When was the last time you wore your ‘skinny jeans?’

Restore your slim, youthful waistline with a tummy tuck

• Have you been avoiding wearing belts?
• Do you choose clothing that camouflages your waistline?
• Are you dreading the thought of wearing a bathing suit?

More and more men and women are turning to a tummy tuck to slim down a protruding abdomen and restore a youthful silhouette.

What is a tummy tuck?

A tummy tuck, or abdominoplasty, is a plastic surgery procedure that gets rid of excess abdominal skin and fat, then tightens up the vertical muscles of your abdominal wall and smoothes the area around the navel.

After a tummy tuck, not only will your waistline be slimmer, but you will be trimmer all the way from your upper abdomen to your bikini line.

Are you a candidate for a tummy tuck?

A tummy tuck might be right for you if you are generally in good shape, but have:

• Weakened abdominal muscles due to pregnancy or aging
• Loose or sagging abdominal skin
• Abdominal fat that doesn't respond to diet or exercise
• A protruding abdomen that is out of proportion to the rest of your body

Who may not be a good candidate for a tummy tuck?

• Men and women who intend to lose a significant amount of weight should wait to have a tummy tuck until their weight is stabilized in a satisfactory range.
• Smokers or individuals with poor circulation are at greater risk of complications for a tummy tuck.

Are there other choices for achieving a slimmer waistline?

• A mini-tummy tuck, or partial abdominoplasty, is often a good choice for patients who have excess fat deposits only below the navel. In this procedure, the incision is much shorter than with a full tummy tuck, and the navel may not be repositioned.

In a mini-tummy tuck, Dr. Rappaport will separate the skin from the incision line up to the navel. Then he will tighten the fascia over the muscle, stretch the skin flap down, remove the loose excess skin and stitch the flap back in place.

• Liposuction is a fat-removal option for patients who have good skin elasticity and muscle tone. This can be an appropriate choice for women who may plan to become pregnant. Liposuction can also be used in combination with a tummy tuck.
• A lower body lift may be a better choice if you have a lost a massive amount of weight following bariatric surgery. This procedure is designed for men and women with a great deal of excess skin surrounding the torso. A lower body lift removes the loose tissues of the abdomen and back, and lifts the skin of the thighs and buttocks to create a slimmer, more youthful appearance.

Who is a good candidate for a mini-tummy tuck?

Good candidates for a mini-tummy tuck are patients with:

• A firm upper abdomen with no separation of the muscles
• No excessive subcutaneous, or just-under-the-skin, fat
• Some weakness or prominence in the area between the navel and the pubic mound
• A genetic tendency toward laxity of the lower abdominal wall. In these cases, it's not unusual to combine a mini-tummy tuck and liposuction.

Mini-tummy tuck patients are usually women who are in good shape, but who have weakness of the lower abdominal wall from pregnancy.

Are tummy tucks done on an inpatient or outpatient basis?

Tummy tucks can be done on an outpatient basis, but most patients prefer an overnight stay in the hospital—which is generally included in the cost of the facility in the Houston area.

How long does a tummy tuck procedure take?

Abdominoplasty is considered major aesthetic surgery; the procedure takes up to three hours.

Is there much discomfort after a tummy tuck?

The discomfort after a tummy tuck is usually associated with tightening of the muscles and fascia. Dr. Rappaport uses in-dwelling pain catheters with local anesthesia, which tend to make the recovery process much more comfortable. The catheter typically remains in place for three to five days. In most cases, it is easily removed at home by the patient.

What is involved in recuperating from a tummy tuck?

After tummy tuck surgery, a support garment and drainage tubes will help reduce swelling and prevent fluid collection. The drains are typically removed in five to seven days.

Tummy tuck recovery takes seven to 10 days and is gradual. Most patients return to non-strenuous activities in two weeks. It can take up to 12 months for the scar to fade.

Dr. Rappaport answers questions about tummy tucks

Can I have a tummy tuck if I intend to have children?

“Yes, you can have a tummy tuck and/or liposuction prior to having children. However, it's important to realize that if you get pregnant, you will likely lose the benefits of your abdominoplasty.”

If I exercise after having a baby, won't that get me back to a pre-pregnancy shape?

“It depends on your body. Some women are fortunate to resume near-pre-pregnancy shape, but most women complain that they cannot return to their previous figure.

“While exercise will help strengthen the muscles stretched open during pregnancy, it cannot replace the effectiveness of tummy tuck surgery for the correction of damaged or loose skin.”

How do you use liposuction in combination with a tummy tuck?

“I tend to be somewhat conservative in combining a full tummy tuck with liposuction of the abdominal area itself. But I often combine liposuction of the flanks, hips or thighs with a tummy tuck or mini-tummy tuck.”

Is a tummy tuck a good way to lose weight?

“No—but having a slimmer waistline will make it look like you've lost weight. A tummy tuck is not a weight-reduction procedure—it is purely a contouring operation. I'm creating a contour of the patient's torso that fits with the rest of his or her body.

“People who need abdominoplasty tend to have laxity and fullness in their midsection. A tummy tuck tightens the abdominal muscles and repositions the skin to achieve a flatter abdomen and put the curves where they should be.”

Wouldn't an ideal female belly be perfectly flat?

“No. A woman's belly should have a gentle softness in the area from below the belly button to the pubic region. This is a natural curve—we're not looking for iron abs.”

What do you consider an ideal waistline?

“A perfect waistline—about an inch above the belly button—is narrower than the hips and chest. Some people who are short-waisted may not have as much of a defined waistline because of the short distance between the rib cage and the hips.”

Does a tummy tuck remove stretch marks?

“A full tummy tuck removes most, if not all, of the skin between the belly button and the pubic region—along with the stretch marks. But any stretch marks above the navel will not be removed.”

Will my tummy tuck scar show when I wear a bikini or low-rise jeans?

“Scar position is an important consideration. I attempt to position the scar so it is concealed by most clothing. Keep in mind, however, that clothing styles do change and that scars are permanent, though they fade with time.”

Does a tummy tuck affect the pubic region?

“Yes. We pay attention to the pubic hairline and try to shorten it so the pubic hair does not extend up onto the abdomen. The benefits of doing this are twofold:

• The lower abdominal contour is improved.
• It supports and elevates the mons pubis, or pubic mound, in patients who may have gained some weight or have some excess laxity with age.”

I've heard of a non-surgical tummy tuck. What is that?

“A new form of light-based energy uses laser heat to tighten excess skin. This does not address even minor fat pockets, but can improve very mild laxity.”

My stomach hangs over my pubic region ever since I lost weight. Can a tummy tuck pull this up and tighten it?

“This may require a procedure called a panniculectomy to reduce significant skin and fat hanging below the abs. This degree of skin sag is often experienced by men and women who were or are morbidly obese.

“Gastric bypass patients often need this type of body contouring for overall hygiene as well as aesthetic considerations.”

Is a tummy tuck considered cosmetic surgery or reconstructive surgery?

“In most cases, a tummy tuck is considered a cosmetic procedure. However, if a tummy tuck is performed in conjunction with a medically necessary hernia repair or panniculectomy, it is possible that some portion of these procedures may be considered for coverage by your insurance carrier.”

What can a patient expect after a tummy tuck?

“My patients tend to be pretty happy with the results of their tummy tuck. You can expect to see a noticeable difference in the shape of your body very soon after your surgery. Over time, as you heal and the swelling subsides, the results will be even more noticeable.

“Many patients remark that they're able to wear fashions that they hadn't been able to wear in years.”