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San Diego Tummy Tuck

tummy-tuck-san-diego

Abdominoplasty surgery, more commonly known as a “tummy tuck” was performed over 100,000 times in the United States last year by plastic surgeons alone. In a sunny climate such as San Diego where a bikini can be worn eight months out of the year, many patients who suffer from excess skin or stretch marks would almost never consider such a revealing outfit in any circumstances. Abdominoplasty surgery is designed to improve some of the issues that arise from pregnancy or significant weight loss. Many women (and men) can suffer from excess skin, stretch marks or striae, and weakened abdominal muscles after a large drop in weight through diet, exercise, weight loss surgery or the delivery of a child. When this occurs, a tummy tuck is often the best (and frequently the only) means to improve your abdominal contour. There is no diet and exercise routine that will rid you of excess skin once this develops.

Tummy Tuck Candidates

The best candidates for a tummy tuck are those who have reached a goal weight that they can maintain, but still have some or all of the following: excess abdominal skin, abdominal stretch marks, and a stretch of the abdominal muscles – rectus diastasis. Skin is much like a rubber band and every individual has different stretching qualities – some are tight and have a tendency to break, others are very stretchy and elastic and everything in between. Depending upon your particular skin quality, weight loss, size of your child etc. – your skin will respond differently. If you are left with excess skin or significant stretch marks, an abdominoplasty surgery can permanently remove this skin, leaving you with an improved overall abdominal contour.

Tab Case Breastaug Img

WHAT TO EXPECT FOR YOUR

Tummy Tuck

Length:
2– 3 hours (depending upon the extent of the procedure)

Anesthesia:
General

In/Outpatient:
Outpatient, occasionally inpatient depending upon the extent of the procedure

Side Effects:
Temporary swelling, bruising and some pain

Risks:
Pain, bleeding, infection, fluid collections, wound healing problems, blood clots

Recovery:
Back to work: 1 – 2 weeks
More strenuous activity: 4 – 6 weeks

Final Appearance:
2 – 3 months

Duration of Results:
Permanent

Patients who remain overweight are often not the best candidates for an abdominoplasty, as their skin is less mobile with a thicker layer of fat, and less skin can be removed. As a result, we encourage patients to continue to reach a goal weight prior to proceeding with a tummy tuck. Occasionally, these patients are better suited to a liposuction procedure to help thin or “de-bulk” the abdominal fatty layer. Then, a tummy tuck procedure can be performed at a later date to address the excess skin.

It is very common after pregnancy for patients to have not only excess skin, but also a stretch of the underlying abdominal musculature. This happens as space is made for the growing fetus and the tissues holding the muscle layer together – fascia – is stretched. This tissue has no elastic component and thus, once stretched, will not tighten up. As a result, we routinely tighten the muscle layer (rectus diastasis) to help flatten the abdominal contour and re-shape the entire waist.

Similarly, we frequently see patients who have some excess fatty tissue along the waist. Once we tighten the abdomen, this area can become more noticeable. Thus, liposuction is regularly added to the waist in conjunction with the overall tummy tuck procedure to help achieve the best overall contour and shape.

Abdominoplasty Surgery

Most tummy tuck procedures are performed in our fully accredited outpatient surgical facility under general anesthesia. All patients are assessed preoperatively to ensure that they are good candidates for the surgery as well as the anesthetic. We strive to keep the incision very low on the abdomen so that it is easily concealed in low cut jeans or even a bikini. In most tummy tuck procedures, the incision extends from hip bone to hip bone.  The skin and fatty tissues are separated from the underlying muscle layer all the way to the rib cage. The muscles are then tightened from the rib cage down to the pubic bone. I routinely do this in two layers to ensure long lasting results. The excess skin is then assessed and removed. We routinely use progressive tension sutures (PTS) or quilting sutures to help eliminate the space and limit the need for drains. This also helps to keep the scar narrow and maintain its position. We then suture the skin back together and create a new, more youthful belly button.

