Tummy Tuck (Abdominoplasty) in Boston


Helena O. Taylor MD, PHD, FACS & Stephen R. Sullivan, MD, MPH, FACS

Named Among the Best Plastic Surgeons in Boston

Abdominal recontouring is one of the most powerful procedures in aesthetic surgery. Despite diet and exercise, an improved abdominal contour is not always possible, particularly after childbirth. With age, pregnancy, or weight changes, patients commonly develop diastasis recti (separation of the abdominal muscles) with abdominal bulge, as well as stretched out skin.

Diastasis recti frequently cannot be corrected with exercises or physical therapy, while surgery can be very effective at restoring muscular position, and when necessary removing extra skin.

What Is A Tummy Tuck (Abdominoplasty)

Tummy Tuck (Abdominoplasty) is an operation for removing excess skin, stretch marks, and fat from the abdomen. At the same time, the umbilicus (belly button) is positioned within the re-draped skin, and the position of the rectus muscles of the abdomen is restored. The scar is placed low on the abdomen at the pubic hair line, similar to, but longer than a c-section, so it can be hidden with underwear or a bikini.

A tummy tuck is usually combined with fat reduction by liposuction of the "love handles" or waistline to remove common areas of excess fat. A midline depression can also be sculpted with liposuction. Patients undergoing abdominal hernia repair (umbilical hernia or ventral hernia or incisional hernia) might also consider having a tummy tuck at the same time to avoid extra operations and improve abdominal contour.

Adbominoplasty Boston

What Is Diastasis Recti?

Diastasis recti is the separation or widening of the space between the rectus muscles of the abdomen. These are the muscles that form a “6 pack”. Excess separation often happens with pregnancy, but can also occur with age and changes in weight. This widening results in a bulge, and weakening of core strength. Unlike a hernia however there is no hole or opening, just a stretching.

Diastasis repair plays an integral role in most tummy tuck or cosmetic abdominoplasty procedures, but may also be performed to reinforce a hernia repair. While we often feel that this muscular repositioning is a functional or reconstructive procedure, insurance carriers consider diastasis recti repair to be a cosmetic procedure.

Tummy Tuck At A Glance

WHAT TUMMY TUCK DOES

  • Repairs hernias
  • Corrects diastasis recti
  • Restores contour
  • Removes excess tissue
  • Liposuction of fat

DURATION OF RESULT

Years

LENGTH OF PROCEDURE

2-3 hours

TYPES OF ANESTHESIA

General Anesthesia

RECOVERY

  • Comfortably at home

TIME OFF SCHOOL OR WORK

  • 10-14 days

TIME OFF ACTIVITIES

  • Light exercise – walk the same day
  • Full exercise and contact sports – 6 weeks

What Are The Types Of Tummy Tuck?

Every operation is tailored to the individual patient and no two operations are the same. There are some general types of abdominoplasty and these include: mini-abdominoplasty, full abdominoplasty, lipoabdominoplasty, and abdominal wall reconstruction. In all types, a scar is traded for excess skin or fat. The scar is placed low and covered by underwear or a bikini. For women who have had a previous c-section, the abdominoplasty scar is lower. The overall goal is to ensure a fitter and flatter appearing abdomen.

  • Mini-abdominoplasty or Mini-Tummy Tuck, places places the most limited scar along the edge of the pubic region and removes excess skin and fat, limited in extent and recovery
  • Full abdominoplasty or Tummy Tuck, is more extensive, though the result is far superior. The scar is placed along the edge of the pubic region and extends along the bikini or underwear line to the hips, removes excess skin and fat, repositions the belly button, and corrects diastasis rect
  • Lipoabdominoplasty, is a full tummy tuck as well as liposuction of surrounding areas such as the flanks or “love handles”, hips, and contouring and sculpting of the midline of the abdomen to highlight the abdominal muscles
  • Mommy makeover, combines a tummy tuck with other procedures to restore a woman’s figure after having a baby. The most common operations include tummy tuck, breast lift (mastopexy), breast augmentation, labiaplasty, and liposuction. Sometimes operations are performed simultaneously if Dr. Taylor and Dr. Sullivan feel it is safe.
  • Abdominal wall reconstruction, is a full tummy tuck as well as repair of umbilical, ventral, or incisional hernias.
  • Post-bariatric surgery body contouring, includes panniculectomy and abdominoplasty to restore your figure after you have successfully lost weight.

