Abdominoplasty Dubai (tummy tuck) is an operation that is designed to reshape the abdomen.
Often, through weight gain and loss, pregnancies and aging, the skin stretches beyond its elastic limit or ability to return to normal shape. An abdominoplasty removes excess skin and fat while the underlying muscles are tightened.
The actual placement of incisions and design of the abdominal incisions vary depending on the looseness of the underlying tissues. Also the amount of fat to be removed, the condition of the overlying skin and prior scars.
For those women where the sagging skin is mainly in the lower abdomen the mini-abdominoplasty is an additional option. As a result, this procedure is not as extensive due to a smaller incision that is easily hidden under a two piece bathing suit. This procedure offers a more rapid recovery and may be done on an outpatient basis.
A Patient’s Guide to Abdominoplasty Dubai
Dr. Matteo Vigo is a member of the International Society of Aesthetic Plastic Surgery (ISAPS). The the world’s leading professional body for board-certified aesthetic plastic surgeons.
Depending on the patient’s aesthetic objective. Dr. Vigo will recommend one of the following three types of tummy tucks available:
FULL OR CLASSIC ABDOMINOPLASTY DUBAI
A Classic Tummy Tuck (which are also referred to as full tummy tucks) is utilized when individuals want to address the sections above and below their belly button. The full length of the abdominal wall.
Many patients who opt for a full tummy tuck often want to resolve general roundness and excess skin. With this procedure, one horizontal or u-shape incision, and possibly a second incision, are made above the pubic area and the belly button. Respectively, to remove excess skin and tighten muscle. Full tummy tucks present the most natural-looking outcome, and can include a much firmer abdomen.
ABDOMINOPLASTY DUBAI – MINI TUMMY TUCK
All Mini Tummy Tucks involve less extensive incisions compared to a full tummy tuck. They are intended to improve only the lower belly, below the patient’s belly button.
This makes the procedure ideal for people who want to rid their bellies of a “pooch”. A tiny bulge or stretch marks in the lower abdominal region only. Dr. Vigo can tighten loose muscles through a single low horizontal incision. (Typically without an incision around the belly button). And also remove excess lower abdominal skin, resulting in a firmer, smoother lower belly.
Abdominoplasty Dubai
ABDOMINOPLASTY DUBAI – EXTENDED TUMMY TUCK
The extended tummy tuck is considered when the goals of the procedure are to address the abdomen while simultaneously targeting the flanks and hips.
To perform this procedure, Dr. Vigo extends the horizontal incision more laterally as well as often incorporating a longer, vertical incision, which enables the surgeon to remove excess skin from the upper and lower abdominal region as well as the flanks while tightening the abdominal wall.
This procedure is often ideal for those patients who have had multiple pregnancies or have lost lots of weight, either through diet and exercise or through weight loss surgery.
When it comes to an Abdominoplasty Dubai, I frequently explain to patients that the procedure is not a single surgical step, but rather a series of elements that can be combined to create customized results.
Liposuction focuses solely on removing unwanted fat cells from the body – such as those that create a noticeable bulge at the belly – an Abdominoplasty Dubai is intended to create sleeker contours by addressing any number of conditions that keep the abdomen from looking toned.
Excess fat
Of course, stubborn pockets of fat are an obvious culprit when it comes to a larger waistline. While liposuction is frequently performed as a standalone procedure, it can also be used as part of a Abdominoplasty Dubai to help flatten the area.
For this element, just about everything is handled as it would be for a solo lipo procedure: Fat is loosened and suctioned out via a cannula. The difference is that while liposuction requires small incisions that are later sutured closed, the incision made for a tummy tuck allows the surgeon access.
Excess skin
While extra fat causes bulges, extra skin creates a sagging pouch that can hide even well-defined abdominal muscles that sit beneath.
The amount of excess tissue can range from a little to a lot (sometimes referred to as an “apron”). For a tummy tuck, the surgeon essentially re-drapes the abdominal skin so that it sits flat and tight, then trims away the excess. The incision and subsequent sutures for this element are typically hidden lower on the torso, where they can be covered by a swimsuit bottom or underwear.
Lax muscles
Over time, belly muscles and their covering fascia can become loose.
Whereas firm fascia holds everything in place – something like interlaced fingers keeping a water balloon from bulging outward – lax fascia allow the contents behind to bulge outward. Abdominal muscles can separate, giving the entire midsection a flabby look.
During an Abdominoplasty Dubai, Dr. Vigo can, if necessary, stitch these muscles and fascia back together to make everything tight and toned. In some cases, as with a mini-tummy tuck, this may be the primary element of the procedure. It is often chosen by moms who have a small bulge that sits below the belly button.
Abdominoplasty Dubai
Belly button placement
Depending on the tummy tuck details, the surgeon may need to “relocate” the belly button, which involves creating a hole in the newly taut abdominal skin. This is so the navel appears where it should to remain proportional with the rest of the body. This is called “umbilical translocation.”
Following this, the body can be further contoured to encourage an hourglass shape by creating an “internal corset.” I have performed measurements that show narrowing of the waist and improvement of the waistline due to work at this stage.
When all of the steps are completed, the incision will be closed with either a special glue or absorbable sutures. This is such that the patient can take a shower the next day and there is no need to remove the sutures. Lasers can be used post-operatively to hasten the healing of scars. Also, use of Exparel injections numb the abdomen for three days, which can minimize pain for patients.
Every patient has a unique body shape and size
Since every patient has a unique body shape and size, as well as personal goals for an ultimate look, each tummy tuck is its own procedure. While there are commonalities between all such surgeries, no two will be exactly alike.
The most common form of tummy tuck involves a horizontal incision near the pubic hairline, so swimwear or undergarments can hide the resulting scar. If there is excess skin above the navel, an incision around the navel may be required.
Sometimes, the surgery involves liposuction to remove pockets of excess fat from specific areas of the body. To reduce scar tissue and increase the speed of healing, I may utilize a harmonic scalpel. This uses ultrasonic energy to perform parts of the tummy tuck surgery. Diastasis is a term used to describe the separation of the two-paired abdominal muscles that make up the front of the abdomen, which is often caused by multiple pregnancies.
Sutures are used to tighten up the abdominal wall, resulting in a flatter stomach. Stronger, tighter abdomen muscles may also help reduce lower back pain.
Abdominoplasty Dubai is not a shortcut to weight loss
This is not a shortcut to weight loss. But, it can be a powerfully transforming surgery and complements the impact that weight loss has on the abdominal profile. Many of our patients say they feel liberated after having a tummy tuck.
They can wear a bikini again, or not wear a shirt or a top to cover up their loose stomach. They feel good about being outdoors running, swimming and golfing. It does a lot to boost a person’s confidence in their bodies and for many of my patients. It’s an incentive to maintain a healthy appearance for the rest of their lives.
For some patients, tighter abdomen muscles may also help reduce lower back pain.
DETERMINE WHICH PROCEDURE IS RIGHT FOR YOU
Deciding which procedure is right for you will be contingent upon several factors and is best done in consultation with an experienced Plastic Surgeon. Some of them include your desired results, overall skin quality, body type and location of excess skin on the body.
