Dr. Carlos Castañeda: Abdominoplasty a.k.a Tummy Tuck
Today Dr. Carlos Castañeda, plastic and reconstructive surgeon, talks to us about abdominoplasty, how it’s performed and what to expect.
The human torso is divided in two parts. For now, we will talk about the bottom half, which includes the abdomen, flanks (sides between lower border of ribcage and upper border of hip bones) and the lower back (Lumbar Vertebrae and Sacrum).
This section may just be the most important one for the body in order to have an attractive and fit look in both males and females. Ideally the waist should be smaller than the distance between shoulders, the front should be at the same level as the sternum and pubic bone, skin should be toned without folding over itself and the bellybutton should sit in the center of it. Individuals with a low body fat percentage usually have skin that lies close to the deep tissue, showing defined lines over the insertions and intersections of the abdominal musculature.
Various factors such as weight gain, pregnancy, sedentary lifestyle, and alcoholism will have a negative impact on the anatomical proportions of this area and will make the body contour in a less aesthetically pleasing fashion.
“Abdominoplasty, or tummy tuck, is designed to tighten the muscles and loose skin of the abdomen to correct a bulging belly that no amount of dieting or exercise will help.”
The abdominoplasty procedure, A.K.A. Tummy Tuck (TT) is recommended for patients when one or a combination of skin looseness, excessive amount of stretch marks, skin folds and irregularities, separation between the rectus abdominis muscles or development of hernias or fat deposits that are not responding to diet and exercise.
The Tummy Tuck technique has evolved over time, and today incisions are placed low over the hipbones and if needed they’re extended into the flanks and maybe even over the Sacrum. It is not wise to sacrifice result for shorter scars.
Firstly, intravenous sedation and a spinal block are placed for maximizing patient comfort, skin is prepped and draped to avoid risk of infection and once the patient is closely monitored and ready, an incision is made over the preoperative makings and the abdominal skin is elevated all the way up to the ribcage border superiorly and to the flanks laterally. Care is taken to avoid unnecessary bleeding and then if needed, the rectus abdominis muscles are sutured together in the midline creating a mechanical effect similar to that of a corset, making the abdomen flatter and also reducing the waist size. Excess skin is then carefully measured and excised, and the pubic skin is lifted when needed. The borders of the incision are then stitched together layer by layer and the belly button stalk is brought out to a small opening right in the midline. A drain is left in place for about a week. On areas to be liposculpted, thickness is assessed by pinching and stretching them, and a solution which contains adrenaline to reduce bleeding and an anti-inflammatory agent are infused into the subcutaneous plane. Fat deposits are then gently sucked out and care is taken to leave a thin uniform layer of fat which will give out a smooth skin surface.
After care is usually easy, no suture removal is necessary as the threads are dissolvable. The drain is removed in about 1 week later and patients can return to their usual activities within 2-3 weeks. A compression garment is worn to reduce inflammation and to promote skin adherence for around 6 weeks.
Final results are visible within 3 months and we always encourage patients to keep up a healthy lifestyle and exercise regimen to maintain the results for a longer time.
If you’re interested in abdominoplasty, please call us at 1-619-610-1667 for a free virtual consultation with Dr. Castañeda himself!