Procedure For Tummy Tuck

Patients often benefit from the experience of two board certified plastic surgeons working together to improve safety and efficiency. Unlike many surgeons who have physician assistants helping or performing parts of the operation, top Boston Mass board certified plastic and cosmetic surgeons Dr. Taylor and Dr. Sullivan work together to perform tummy tuck operations. They are also among very few plastic surgeons in the Boston area to use the latest and most effective medications for pain control and opioid reduction, including Exparel® (liposomal bupivacaine).

Post-Bariatric Surgery Body Contouring

Post-bariatric weight loss surgery with Dr. Taylor and Dr. Sullivan can restore your figure after you have successfully lost weight.

If you have deflated areas of your body after weight loss, you may be a candidate for an operation with Dr. Taylor and Dr. Sullivan. Exercising and weight loss are important, but they can't remove excess skin or stretch marks. Only post-bariatric weight loss surgery can remove the excess skin.

Patients often consider a tummy tuck (abdominoplasty) for removal of abdominal skin and fat, breast lift (mastopexy) for women to lift and make the breasts perky, gynecomastia surgery for men to create a masculine and muscular chest, arm lift (brachioplasty) to tighten the arms, or thigh lift to remove excess skin from the upper-inner legs.

Each patient is carefully evaluated and if Dr. Taylor and Dr. Sullivan consider you to be a good candidate for an operation, they will customize a tailored surgical plan for your body. Dr. Taylor and Dr. Sullivan, Boston board certified plastic and cosmetic surgeons, work closely with the team at the Mount Auburn Hospital Weight Loss Center, where they give informational seminars to interested patients. It is never to early to consider your reconstructive options.

Tummy Tuck Boston

What Is The Recovery With Tummy Tuck

Tummy Tuck Boston

Patients recover quickly with limited discomfort and are able to leave Mount Auburn Hospital on the same day as the operation. You will be walking on the day of the operation and may shower the next morning. Some discomfort and tenderness is normal, though when compared to a caesarian section, for example, most of our Boston tummy tuck patients tell us that it is an easier recovery. Before, during and after the operation we’ll prescribe multimodal non-narcotic medications to minimize discomfort and limit the need to use opioid medications such as oxycodone.

Most patients benefit tremendously from our use of long-acting numbing medicine, known as Exparel, to limit discomfort for several days following the operation. Our treatment regimen is also guided to prevent symptoms such as nausea, vomiting, and constipation to ensure a gentle and comfortable recovery. For many patients, surgical drains are necessary and are the most annoying part of their recovery. These are typically removed about five - ten days after surgery.

  • Remove excess skin
  • Flatter smoother abdomen
  • Remove stretch marks
  • Correct diastasis recti and tighten abdominal wall
  • Repair belly button hernias or other hernias
  • Restore abdominal core strength
  • Improve lower back pain
  • Improve urinary incontinence
  • Remove scars on tummy
  • Improve tummy contour
  • Remove excess fat from abdomen
  • Remove abdominal pannus
  • Improve clothing fit

Faqs About Abdominoplasty

What are the risks with a Tummy Tuck?

Every patient is unique, both with planned procedures as well as potential risks. General risks of abdominoplasty can include bleeding, scar, infection, fluid collection, pain, and blood clots in the legs that could embolize or travel. With careful patient and procedure selection, and detailed attention to perioperative care, most potential complications are thankfully rare with tummy tuck.

What is recovery like?

Our preference is to perform most liposuction with sedation or general anesthesia in the operating room as a day surgery procedure. Patients wear compression garments for several weeks after surgery. Bruising and some swelling is common, but varies in severity. It takes several weeks to months for the swelling to resolve. Patients report being sore the first week, but significant pain is rare.

When it comes to your tummy tuck Boston plastic surgeons Dr. Taylor and Dr. Sullivan make safety their top priority. They will provide specific information and instructions to help you prepare for your procedure. We take precautionary steps to minimize risks and complications from surgery to help you recover with the least amount of discomfort and time.

Will I have a scar with a Tummy Tuck?

Tummy tuck trades a scar for improved body contour. The trade-off is typically a good one and the scars can be placed in the least conspicuous location. The scar from a tummy tuck is even lower than that of a C-section scar, and although longer, the scar can usually be hidden by underwear or bikini bottom. We use dissolving buried sutures to avoid the need for suture removal or unnecessary suture scars.