The amount of excess skin will also determine which procedure is most appropriate. Finally, any scarring attained from a previous cosmetic procedure or surgery can determine which kind of tuck the patient qualifies for.
THE RECOVERY
You’ll want to figure out a time frame for your recovery so you have ample time to heal and can take a break from certain aspects of your life. Make sure you make the proper arrangements and are fully prepared for your recovery period.
Your drains will be left in for a few days after the surgery. You’ll be shown how to take care of and empty the drains. You’ll likely need to take an antibiotic and an anticoagulant while your drains are in place.
You’ll wear an abdominal binder for about six weeks. This helps to avoid fluid buildup and helps to support your abdomen.
While the recovery period is usually shorter for a mini-tummy tuck. You’ll still need to avoid strenuous activity for at least six weeks. This includes any vigorous exercise or heavy lifting.
Who is a Candidate?
- Women with loose or sagging abdominal wall skin.
- Women with abnormal relaxation of the anterior (front) abdominal wall muscles due to weight gain or loss, pregnancies, or prior surgery.
- Those who are unable to tighten the abdominal wall skin with exercise.
Intended Results
- A smoother flatter abdomen.
Procedure Description
- The procedure is usually performed at an accredited outpatient facility or hospital.
- Anesthetic options include local anesthesia with oral sedation, conscious sedation and general anesthesia.
- Mini-abdominoplasty can usually be performed under conscious sedation on an outpatient basis.
- Standard abdominoplasty tightens all of the abdominal wall skin leaving a standard scar.
- Mini-abdominoplasty tightens the lower abdominal wall skin only leaving a shorter scar.
- Small suction drains may be inserted with both procedures.
Recuperation and Healing
- Discomfort is usually controlled with oral medications or nasal spray.
- Recovery may be at home with a responsible adult caregiver, at a supervised recovery facility or at the hospital with an overnight stay.
- If placed, drains are removed in 2-7 days.
- Sutures are usually removed in 2-3 weeks.
- A compression garment with dressings over the incision sites is used.
- Light activity may be resumed in 7-21 days. Sports will probably not be comfortable for about 6 weeks.
- An abdominal binder (compression garment) is usually worn for 4-6 weeks.
Other Options
- Liposuction-liposculpture of the area.
Note
Abdominoplasty Dubai – The specific risks and the suitability of this procedure for a given individual can be determined only at the time of consultation. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally. Major complications are rare.
Abdominoplasty Dubai FAQs
Although skin is highly elastic, it can only take so much stretching before the effects become permanent. For someone who has been pregnant or lost a large amount of weight, one of the after-effects is often excess skin and residual fat around the midsection. This occurs because the skin stretches to accommodate excess fat or a growing baby.
Unfortunately, after birth or weight loss, the stretched skin remains. Another related issue is that pregnancy often causes the abdominal muscles to stretch too, which further contributes to the appearance of a sagging or expanding waistline.
Stretched skin and muscles can’t be dieted away or tightened with exercise. The only way to remove the excess tissue is with a tummy tuck, a procedure that removes the tissue to create a smoother, flatter, trimmer waistline.
While a tummy tuck can improve the appearance of your body after you lose weight, this procedure isn’t a substitute for weight loss. If you’re carrying excess weight in your midsection, a tummy tuck may not give you the results you desire. It may be more effective to lose excess weight first.
Abdominoplasty Dubai FAQs
This procedure is a good option for anyone who wants to remove excess skin and small fat deposits left behind after childbirth or weight loss. This includes people who have lost weight after having weight-loss surgery, as well as people who have lost weight primarily through exercise or dieting. The ideal candidate is:
- In good overall health
- Physically fit in general
- At a stable weight
If you still have a lot of weight you want to lose, or are planning to have more children in the future, it may be wiser to put off having a tummy tuck. This is because losing more weight or having more children will further change your body, and that may undo some or all of the effects of the tummy tuck procedure.
Abdominoplasty Dubai FAQs
The nature of your Abdominoplasty surgery depends on the body you have now and your goals for your body in the future. All Abdominoplasties at least involve removal of excess skin around the midsection. All Abdominoplasties leave scars, although they do fade and are positioned carefully to make them easier to hide.
Standard Abdominoplasty will do three things:
- Remove excess skin
- Remove excess fat around the waistline
- Tighten the abdominal muscles
Performing these steps sculpts, firms, and smooths the waistline. This is ideal for people who have excess skin after weight loss, giving birth, or simply as a result of the bodily changes that come with age. Standard tummy tucks require making a lengthy incision just above your pubic region. While the incision is placed so that it can be hidden by undergarments or a bikini, there will be lasting scarring.
Mini Abdominoplasty:
Similar to a standard Abdominoplasty, this procedure removes excess fat and loose skin from your lower abdomen, beneath the belly button. The muscles may be tightened or not, depending a patient’s needs. Since smaller amounts of tissue are removed in a mini Abdominoplasty, the incisions made are smaller too, and these are easily hidden by undergarments.
Extended Abdominoplasty:
This procedure is similar to a standard tummy tuck, but rather than focusing solely on the skin of the abdominal area, I also remove excess skin on the sides of the abdomen and on the lower back.
This kind of tummy tuck is also known as a 360-degree, extended abdominoplasty, or belt lipectomy. I often perform this procedure on people who have lost large amounts of weight. As this procedure involves removing skin from your back and sides as well as from your front abdominal area, incisions are longer, and scarring is more extensive.
Abdominoplasty Dubai FAQs
Recovering from a tummy tuck can take several weeks or months, especially if your procedure involves tightening the abdominal muscles. During this time, you’ll be advised to wear a compression garment to help reduce swelling and to provide support and protection for your abdominal area as it heals.
Additionally, it’s important to limit some kinds of physical activity in the first few months after the procedure. In particular, activities that involve the core muscles, including light and heavy lifting, as well as exercises, should be avoided.
Complete healing after a tummy tuck takes time. While you’ll find that most swelling is gone fairly quickly, it can take a year or more for your body to completely heal and for scarring to fade significantly.
Abdominoplasty Dubai FAQs
The results with tummy tuck surgery will be fairly long lasting or even permanent, provided the patient maintains an active lifestyle with a balanced diet and regular exercise and fitness regimen. Sedentary lifestyle or unhealthy diet may reverse the gains achieved through tummy tuck surgery over a period of time. In any case, tummy tuck is not a substitute for the effects of aging, which will continue to be established over time.
Abdominoplasty Dubai FAQs
How Much Is a Tummy Tuck in 2021?
One of the most common questions we get regarding tummy tuck cost is “how much is a tummy tuck cost.” Unfortunately, this is a really hard question to answer because there are so many factors that affect the price. Dr. Vigo can’t tell you right now how much your tummy tuck will be. But for the sake of transparency, we can discuss some of the factors to give you a ballpark figure:
The Extent of the Procedure
Sometimes, all a tummy tuck involves is tightening the loose, sagging skin below your navel. But the scope of the procedure can be a lot greater depending on your needs. In fact, this procedure is so customizable that there are three different names for it: a full (traditional), mini, or extended tummy tuck. A mini tummy tuck only addresses loose skin and excess skin and fat beneath your navel.
