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Surgical Solutions : Tummy Tuck
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There are three basic techniques used to flatten a protuberant abdomen. Liposuction, mini-tucks and full tummy tucks. The best technique for you will depend largely on your goals and your specific problem.
Liposuction alone can produce a thin abdominal wall for some. If your laxity and excess skin is below your navel, a mini tummy tuck may be right for you. For those with severe laxity of their abdominal muscle or excessive skin, a full tummy tuck may be their only solution.
A full tummy tuck is usually performed on an outpatient basis under general anesthesia with the patient asleep, or with spinal anesthesia. Surgery routinely starts by infiltrating fluids under the skin thereby creating a hydraulic dissection. This loosens up the skin. A long incision (red line) is made low down in the abdomen just above the pubis and all the tissues of the abdomen superficial to the muscles are elevated. The skin flap becomes very flexible due to the liposuction and slides down easily.
The flap is elevated up to the navel and after going around it, limited dissection is done in the upper abdomen so as to preserve most blood and lymphatic vessels and nerves. If needed the abdominal muscles are tightened at the midline. The excess skin can easily be removed, the belly button which has been buried inside is brought out through a circular incision at the correct location and the abdomen can be closed. This provides a firmer abdominal wall and narrows the waistline.
Using the tumescent liposuction technique with limited dissection allows for liposuction to be conducted safely at the same time of the tummy tuck operation, creating good contour, better waste line while minimizing the risks of seromas, bleeding and infections.
When the belly button sits to high in the abdomen or when there is minimal skin sagginess above it we recommend a small operation called a mini-tuck. The incision is kept lower than in the full tummy tuck albeit it is as long. There is no scar around the belly button. The patient may go home in the same day.
With full tummy tucks the patient stays in the hospital for one to two nights. Pain is also not a big problem due to liberal use of local anesthetics in the tissue planes during liposuction.
Regardless of which procedure you have, your incisions are closed with small sutures. Small drains may also be inserted to eliminate fluid buildup. Snug elastic bandages are then applied to the area. All tummy tucks in our centers are done under spinal anesthesia with mild sedation.
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