Tab Case Breastaug Img

WHAT TO EXPECT FOR YOUR

Mini Tummy Tuck

Length:
1 – 2 hours (depending upon the extent of the procedure)

Anesthesia:
General, or local with IV sedation

In/Outpatient:
Outpatient

Side Effects:
Temporary swelling, bruising and some pain

Risks:
Pain, bleeding, infection, fluid collections, wound healing problems, blood clots

Recovery:
Back to work: 1 week
More strenuous activity: 3 – 4 weeks

Final Appearance:
2 – 3 months

Duration of Results:
Permanent

As pregnancy equally affects a woman’s breasts, many women elect to simultaneously undergo a breast augmentation or lift to restore themselves to a better than pre-pregnancy appearance.  This is commonly described as a “mommy makeover.” With this combination, we can frequently complete the most dramatic transformations for patients. For most men, their primary concern is skin and less of the underlying muscle stretch (as it is weight loss not pregnancy). They are more often candidates for a “skin only” type abdominoplasty where only the skin is removed and the muscles do not need to be addressed. However, patients who have lost more that 100 lbs may need muscle tightening because of the “intra-abdominal” fat that accumulates with weight gain. This, just like a growing fetus, can stretch the muscles internally resulting in a lax abdominal wall.

Mini Tummy Tuck

Tummy tuck surgery can be tailored to meet the needs of every patient. A “mini” tummy tuck is a procedure designed to address skin or muscle bulge that are contained to the lower abdomen only (from the belly button down). Some women complain of an abdominal “pooch” or bulge that is localized to the lower abdominal wall only. In this surgery, excess skin is removed and the muscle is tightened, but the belly button is not repositioned, and thus there is no scarring around it. As this procedure is more of a limited approach, so too is the scarring as well as the recovery. Since we are not addressing or creating a new belly-button, care is taken to leave the scar very low on the abdomen so that it is easily concealed in a bikini or low-rise jeans. Drains may or may not be used in this procedure depending upon the specifics of each patient.

Tab Case Breastaug Img

WHAT TO EXPECT FOR YOUR

Extended Tummy Tuck

Length:
3 – 4 hours (depending upon the extent of the procedure)

Anesthesia:
General

In/Outpatient:
Outpatient, occasionally inpatient depending upon the extent of the procedure

Side Effects:
Temporary swelling, bruising and some pain

Risks:
Pain, bleeding, infection, fluid collections, wound healing problems, blood clots

Recovery:
Back to work: 1 – 2 weeks
More strenuous activity: 4 – 6 weeks

Final Appearance:
2 – 3 months

Duration of Results:
Permanent

Extended Tummy Tuck

Just like the women for whom a tummy tuck is too much and are candidates for a mini abdominoplasty, there are those where a standard procedure is not enough and are better suited for an “extended tummy tuck.”  An extended tummy tuck is just that, further extended around the sides to address the patient’s waist as well as excess that extends to the lower back and upper buttock.  A number of women have excess skin that is not merely confined to the abdomen alone and need a more extensive removal of skin. The scar stays within the borders of a bikini and extends around the waist stopping several inches short of the midline on both sides. Drains are routinely used to help reduce the accumulation of fluid beneath the skin during the early recovery period.

In order to successfully accomplish this procedure, our San Diego extended tummy tuck patients need to be operated on from both the front and the back. Thus, the procedure takes a bit longer and patients may be required to be monitored overnight to ensure a safe and uneventful recovery. Results are immediate and continue to improve and refine over the next eight to 12 weeks.

Tummy Tuck Recovery and Results

An abdominoplasty that involves the tightening of the underlying abdominal musculature is the technique that results in the most post-operative discomfort. “Skin-only” procedures often are much better tolerated since the muscles are not touched in this technique. Thus, we routinely offer patients the opportunity to use Exparel, a 72-hour “long-acting” pain reliever that is injected into the tissues at the time of surgery. There is no discomfort to the patient in the administration of this medicine. Patients often have little pain in the areas traditionally the most troublesome. In addition, oral pain medication, in combination with muscle relaxation, are routinely used, helping to keep patients comfortable through their recovery. We regularly use a single drain tube in most tummy tuck surgeries that stays in place for approximately one week. This can help in reducing swelling and making your recovery more rapid.

Most of my San Diego tummy tuck patients will notice an immediate improvement in the shape and contour of their abdomen and waist as soon as they awake from their procedure.  Just like any surgery, swelling will persist for six to eight weeks depending upon the procedure and individual patient.

San Diego Tummy Tuck Consultations

Contact our office to schedule your consultation with Dr. Marin.

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