The Volume of Fat Removed
When we say the extent of your procedure affects the cost, we’re talking about a few things. First, we’re talking about how many things are being done, such as fat removal, excess skin removal, skin tightening and lifting, muscle tightening, muscle reshaping, or muscle repairing. The more services you have provided during your procedure, the more expensive your procedure will be. But you don’t just have to consider how many things are being done. You also have to consider how much work is being done. If we have to remove so much fat we are required to perform liposuction, for example, your procedure will cost more.
The Size of the Area
If we’re just tightening loose skin and removing fat from your lower abdomen, your procedure won’t cost very much. However, in the case of a full tummy tuck, the scope of the procedure includes both your lower and upper abdomen. Extended tummy tucks cost the most because they also cover the sides and back.
The Type of Anesthesia Used
The type of anesthesia and the dosage you receive are two other significant factors that will affect how much your procedure costs. The larger your required dosage is, the more expensive it will be. The appropriate dosage for your needs will depend on how long your procedure takes and how much you weigh. Regarding the type of anesthesia, general anesthesia is usually more expensive than local anesthesia. This takes into account that local anesthesia is usually administered with a sedative so you can sleep through your procedure.
The Number of Procedures Performed
Sometimes, lifting and tightening your stomach skin isn’t enough to achieve your ideal aesthetic. In such cases, you may be a good candidate for another procedure, such as liposuction. Liposuction is a fat removal procedure designed to contour an ideal body by removing excess fat via suction.
Lipo is an ideal complement to a tummy tuck because it can remove more excess fat than a tummy tuck can. However, if you combine liposuction with your tummy tuck, you can save money on both procedures. Other factors that can change the cost of liposuction include the technique used and the number of areas sculpted.
Each patient is unique, and so aesthetic procedures will naturally have different outcomes on their bodies.
At your consultation with Dr. Vigo, he will cover the full cost of your treatment including:
- Surgeon Fees
- OT and Anaesthesia costs
- Cost of Disposable/consumables used during surgery
- Room charges for two days/one night
- Post operative surgeon visits
- One OPD follow up visit.
- Excluded form the price is medicines and any service not related to the surgical procedure.
Start your journey today and book a no-obligation consultation.
A distinct improvement in the abdominal contours can be seen immediately after the tummy tuck procedure. The swelling and bruising will continue to subside gradually over several weeks, and the full effects of the surgery will become visible.
Abdominoplasty Dubai FAQs
Panniculectomies and tummy tucks are used to get rid of excess skin around the lower stomach after losing weight. While a panniculectomy is considered a medical necessity after a significant amount of weight loss, a tummy tuck is an elective procedure for cosmetic reasons.
Safety
Common side effects for both procedures include pain and numbness. Scarring is also likely, though it will fade over the course of several months.
Rare complications include infection, significant pain and numbness, and bleeding.
Convenience
Both types of procedures are invasive surgeries that require a great deal of preparation and post-operative care.
It’s important to find a board-certified surgeon with extensive experience in each procedure.
Cost
A panniculectomy is more expensive than a tummy tuck, but it’s often covered by medical insurance. A tummy tuck is less expensive but is not covered by insurance.
Efficacy
Panniculectomies and tummy tucks share similar success rates. The key is to make sure you lose weight before surgery, as weight maintenance is crucial to maintaining your treatment.
Overview
Panniculectomy and tummy tuck (abdominoplasty) are two surgical treatments aimed at removing excess lower belly skin. They may both be performed in cases of extreme weight loss from natural or surgical causes.
The goal of panniculectomy is to primarily remove hanging skin, while a tummy tuck also provides contouring effects to enhance your muscles and waistline. It’s also possible to have both procedures done at the same time.
The goal for both procedures is similar: to remove excess skin from the stomach. However, it’s important to learn the key differences between the two so that you get the results you want.
Comparing panniculectomy and tummy tuck
Both panniculectomies and tummy tucks target lower belly skin. The goal of the procedures is to get rid of loose, hanging skin that often forms after losing a lot of weight. This may be due to surgeries such as a gastric bypass, natural weight loss, or even pregnancy.
Panniculectomy
A panniculectomy is an invasive surgical treatment. It’s most helpful for people who have recently had weight loss surgery and are left with large amounts of hanging skin on the lower belly.
This type of surgery may be considered a medical necessity if the remaining skin affects your quality of life. For example, you may develop rashes, infections, and ulcers underneath the area of hanging skin.
During a panniculectomy, your surgeon will make two cuts into the abdominal wall to remove excess skin in the middle. Then the bottom portion of skin is reattached to the top via suturing.
Tummy tuck
A tummy tuck is also intended to remove excess skin. The key difference is that this invasive surgery is usually elected for aesthetic reasons and isn’t medically necessary like a panniculectomy.
In some cases, a tummy tuck can help alleviate incontinence and back pain.
With a tummy tuck, your doctor will cut out excess skin while also tightening abdominal muscles. While the surgery itself won’t give you six-pack abs, it will make it easier for you to build abdominal muscles on your own through exercise in the future.
How long does each procedure take?
Surgeries of this nature take time. Aside from the actual time spent in surgery, you should expect to arrive at the hospital early for pre-operative care. You’ll also need to stay in post-operative care while your doctor monitors your initial recovery.
Panniculectomy timeline
It takes about two to five hours for a surgeon to perform a panniculectomy. The exact timeline depends on the length of incisions made, as well as the amount of excess skin that’s being removed.
Tummy tuck timeline
A tummy tuck may take two to four hours to complete. Though the skin cutting may be less extensive than with a panniculectomy, your surgeon will still need to shape the abdominal wall in a tummy tuck.
Comparing results
Both panniculectomy and tummy tuck share similar success rates. The key is to maintain a healthy lifestyle following the procedure so you get the best results.
Results of a panniculectomy
The recovery process may be slow, but the results from a panniculectomy following massive weight loss are considered permanent. If you maintain your weight, you shouldn’t need any follow-up surgeries.
Results of a tummy tuck
The results of a tummy tuck are also considered permanent if you maintain a healthy weight. To increase your chances for long-term results, your doctor may recommend you lose or maintain a stable weight before the procedure.
Who is a good candidate?
You may be a better fit for one procedure over another. Both panniculectomies and tummy tucks are intended for adults and for women who aren’t pregnant, as well as for those who don’t smoke and are at a stable body weight.
It’s important to remember that while both surgeries target excess lower belly skin, these aren’t weight loss procedures.
Panniculectomy candidates
You may be a candidate for a panniculectomy if you:
have recently lost a large amount of weight and have loose belly skin that you want to remove
are experiencing hygiene issues from excess skin hanging below the pubic region
keep getting ulcers, infections, and other related issues under the hanging skin
have recently had gastric bypass or bariatric weight loss surgeries
Tummy tuck candidates
A tummy tuck may be a good fit if you:
are trying to get rid of “belly pooch” from a recent pregnancy
have trouble getting rid of excess skin around the abdomen despite diet and exercise
are in overall good health and are at a healthy weight
have talked to your surgeon and they want to perform this operation after a panniculectomy
Comparing costs
The cost of panniculectomies and tummy tucks can vary drastically, especially when considering insurance coverage. Below are total estimated costs.
You’ll need to check with your doctor for a breakdown of all the costs before the selected procedure. Some facilities may provide a payment plan option.