Is a Tummy Tuck covered by insurance?

Tummy tuck is considered cosmetic and not covered by insurance (at least until women become CEOs of all insurance companies!). When you come in for your consultation we will evaluate your condition to determine if you might qualify for some coverage by your insurance company with a simultaneous hernia repair. Depending on which procedures meet your goals, your policy may provide some coverage.

Can I have more children after a Tummy Tuck?

Although a tummy tuck will not affect your ability to have more children, you should consider postponing procedures such as tummy tuck until after you are done having children. Nevertheless, operations can be performed again in the future.

Am I a candidate for a Tummy Tuck?

Women or men with excess skin and abdominal fat and bulge from diastatsis recti are potential candidates for a tummy tuck. The ideal candidate is a nonsmoker, in good health with a BMI less than 30, and, if a woman, is finished with childbearing. Safely lose the weight you can and be at a weight that you can maintain. If we determine you to be a good candidate and you wish to proceed, we will be in this together with you to help you to achieve your goals, as quickly and as safely as possible.

ABDOMINOPLASTY (Tummy Tuck) AFTERCARE INSTRUCTIONS

  • In the week before your operation:
    • Consider eating pineapple, it may help reduce bruising
    • Consider supplementing with Arnica montana, it may help reduce bruising
    • Complete household chores and prepare meals for the first few days of postoperative recovery
    • Follow preoperative instructions with eating, drinking, and medications
    • Order two compression garments specific to your size. The garments do not need to be expensive. Dr. Taylor and Dr. Sullivan can make some recommendations of garments that can be ordered from Amazon or online.
  • Postoperatively, get out of bed and walk (with assistance) every few hours after your operation to decrease the chance of postoperative problems such as blood clots.
  • Practice 15-20 deep breaths every hour to keep your lungs open.
  • After Tummy Tuck, it is important for you to have someone available to stay with you for the first 24-48 hours, as you may feel drowsy. You may require help the first few times you get out of bed.
  • You may need to walk slightly “stooped over” (bent at the hips) for a few days to release tension on the suture line. When in bed keep your head elevated about 30 degrees (two pillows under your head and back) with the knees slightly flexed (one pillow under your knees).
  • Please take your medications as directed by Dr. Taylor or Dr. Sullivan to manage discomfort or symptoms. You are likely to be given:
    • Acetaminophen (Tylenol) 1000 mg every 8 hours, space doses 4 hours after Ibuprofen so one or the other is taken every 4 hours
    • Ibuprofen (Motrin) 800 mg or Colecoxib (Celebrex) 200 mg every 8 hours, space doses 4 hours after Acetaminophen so one or the other is taken every 4 hours
    • Gabapentin 300 mg every 8 hours for 7 days. If you have dizziness, double vision, or significant sleep disturbances, consider stopping the Gabapentin.
    • You may also be given:
    • Vitamin C 500 mg daily for 50 days
    • Oxycodone 5 mg – 1-2 tablets every 6 hours as needed for pain, though many patients may not need it
    • Colace 100 mg twice daily to prevent constipation, it is important to have a bowel movement each day. Prune juice may also be helpful.
    •  Zofran 8 mg every 8 hours if needed for nausea
    •  Scopolamine patch will be placed behind the ear on the day of surgery and can stay for 3 days to prevent nausea
  • Eat a light diet for 2-3 days and avoid spicy food. Some suggestions to ease abdominal discomfort or indigestion after surgery:
    • Drink water or warm liquids
    • Prune juice to prevent constipation

