are a good candidate for abdominoplasty if you have good general health and realistic expectations. The best results are seen in individuals who do not have large amounts of fat that need to removed. In such cases, it is better to stage the operation so that some of the fat is removed before the actual tummy tuck. Generally, the younger you are, the better a candidate you are for surgery. A person’s physiological age is more important than his or her chronological age. That is to say, you may be 60 years old, but your skin and general health may be better than that of a 50 year old.

How do I pay for a Tummy Tuck (Abdominoplasty) in Virginia?

You can pay for tummy tuck surgery by certified check, credit card, or cash. Payment for cosmetic surgery is expected prior to any procedure. If you are scheduled for surgery several weeks in advance, you may pay by personal check.

Are there Tummy Tuck (Abdominoplasty) scars?

Yes. The length of the scar will vary according to the procedure you need. If a mini-abdominoplasty is being done, the scars are very short. If a full abdominoplasty is being done, the scars are longer. You usually will also have a scar around the belly button, and you may have a small scar between the belly button and the pubic hairline. After several months, these scars fade and become less visible. Remember that tummy tuck is an operation that strives for shape in exchange for scars. You must be comfortable with this idea.

Does a Tummy Tuck (Abdominoplasty) hurt?

The pain involved in abdominoplasty is very tolerable. We have heard our patients describe it as “muscle aches and pains” or “soreness.” Many patients say that it was better than what they expected. Having said that, remember that pain is very subjective, and it is not easy to predict what degree of pain you will have. Since muscle is not cut in   a tummy tuck, the pain level is usually not as bad as most other operations, like c-sections or hysterectomies.

Will I be awake during the Tummy Tuck (Abdominoplasty)?

Not usually. If you are having a large area of liposuction and undergoing abdominoplasty at the same time, you will have the operation in an outpatient facility under general anesthesia. Minor lower abdominal skin excisions can sometimes be done under local anesthesia.

Where will the a Tummy Tuck (Abdominoplasty) be performed in Virginia?

Virginia tummy tuck surgery is usually done in an outpatient facility. Only in rare situations, where the patient may have risk factors, does Dr. Marefat suggest surgery in a hospital environment. Minimal skin excisions could be done in the office, however this is very seldom done.

Are medical photographs taken of the Tummy Tuck (Abdominoplasty)?

Yes. In all cosmetic and reconstructive cases medical photos are taken. Photographs are mandatory because this is the only way for us to compare your before and after results. Photographs in plastic surgery serve the same role as x-rays do in orthopedic surgery.

How do I get started with Tummy Tuck (Abdominoplasty) in Virginia?

Dr. Marefat and the staff at Metropolitan Plastic Surgery would be happy to help you set up a private consultation to discuss tummy tuck (Abdominoplasty) in Virginia. Schedule an appointment online or call one of our locations, our Arlington, Virginia office at 703-516-7600 or our Woodbridge, Virginia office at 703-560-9583.

Are there financing options for Tummy Tuck (Abdominoplasty) in Virginia?

Dr. Marefat offers a number of financial assistance programs and payment programs to cover the cost of a tummy tuck (Abdominoplasty) in Virginia. Please visit the Patient Financing section of our website for more details or ask the staff at Metropolitan Plastic Surgery about these options so you can get started with a tummy tuck (Abdominoplasty) in Virginia today.