Costs of a panniculectomy
A panniculectomy is far more expensive out of pocket. This may not include other associated costs, such as anesthesia and hospital care.
Many medical insurance companies will cover a portion of this procedure. This is especially the case if your doctor thinks the panniculectomy is medically necessary.
You’ll want to call your insurance company ahead of time to see how much they’ll cover or if you’ll need to work with a specific surgeon.
Another consideration is the cost of taking time off work. It can take up to eight weeks to recover from this procedure.
Costs of a tummy tuck
While a tummy tuck is the cheaper option of the two procedures, it’s usually not covered by medical insurance. Like a panniculectomy, you’ll need to spend time off work or school after a tummy tuck surgery. Since this surgery isn’t as extensive, you’ll spend less time in recovery.
The average recovery time is about four to six weeks. More or less recovery time may be needed depending on the incision number and size.
Comparing the side effects
Like any type of surgery, both panniculectomy and tummy tuck can cause immediate discomfort, along with a risk of side effects. Some of these effects are common, while others are rarer and require further medical attention.
Side effects of a panniculectomy
It’s common to experience pain for the first few days post-surgery. Your skin may also be numb, and the numbness can last for several weeks. The numbness is from the two areas of skin being sutured together after removing the excess skin between them during surgery.
Fluid retention is another possible side effect that may be minimized with drains inserted into the stomach after surgery.
Additionally, you may not be able to stand up straight for a week or two due to the healing process.
The following side effects are rare, and may require emergency medical attention:
infection
heart palpitations
excessive bleeding
chest pain
shortness of breath
Side effects of a tummy tuck
Immediate side effects of a tummy tuck include pain, bruising, and numbness. You might feel slight pain and numbness several weeks later.
Rare but serious side effects include:
infection
excessive bleeding
anesthesia complications
deep vein thrombosis
Comparison chart
Below is a breakdown of the primary similarities and differences between these two procedures. Consult your doctor for further details, and to see which surgery is best for your own circumstances.
Panniculectomy Tummy tuck
Procedure type Surgery with two large incisions Surgery, though less extensive
Pain General anesthesia prevents pain during procedure. You may feel slight pain for several months, along with some numbness. General anesthesia prevents pain during procedure. You may be in pain for the first few days following the procedure.
Number of treatments One procedure that takes between 2 and 5 hours One procedure that takes between 2 and 4 hours
Expected results Long term. Permanent scarring is expected, but will fade some with time. Long term. Permanent scarring is expected, though not as prominent.
Disqualification Pregnancy or plans to become pregnant. You may also be disqualified if a surgeon thinks a tummy tuck is a better
Tummy tuck surgery can often accomplish results beyond those that you can achieve through diet and exercise. Heredity, weight loss, pregnancy, and even age can cause or leave a rounded belly, when you desire a flatter profile. However, any surgery has its risks and conventional tummy tuck procedures are known for their long and uncomfortable recovery periods.
There’s good news, though, if you’re still considering a tummy tuck. New techniques and technological advancements are changing the surgery to speed up recovery time, minimize discomfort, and reduce visible scars. Most of the drawbacks of conventional tummy tucks are now diminished, and the positive impact on your life has improved. Combined with other procedures to achieve your cosmetic goals, it’s possible to create a “new you” to move forward with confidence.
There are different types of Tummy Tuck surgery available. Dr. Matteo Vigo will advise on the appropriate technique for each individual case; this will depend on how much excess skin needs to be removed and the extent of any underlying muscle damage:
Conventional abdominoplasty
The traditional approach to abdominoplasty created a horizontal incision along the lower abdomen. Skin and fat were then separated from the muscle, the belly button was cut for relocation, and then the muscles were tightened surgically. Skin and fat were then folded back down, the excess tissue cut away, and then sutured together to close the incision.
There are three primary problems with this approach. The separation of skin, fat, and muscle can compromise blood flow to the affected areas, prolonging the healing process and potentially causing complications to recovery. Liposuction can’t be performed at the same time as a conventional tummy tuck, since this may further affect the recovery process. Traditional abdominoplasty requires the installation of drainage tubes to allow fluid build-up an exit route from the body.
Mini abdominoplasty
A mini-abdominoplasty is similar to a standard abdominoplasty with a few differences. Like the latter, the mini-abdominoplasty uses a waist crease incision but often (but not always depending upon the amount of skin to be removed) the incision is not quite as long as with the standard procedure. A shorter incision does not mean you will heal faster or have a shorter recovery, the difference in incision length is not enough to make such a difference. Wounds heal side to side, not end to end, so a shorter incision heals in the same time as a longer incision. There are some other substantial differences. There is no incision made around the umbilicus, and it is for this reason that when the skin is lifted up off the abdominal wall, it is only to the level of the umbilicus. As only the lower abdominal wall is exposed, only the lower abdominal muscles can be tightened.
There is a variety of abdominoplasty procedure where the umbilicus is left intact on the outside skin but cut at its base from the abdominal wall. This is called floating the “umbilicus”. In this procedure, the umbilicus is left intact to the surrounding skin on the outside, but as the abdominal skin is lifted upwards off the abdominal wall, when the umbilicus is encountered, it is transected (cut) from its attachment down below on the abdominal wall. Now the umbilicus floats upward off the abdominal wall, remaining attached to the abdominal skin. This will allow the surgeon access to the upper abdominal muscles for tightening. This is a fantastic procedure but is limited to the rare situation when there is abdominal muscle laxity but minimal to no upper abdominal skin excess. As the abdominal skin is pulled downwards to the pelvis, so does the position of the umbilicus. Lastly, when the abdominal wound is closed, the umbilicus may be pulled down slightly, usually no more than a centimeter or so, and this doesn’t appear to cause any concern in my experience.Patient selection is critical, as if this procedure is performed on a patient with too much upper abdominal skin laxity, the umbilicus will end up too low on the abdomen which will not look good.
The indication for a mini-abdominoplasty is basically excess lower abdominal skin with or without a lax lower abdominal wall. The upper abdomen is in good shape, no excess skin or lax wall. In these cases there is no reason to alter the upper abdomen and thus no need to get the umbilicus out of the way and therefore there is no need for an incision around the umbilicus. the recovery from this procedure is easier than a standard abdominoplasty because only the lower half of the abdomen is operated, as opposed to the entire abdomen. An easier recovery is not a reason to select this procedure. If you need a standard abdominoplasty and you select a mini-abdominoplasty procedure, you will probably be very disappointed as there will be either too much skin laxity in the upper abdomen, a bulge in the upper abdomen from abdominal muscles that were not tightened, or both. This is where the experience of the surgeon is very important. However, if you do have a mini-abdominoplasty and you really need a standard abdominoplasty or later on with weight changes you develop the need for a standard abdominoplasty, the performance of a mini-abdominoplasty now will not burn any bridges for later. That is to say, if you have a mini-abdominoplasty now, you can easily perform a standard abdominoplasty at any time later.