WOUND CARE

  • The drainage bulbs connected to the end of the drains should be compressed at all times to keep suction. It is normal for red fluid and blood clots to form in the drains. Please record time and amounts of drainage over a 24-hour period – we will provide a form. Usually the drains will be removed when the drainage is 30cc or less in a 24-hour period. All patients heal differently and according to many factors. On average, drains remain for about one week.
  • You may shower or sponge bath the day after the operation with assistance and wash your skin as you normally would with soap and water. Avoid soaking the incision, although It will not hurt to get a splash of water on the wounds. Avoid submerging the drains. Gently pat dry after washing.
  • Wear the abdominal binder continuously for 3 weeks after tummy tuck surgery, then for 12 hours of each day for an additional 3 weeks, and thereafter as needed for comfort. You can take it off to shower. The binder helps control swelling and fluid build-up. If the binder rubs your skin, it can be worn over a soft t- shirt. We can provide suggestions for other types of binders to order as well.
  • Most wounds will be closed with absorbable sutures that are buried and covered with skin glue. The skin glue forms a barrier to water. Please do not remove the glue, it will fall off on its own after a few weeks. Do not apply any lotions, potions, ointments, creams or solutions (e.g. no hydrogen peroxide or alcohol) as they can be harmful to the fragile healing tissue.
  • Do not smoke or expose yourself to smokers or nicotine as skin and wounds can be compromised.
  • Infection is very uncommon, but please call Dr. Taylor or Dr. Sullivan at any sign of infection which would be signaled by fever, increased pain, spreading redness or significant swelling.

ACTIVITY

  • For the first few days following Tummy Tuck surgery, raising your blood pressure and heart rate can cause bleeding. Stress on your abdominal muscles or vigorous activity could stretch or break the stitches. We recommend walking 15 minutes several times per day and gradually increasing activity tailored to your recovery.
  • Please do not drive until turning the steering wheel can be done safely and without pain (usually 7 to 10 days). Do not drive while taking pain medications such as oxycodone.
  • Do not lift anything heavier than 10-20 lbs, run, lift weights, or perform strenuous exercise for 6 weeks. You may begin having sexual intercourse approximately 4 weeks postoperatively.
  • Massage to the areas of scar and liposuction can help increase circulation and soften firm areas under the skin. Please wait at least 3 to 4 weeks after surgery to start massage to avoid increased swelling.

GENERAL OUTCOMES

  • Moderate swelling and bruising is to be expected. This is most notable in the pubic region, above and below the incision, and in areas of liposuction. Bruising may last for a few weeks and will move down your body due to gravity.
  • The incisions often appear lumpy and bumpy. This is normal and the incisions will flatten over a few weeks.
  • You may find that your clothes may not fit as easily as before. Please be patient. And because of the removal of tissue from your abdomen, a feeling of tightness is to be expected. The swelling and feeling of tightness will gradually subside over the following months.
  • You may notice that you actually gain weight following Tummy Tuck and Liposuction. This is because the body retains fluid with swelling. The swelling may persist for 6 weeks or more before it slowly decreases.
  • Tingling, itching, and numbness of the skin are all normal after Tummy Tuck. Tingling and itching are signs of healing and will resolve. Sensation usually returns gradually and slowly over weeks to months though some areas may always have decreased sensation. Please be patient and avoid resting against hot surfaces, which can injure or burn the skin.
  • Scars take one full year to mature. You may notice that they become red, raised and firm for several weeks to months before becoming soft, flat and pale. Avoid Vitamin E as it can irritate the scar. Mederma has no proven benefit and is not worth the expense. Silicone cream or skin moisturizer with sunscreen and gentle massage may be helpful.
  • Infrequently after surgery you may have fluid in the abdomen after the drains are removed. If this happens, you will notice a fullness or sloshy feeling and may even have some drainage. Please contact our office so we can aspirate it easily.
  • Please call our office (617-492-0620) if you have:
    • Continuous bleeding (a small amount bleeding from the incision is expected)
    • Significantly more swelling on one side when compared to the other
    • Worsening pain
    • Fever, spreading redness or irritation of the skin
    • Shortness of breath

It is important to be seen by Dr. Taylor or Dr. Sullivan after your operation. They will see you in follow-up appointments at 1 week, 3-4 weeks, 3-6 months, and 1 year or as often as needed post-op. Call Taylor and Sullivan Plastic Surgery to schedule your appointments at (617) 492-0620 between the hours of 8:30 – 5:00 or visit our webpage at www.massplasticsurgeons.com. We are always available for postoperative concerns or emergencies and can be reached through our paging service 24 hours per day at (617) 492- 0620.

Download our Abdominoplasty (Tummy Tuck) postoperative instructions.

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300 Mount Auburn St. Ste 304, Cambridge, MA 02138

Taylor & Sullivan Plastic Surgery Boston
American Society of Plastic Surgeons American Board of Plastic Surgery Fellow American College of Surgeons America Association of Plastic Surgeons Sigill Massachusetts

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300 Mount Auburn St. Ste 304, Cambridge