Endoscopic tummy tuck
An endoscopic tummy tuck allows the abdominal wall to be repaired or tightened in a similar way to a full tummy tuck but with a much smaller incision. Recovery time is comparable to a full tummy tuck since the abdominal wall repair (muscle repair) is what often creates most of the discomfort. A drain and an abdominal binder are still used during the recovery. Because the requirements for an endoscopic tummy tuck are so specific, this procedure may not be right for some patients. An endoscopic tummy tuck is ideal for patients with good skin tone and loose abdominal wall muscles. A modified endoscopic tummy tuck is similar to an endoscopic tummy tuck combined with a mini tummy tuck. A modified endoscopic tummy tuck may be appropriate in patients who have had a prior C-section and already have a scar near the pubic bone.
Lipoabdominoplasty
Would you like a flatter, more toned abdomen? When you’ve tried exercise regimes to no avail, you may wish to consider surgical options. To improve the aesthetic appeal of your abdomen, an abdominoplasty, otherwise known as a tummy tuck, is an appropriate solution. A tummy tuck involves the removal of excess skin found in the lower abdomen, and can also tighten the abdominal muscles.
However, a tummy tuck isn’t the best option for the removal of excess fat. When you are wishing to remove fat without removing any excess skin, liposuction is the better option. Liposuction involves using small cannulas to remove excess fat. However, this procedure is suitable for those who still have good skin laxity, as the skin will need to shrink once the fat has been removed.
This is where lipoabdominoplasty comes in. Lipoabdominoplasty combines the tummy tuck and liposuction – so you can have excess skin removed through the tummy tuck, and have liposuction at the same time.
Who can have lipoabdominoplasty?
If you are considering lipoabdominoplasty, you will have to be in good physical and mental health. You will also be required to quit smoking prior to the procedure, as well as during the recovery period.
If you have excess fat and skin around the abdominal area you will be considered a suitable candidate for a lipoabdominoplasty. If you have been pregnant or undergone a large weight loss, you will be a suitable candidate.
However, if you are considered obese, you will not be suitable for this procedure.
What does lipoabdominoplasty involve?
The lipoabdominoplasty procedure combines a tummy tuck and liposuction.
During the tummy tuck, the surgeon will make an incision which runs from hip to hip. This incision size will vary depending on the amount of excess skin which is being removed. The abdominal skin is then lifted, and the muscles and skin are tightened. The belly button will also be repositioned.
Reverse abdominoplasty
The Reverse Abdominoplasty, sometimes referred to as the Revise Tummy Tuck, is a surgical procedure designed to lift and tighten lax sagging skin from the stomach. Different from the traditional Tummy Tuck, which excises skin from the lower stomach, the Reverse Abdominoplasty removes skin only from the upper portion. An inframammary incision below the breasts is used for a Reverse Abdominoplasty, leaving the scars well hidden within the breast crease. The technique can easily be combined with other body sculpting procedures, such as a Breast Augmentation using the same incision, for optimal results. The ideal candidate will be in good health, not smoke, understand the surgical procedure, and hold realistic expectations for their results. Women who are planning on becoming pregnant in the future should discuss their aesthetic goals with the doctors first. There is the possibility that pregnancy will pull and stretch abdominal tissues, un-doing the initial surgical results. In this instance, a revision procedure may be necessary.
THE REVERSE ABDOMINOPLASTY PROCEDURE
The procedure begins with a small incision along the inframammary fold, along the crease breast crease. From here, he will excise the unwanted, loose skin along the upper abdomen, as well as the unsightly fatty deposits. The remaining skin is then pulled upward until taut, followed by dissolvable stitches to hold the tissue in place. With this procedure, there is no need to reposition the belly button, which often occurs during the traditional Tummy Tuck.
RECOVERY
Patients should expect the recovery after the procedure to take between one and two weeks. Initially, patients will need to wear a special surgical bandage or compression garment. Swelling, bruising, and tenderness may remain for the first 10-14 days.
There will be mild to moderate discomfort for the first week, so at this time, you will be prescribed with pain medications needed for a comfortable, at-home recovery. In one to two weeks, patients will feel well enough to return to work. Strenuous activities, heavy lifting, and exercise should be postponed for four to six weeks.
Circumferential abdominoplasty
After liposuction or considerable weight loss, Dr. Matteo Vigo may suggest a circumferential abdominoplasty. Circumferential abdominoplasty uses longer incision to remove excess skin from the lower tummy while lifting the butt, hips, and thighs.
During your procedure, local anesthesia will be administered to give you the most comfortable experience. Dr. Matteo Vigo starts by operating on your buttocks and thighs, removing excess skin and soft tissue. He then closes the incisions on your backside with sutures before gently and safely turning you.
Next, he makes an incision in your abdominal skin and lifts it off your abdominal muscles. Your belly button is repositioned on the new tummy, and your muscles are tightened before being replaced over your abdomen. Dr. Matteo Vigo places drains underneath your incisions before stitching you up.
Circumferential abdominoplasty is an in-patient procedure and usually requires several days in the hospital before returning home. Dr. Matteo Vigoremoves the drainage tubes in 1-2 weeks after your surgery.
Fleur de Lis abdominoplasty
The fleur de lis abdominoplasty surgery is performed with the aim of removing large amounts of excess skin for overall better body contouring.
What is Fleur de Lis Abdominoplasty?
The focus of the fleur de lis abdominoplasty surgery is to remove large amounts of excess skin from the abdominal area of the body. During this surgery, some form of fat removal and muscle tightening may also take place if needed, but this is more in line with a regular tummy tuck.
A fleur de lis surgery differs from the more traditional abdominoplasty surgery in a number of ways. But, the primary difference between the two surgeries is the incision.
The fleur de lis incision is where the procedure gets its name. It includes the traditional, vertical, incision from hip bone to hip bone. But, then there is also a horizontal incision from the bottom of the ribs down to the pubic area, intersecting with the first incision. This allows for the removal of loose skin that exists on the lateral side of the abdomen. This extended incision allows for skin to be removed both from above and below the first incision, but then both to the right and left thanks to the second.
This means a greater deal of skin can be removed during the fleur de lis procedure compared to a traditional abdominoplasty surgery.
As such, the amount of excess skin will be what determines whether you need a partial, full or a fleur de lis abdominoplasty surgery. The more excess skin you have the more intensive a procedure you will need.
Fleur De Lis Consultation
During your consultation, Dr. Matteo Vigo will discuss your expectations and desires prior to the surgery. It is important to be honest during this process, as only then can the right surgery be chosen for your individual needs. If you have been told by others to seek a body contouring procedure, then you will not be eligible for surgery.
All health concerns and questions regarding the surgery – including costs – will be explained at this time.
The Fleur de Lis Surgery
Once you have decided upon and been approved for the fleur de lis surgery, there may be some pre-surgery checks to be made. But, this will be decided during your consultation and all performed prior to your surgery. Should you feel ill or your health deteriorates whatsoever prior to the surgery date then it is important to inform your surgeon. Your surgery date will then be rearranged to suit your wellbeing and overall health.
You will be advised against the following prior to your surgery:
Stop smoking at least six weeks prior;
Avoid taking blood thinners, such as aspirin;
Do not take anti-inflammatory drugs;
Or herbal supplements.
During the surgery your excess skin will be removed, your tummy muscles tightened and your belly button will also be relocated. Dissolvable stitches are then used to close the incisions and a compressive dressing will be used. This helps the wounds to seal and heal with good support.
Post Fleur de Lis Surgery
As with all surgery with Dr. Matteo Vigo, you will receive dedicated support and aftercare following your fleur de lis surgery. Typical advice we give during this time includes:
Avoid excessive strain during the first week post-surgery.
Wear a support garment for 4-6 weeks following surgery.
Light exercise can be resumed around 3-4 weeks after your surgery.
Full exercise is possible around 6-8 weeks.
Massage the scar once fully healed to improve the appearance long term.
A fleur de lis wound can take longer to heal than your average abdominoplasty or tummy tuck surgery wound. This is, largely, due to the area where the vertical and horizontal scar meets having difficulty healing. This will eventually heal given time.
An Abdominoplasty Dubai is a highly individualized procedure. You should do it for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image.
In general, you may be a good tummy tuck candidate if:
You are physically healthy and at a stable weight
You have realistic expectations
You are a nonsmoker
You are bothered by the appearance of your abdomen
Patients who are good candidates for abdominoplasty procedures are finished having children and have increased amounts of skin laxity or looseness from the belly button down to the suprapubic region. A significant amount of skin is required in order to undergo an abdominoplasty procedure without tension to the lower scar. Patients should be in excellent health, should have a history and physical exam, often a 12 lead EKG, and full set of laboratories to determine their preoperative clearance. Patients who have increased amount of intraperitoneal fat are often referred to as beer belly-like abdomens often do not get a great result for abdominoplasty for the reason that the fat cannot be removed in the abdominal cavity through surgical correction as can be with an abdominoplasty. Remember a tummy tuck only removes the skin and fat outside of the muscle layers of the abdomen. Scarring is another concern, especially with patients who have increased melanin or darker skin. (For example, African American, Asian, Middle Eastern). Increased risk of keloid, hypertrophic scarring and pigmentation changes can certainly occur.
1. You have loose skin around your abdomen.
Although a Abdominoplasty Dubai can certainly target stubborn pockets of fat, to qualify for this procedure, you must also have a significant amount of excess skin around your abdomen. A plastic surgeon will create a fairly sizeable incision to perform a tummy tuck, and if you do not have enough excess skin, it can cause tension in the scar, leading to an unsightly “stretched” look. Both full and partial tummy tucks are available, so if you only have excess skin below your belly button, you may still be a candidate for the latter procedure.
2. You are have overall good health.
Although tummy tucks are low-risk procedures, you should not undergo this surgery if you have any serious underlying health issues. Because you will be sedated with general anesthesia, you must have a healthy heart and lungs. Additionally, autoimmune disorders and connective tissue disorders can cause serious problems with the healing process. Finally, if your skin typically develops thick, raised scars, you should discuss this with your doctor before undergoing a tummy tuck.
3. You have realistic expectations for the surgery.
Although Abdominoplasty Dubai can have a remarkable impact on your appearance and self-confidence, they are not intended to be a weight-loss surgery. You should be aware that following your surgery, you will face a significant amount of recovery time, and your results will appear gradually as your healing progresses. To maintain the results of your tummy tuck, you will need to eat a healthy diet and maintain a regular exercise routine. If you are committed to a healthy lifestyle, you are likely an excellent candidate for this procedure.
4. You have had a baby or lost a significant amount of weight.
Both pregnancy and obesity can cause damage to the abdominal muscles and can stretch the skin around the belly. The skin and muscles are permanently damaged, and even after a patient delivers the baby or reaches a healthy weight range, the tissues will continue to hang loosely around the stomach. A tummy tuck can repair these tissues so that your body will more accurately reflect your healthy weight range.
5. You are not planning on becoming pregnant.
If you are planning to have more children, you should wait to undergo a tummy tuck. Future pregnancies can separate the repaired muscles and re-stretch the skin around your belly, meaning you will have to undergo another procedure to restore the results of your first tummy tuck. However, if you do have an unexpected pregnancy, your previous tummy tuck will not affect the health of your baby.
6. You are not planning on losing more weight.
You should be within 15 to 20 pounds of your ideal weight before undergoing a tummy tuck. While many patients do lose some weight after the procedure, if you lose more than 30 pounds, it can leave more excess skin and sagging muscles around your stomach, negating the results of your procedure.
Are workouts not giving you the firm tummy you long for? If the extra fat or additional skin on your tummy has failed to shrink with exercise or diet, you may want to try a tummy tuck, also known as abdominoplasty. The tummy tuck is a cosmetic procedure that makes your abdomen firm and flat by taking out surplus fat and skin and tightening the abdominal muscles.
The tummy tuck is a major plastic surgery, so it is important to educate yourself about the procedure before making the decision to go under the knife. You should analyze your personal situation, your medical conditions, and your expectations of the procedure. Remember, a tummy tuck should be the last option after you have tried all other options to no avail. It is also important to note that a tummy tuck should not be used as a weight loss substitute.
To analyze your candidacy for a tummy tuck, you should start by making sure that you are doing it not to satisfy the desire of someone else, but for yourself. If you are in good physical condition and you haven’t experienced any major health problems in the last five years, you are possibly a good candidate for the procedure. In order to be an ideal candidate for a tummy tuck, you should have realistic goals and expectations for the procedure in addition to having a positive attitude.
You may be a good candidate for a tummy tuck if:
Factors like aging, genetics, surgical procedures, weight loss, or pregnancy have given you extra loose skin on your tummy.
You do not smoke or are ready to quit smoking months before the procedure. It is important to understand that nicotine slows the healing process and makes you more susceptible to infection, inflammation, and other complications.
Your weight is stable. If you are slim and have excess skin or fat on your abdomen, you are a good candidate for a tummy tuck. If you are highly obese, you may not be a good candidate for this procedure.
You are in good physical condition to stand the surgery.
You have no plans for more children, if you are a woman. Remember, the muscles restored during a tummy tuck can disengage again when you get pregnant.
You may not be a good candidate for a tummy tuck if you are in poor health or if previous surgeries have created scars on your abdomen.
If you are a woman who wants to be pregnant in the future, you should delay a tummy tuck. Moreover, if you are planning to lose weight, you should postpone a tummy tuck until your weight has stabilized. Also, you should know that the tummy tuck is a surgical procedure, and it will create scarring on your body. If you don’t like scars, you should reconsider your decision to have the procedure.
As said earlier, the tummy tuck procedure is a last resort to get rid of unnecessary fat on your abdomen. You should try every other option like exercise and diet before undergoing surgery. Go for this option only if you’ve exhausted all other options, and if you feel that the shape of your abdomen is marring your self-confidence.
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Areas that can be treated with an abdominoplasty include:
Upper abdominal area
Lower abdominal area
Both upper and lower abdominals
The ‘belt line’ – around the midriff from front to back
Entire stomach, lower back and buttocks
The underlying abdominal muscles
An abdominoplasty, is a plastic surgery procedure where excess skin and fat are removed from the abdomen to achieve a smoother and tighter appearance to the stomach. The best candidate for a tummy tuck is someone who is as close to their ideal weight as possible, in good health and have realistic expectations of what can be achieved with tummy tuck surgery. Tummy tuck procedures can be performed on both male and female patients as long as they are over the age of 18, there is no upper age limit to a tummy tuck although all patients will be required to have a pre-surgery check up to make sure they are fit and well enough to have elective surgery.
Tummy tuck patient examples include:
Patients who have lost a significant amount of weight and have been left with excess skin in the abdomen area.
Patients following pregnancy have had their abdominal muscles and skin stretched resulting in loose skin sitting on the stomach.
Patients who have lost weight with diet and exercise but still feel their stomach is not in proportion to the rest of their body, and usually the skin is lacking elasticity to be suitable for liposuction alone.
Patients who have previously had a C-section and have retracted scarring.
Tummy tucks should not be thought of as a substitute for weight loss or an exercise program. The procedure cannot correct stretch marks, although these may be removed or somewhat improved if they are located on the areas of excess skin that will be treated.
Types of tummy tuck
There are a variety of different tummy tuck techniques. The one you have will depend on how much skin and fat you need to have removed. Your surgeon will explain the different types and be able to advice on which type they feel is most suitable for you.
Full Abdominoplasty: This is known as a full tummy tuck or a standard tummy tuck. It is one of the most commonly performed tummy tuck procedures. It is designed to remove fat, repair any torn muscles and remove any excess skin. A full tummy tuck scar sits along the upper pubic region, your surgeon will usually try to plan it so it will sit in your underwear line so when wearing clothing such as a bikini it should remain concealed.
Extended Abdominoplasty: An extended tummy tuck will not only remove skin and fat from the tummy area but it will also target the excess skin in the flanks, upper hips and lower back regions too. An extended tummy tuck also comes with an extended scar which often stretches around the back of the patient.
Mini Abdominoplasty: A mini tummy tuck is best for patients who only have a small amount of tissue between the areas above your pubic region to the tummy button, your stomach may have a crinkly appearance but doesn’t necessarily over-hang. A mini tummy tuck can also still repair the muscles as well as removing excess skin and tightening up the lower part of the tummy. A mini abdominoplasty scar is usually a lot smaller than a full abdominoplasty but this is not always the case, the biggest different in scar is that no scar will be made around the belly button as this section of the stomach is not touched in a mini abdominoplasty.
Fleur de lis Abdominoplasty: A fleur de lis tummy tuck is designed to target excess skin from both the upper and lower abdomen in a vertical direction. The skin is pulled downward and inwards towards the center of your abdomen resulting in a smooth and tummy. The technique gets its name from the incision used which is a long, vertical scar that extends from the bottom of your breastbone to your upper pubic region and then across the upper pubic region like a standard tummy tuck scar.
Brazilian Abdominoplasty: A Brazilian tummy tuck is the name for the combination technique of liposuction with a tummy tuck. Liposuction is used to remove fat from the areas being treated to help give a more sculpted appearance once the excess skin is removed and tightened. The Brazilian tummy tuck technique can be applied to all the different tummy tuck types including a full tummy tuck, extended tummy tuck, mini tummy tuck and fleur de lis tummy tuck procedure. Scarring after a Brazilian tummy tuck will depend on which type of tummy tuck is performed.
What does a tummy tuck involve?
A tummy tuck procedure is performed under general anaesthetic in hospital. Patients usually are required to stay overnight after the procedure and will be able to return home the following day once checked over by the surgeon or nursing team.
The procedure will start with an incision being made, the size and position of the incision will depend on what type of tummy tuck procedure is being performed. For a full tummy tuck for example a horizontal incision will be made along the upper pubic region and around the belly button.
Dr. Matteo Vigo will then work to remove most of the skin and fat between your belly button and upper pubic region.
Some patients may be experiencing abdominal separation (Diastasis recti) which is where stomach muscles weaken and separate. It affects most women during and after pregnancy where the stomach and underlying muscles have been stretched but it can also occur in patients who have been doing excessive abdominal exercises or weightlifting the wrong way. Abdominal separation correction is included in an abdominoplasty procedure and involves using stitches to repair the abdominal wall and reduce the gap between the muscles.
The skin around your bellybutton will then be repositioned and brought out via a small incision and sutured back into its normal position. The incision will then be stitched together and bandaged up with tape and a garment is placed over the area treated. A tummy tuck procedure usually takes around 3 hours to complete.
Tummy Tuck aftercare
Every patient will heal differently after a tummy tuck and this is just down to their own personal healing rates and also the type of tummy tuck procedure that was performed. You will be given a course of painkillers and antibiotics to take following surgery and you will need to wear your surgical garment for 6 weeks following your procedure to help aid any fluid retention and support you whilst you heal. Patients may feel tight in their stomach for the initial week following surgery but this should get better as the swelling subsides and we encourage patients to get up and take regular walks throughout the day. Patients should avoid lifting anything that could make you strain for 6 weeks which includes children, heavy bags and vacuum cleaners for example.
Patients can look to return to work after 2-3 weeks, however this will depend on their job role – if your job is a little more strenuous or requires manual labour then it may be best to wait until your surgeon gives you the go ahead or see if you can take on a less demanding role temporarily whilst you are healing. Patients should also wait 6-8 weeks before returning to exercise, as with any procedure, it is important to listen to your body, take things gradually and always rest when required.
Tummy tuck results
The results of a tummy tuck are best seen after 6 weeks when all the swelling has subsided. It can take over a year for the scars to fully heal, your surgeon will be able to advise you on how to get the best out of your scars. This usually involves regularly massaging and moisturising the scars and keeping them out of the sun.
The results of a tummy tuck are designed to be permanent although lifestyle factors such as ageing, pregnancy and extreme weight loss or gain could alter the results.
Normally, general anesthesia is required for a tummy tuck surgery. An abdominoplasty is a reasonably large surgery requiring extensive dissection, muscle tightening, and large amount of skin removal. The patient must be kept from moving on the operating room table and complete surgical control is vital. The layer over the rectus muscle called the fascia is tightened in the midline as well. We have performed hundreds of tummy tucks under general anesthesia with safe and predictable results.
If you are considering a tummy tuck surgery and consult with more than one surgeon, you will likely get differing opinions about what type of anesthesia should be used. Do you need to have a general anesthetic and should the procedure be completed in the hospital setting? Or, is it better to use a deep sedation or even a conscious sedation anesthesia? Do you need an anesthesiologist or are certified nurse anesthetists (cRNAs) safe? The answers to these questions are not always clear and certainly can be debated. Here are my thoughts.
Anesthesiologist or nurse anesthetist?
If you talk to a surgeon who routinely uses an anesthesiologist for his/her procedures, you might be told that only an anesthesiologist has the training and knowledge to keep you safe during a tummy tuck. After all, do you really want to take your chances on having a complication by using an anesthesia provider who has less than the maximum amount of schooling and training? You might also be told that there just isn’t any reason to “scrimp” on your safety by trying to save a few dollars by using a nurse anesthetist.
Such statements seem convincing at first, but do they have merit? I can tell you that these statements were given to me as “selling points” by an anesthesiologist group that wanted me to use their services for my surgeries. They told me that even though they charged more for their services, I would more than make up for the extra costs by being able to “sell” the idea that I was providing a safer and more complete service. I could even charge my patients more for the surgeries because I would be easily able to convince them that they were getting a better product.
As a board certified surgeon, I certainly do not want to offer anything less than the best service possible to my patients and I certainly do not want to do anything that would compromise their safety. So I did some research to find the facts. And the facts are that there aren’t many clear facts. In all of my research, I have been unable to find a convincing study that proves that anesthesiologists are safer or provide better anesthesia than cRNAs for outpatient plastic surgery procedures including tummy tucks. Nor could I find studies that prove that cRNAs are better or safer.
There are two facts of which I am certain. One is that there are really good anesthesiologists and there are really good cRNAs. And two is that there are also really marginal anesthesiologists and equally marginal cRNAs. There are anesthesiologists that work almost exclusively in the hospital system and almost always use a general anesthetic. I would not feel very uncomfortable with such a person providing a deep anesthesia for a tummy tuck procedure because they just don’t do it all the time. There are cRNAs that spend almost all of their time providing deep sedation anesthesia in the outpatient setting that I would feel very uncomfortable giving general anesthesia for an open heart surgery because they just don’t do it all of the time. I would never want to minimize the importance of schooling and training, but like many things, schooling and training become less important the farther one gets into their career. At some point in time, it is the daily routine and knowledge gained from hands on experience that really matter most.
So anesthesiologist or cRNA? The answer could be either. I would choose the one that is the best at what they do. And the one that is the safest and most conscientious. I would choose the one that is the most caring and detail-oriented. And the fact is that such a person could either be an anesthesiologist or a cRNA. If you ask me, I would choose either of my two nurse anesthetists because I know their skill set, their attention to detail, their insistence on safety and protocol, and their track record of over 9 years of zero anesthesia complications while working in my operating room.
Is general anesthesia needed?
Just as there are myths spread about differing anesthesia providers, there are also untruths commonly discussed about the type of anesthesia needed to perform a world class tummy tuck surgery. I have often heard that general anesthesia is preferred or even required to complete an effective tummy tuck. Such statements are, of course, mostly made by surgeons who routinely use general anesthesia for their procedures. The basis for their assumption typically references one of the following ideas.
Effective tightening of the abdominal muscles during the rectus plication requires relaxation of the muscles that can only be achieved with a general anesthetic.
If muscles are tightened or plicated without general anesthesia, the post operative discomfort will be worse than necessary.
Deep sedation anesthesia for tummy tuck surgery is too much of an airway risk.
If I were a patient and was told any or all of these statements by a surgeon, I would be rather easily convinced that I needed a general anesthetic. And if any of the above statements were true all of the time, I would agree that general anesthesia would be preferable. But there is little, if any, evidence that these statements are always, if ever, true.
I have been using deep sedation or MAC anesthesia for tummy tuck surgery for 15 years. I purchased a general anesthesia ventilator during my first year in practice because I thought I might need it for tummy tuck surgery, but ended up giving it to a medical team in Africa several years ago because I never used it. The reason I never used it was because I was able to develop a technique for muscle tightening in which the sutures could be placed during a patients natural exhalation with deep sedation that did not compromise how tightly the muscles could be approximated. This technique allows for very effective muscle tightening without unnecessary tension on any individual suture and it does not result in unnecessary post operative discomfort. My patients, almost across the board, report that their post operative discomfort is less than expected even without the need for long acting local anesthetics such as Exparel. And I can report that in my 9 years of private practice doing more than 50 tummy tucks per year, I have never had an airway compromise during a tummy tuck surgery. The above statements simply are not true for all surgeons and certainly do not apply to my practice.
Why could deep sedation be preferable?
There are many surgeons that perform tummy tucks using general anesthesia and many that use deep sedation. I would argue that the type of anesthesia does not affect the end result of the surgery in any measurable way. Many surgeons that use general anesthesia have before and after photos with great results and surgeons that use deep sedation do as well. So why would deep sedation be preferable if the end result is likely the same?
If an endotracheal tube is not placed, the risk for sore throats is minimized or eliminated.
If a laryngoscope is not used, the chances of a chipped tooth or injury to the mouth is eliminated.
The risk of post operative nausea and vomiting has been shown to be significantly less with propofol than with general anesthetic medications including nitrous oxide.
The speed of recovery from anesthesia is significantly faster with deep sedation anesthesia than with general anesthesia.
The risk of blood clots (DVTs) and pulmonary compromise (PE) and death has been shown to be lower with spinal and epidural anesthesia when compared with general anesthesia. Deep sedation anesthesia is also thought to have this lower risk when compared with general anesthesia.
For these reasons, I have exclusively used deep sedation anesthesia for my tummy tuck patients. I strongly feel that I am doing so because it is the safest and most patient friendly method of anesthesia for tummy tuck surgery when given by skilled anesthesia providers.
A Tummy Tuck Without General Anesthesia Improves Recovery and Reduces Costs
We often think that advances in medicine mean that doctors can address problems that couldn’t be treated before. But we also should realize that medical innovations can lead to less invasive ways to perform standard surgical techniques. Traditional tummy tucks have been available for more than 100 years. Board certified in cosmetic surgery of the body, breasts and extremities, stays on top of surgical methods that help his patients look better and feel better about themselves. Today an “awake” tummy tuck without general anesthesia is a safer option and offers numerous benefits to patients.
Tumescent solution is critical for a tummy tuck without general anesthesia
The ability to combine local anesthetics with a blood vessel constrictor, lidocaine and epinephrine, in a saline solution and deliver them to a targeted region of the skin and subcutaneous tissue, makes development of tumescent anesthesia a significant advance for a tummy tuck without general anesthesia. Accuracy and safety are increased and the risk of lidocaine toxicity is reduced. Using a thin, blunt cannula or needle, A plastic surgeon infuses large quantities of the tumescent local anesthesia through small needle punctures to numb the specific area. This procedure causes the tissue to become swollen and firm – or tumescent.
The addition of a mild oral sedation during the first half of the procedure and IV sedation or twilight anesthesia during the second half of the procedure relaxes patients during the “awake” tummy tuck procedure so that they remain able to communicate with the doctor and follow requests. Other benefits of a tummy tuck without general anesthesia include the following:
Minimal bleeding: Traditional tummy tucks use electrocautery to prevent large amounts of blood loss. Massive dissection required to free up the abdominal flap also adds to the blood loss. Tumescent anesthesia narrows the blood vessels in the targeted tissue and allows it to be removed more efficiently and with considerably less bleeding.
Better results: With an “awake” tummy tuck procedure, patients can respond to doctors’ questions and move as necessary during the surgery. Following routine liposuction and before the actual tummy tuck, the patient can be inspected in a standing position. This step eliminates any guessing and improves the odds of achieving the optimal body shape and making a symmetrical incision. Patients may also use the restroom, avoiding the need for an indwelling urinary catheter.
Faster recovery: After a tummy tuck without general anesthesia, the patient can stand up from the operating table much sooner, ambulate and get dressed with assistance. This recovery is virtually unheard of with traditional tummy tucks, which require heavy sedation. Due to its long-lasting effects, tumescent anesthesia offers a minimum of 4 to 8 hours of pain control following the surgery.
Less cost: A tummy tuck without general anesthesia can be performed as an in-office procedure. It requires less time on the operating table and in recovery. Since hospitalization isn’t required, patients realize significant savings from this elective cosmetic surgery procedure.