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Tummy tuck (abdominoplasty)

About the procedure

A tummy tuck procedure, or abdominoplasty, is a procedure that is used to improve the contour of the abdominal wall. After people get older, the skin on the abdomen tends to sag and droop. This is very common in women who have had children or in patients who have lost weight, especially after weight loss surgery. This extra skin can be discouraging to patients because no matter how much they exercise and work out, the extra skin doesn’t go away. Sometimes when there is significant extra skin, it can be difficult to find clothing that fits properly and irritating rashes can form on the underside of the extra skin.

In order to remove the extra skin and regain the youthful contour of the abdominal wall, Dr. Hirsch will perform an abdominoplasty, or tummy tuck. During this procedure, Dr. Hirsch will lift up the skin on the abdominal wall and will remove the extra skin while pulling the remaining skin tight. Usually, Dr. Hirsch will tighten the abdominal wall muscles as well, which will help improve waistline definition. In order to sculpt and contour the sides of the abdomen, Dr. Hirsch will perform liposuction along the flanks. If you have a rectus diastaisis, Dr. Hirsch will correct this as well at the same time as your abdominoplasty.  The end result of the abdominoplasty procedure is a tighter, flatter abdominal wall! 

Because the abdominal wall is much tighter, patients usually experience mild to moderate discomfort after a tummy tuck, although they can usually go home on the same day as surgery. Most of the discomfort is due to the tightening of the abdominal wall, rather than the cutting away of the skin. Patients are asked to wear a compressive garment over their abdomen (especially if liposuction was performed as well), and may have drains in their abdomen as well. The discomfort after a tummy tuck is greatest during the first 2-3 days following surgery, but is usually significantly improved by 1 week and then almost gone at 2 weeks in most cases.

Frequently asked questions about tummy tuck (abdominoplasty):

What does the abdominoplasty scar look like, and where is it located?


The abdominoplasty scar runs along the lowest part of the abdominal wall, above the pubis, and runs from hip to hip. Depending on patient preference, the scar location can be modified and can be located slightly higher or lower as desired.


After I had my child, my rectus muscles look like they are spread apart.  Can this be fixed?


What you are describing is a rectus diastasis, which is a very common occurrence after pregnancy or massive weight loss.  During pregnancy, as the baby grows and your uterus enlarges, it pushes against your abdominal wall which causes the tissues in your abdominal wall to stretch.  As a result, the space between your rectus muscles increases as well.  Once the baby is born, the tissues of your abdominal wall shrink and return to your pre-pregnancy size with a few exceptions: there is usually extra skin that has been stretched out (especially in your lower abdomen), and the space between the rectus muscles generally does not disappear.  While exercise may help you lose your extra pregnancy weight and tone your abdominal muscles, no amount of exercise can completely get rid of the extra skin and eliminate the space between your muscles.

Fortunately, there is a surgical solution to this extra skin and rectus diastasis.  When Dr. Hirsch performs your abdominoplasty, he will remove the extra skin from your belly and will also tighten, or plicate, your rectus muscles.  This will greatly reduce the size of the space between the muscles and will help you achieve a youthful, more natural look to your belly!

Will I need to take blood thinner shots to prevent blood clots after abdominoplasty?


In some cases, you will need to take blood thinner shots after abdominoplasty to reduce the chances of you getting a blood clot in your legs- a potentially fatal condition. Every patient is different, and certain risk factors such as weight, activity level, and other general medical conditions are taken into account when deciding whether or not blood thinner shots are necessary. Dr. Hirsch will discuss this with you at the time of your consultation.
  

What is a fleur-de-lis abdominoplasty?


A fleur de lis abdominoplasty is a special type of abdominoplasty procedure. Most people who have extra skin on the abdominal wall have extra skin in the horizontal dimension, which can be removed with a traditional abdominoplasty as the skin is lifted up and is pulled tightly down. However, in some patients and especially after significant weight loss, extra skin forms in the vertical dimension and cannot be removed by pulling the abdominal wall skin down. This extra vertical skin can only be removed by pulling the skin tight towards the midline of the abdomen and removing the skin from the middle of the abdomen. The vertical incision is combined with the horizontal incision to give the final appearance of a large anchor incision, in the shape of a fleur-de-lis. If you lose a significant amount of weight, especially after weight loss surgery, you may be a candidate for a fleur-de-lis abdominoplasty.
  

What is the difference between a panniculectomy and an abdominoplasty? And which is covered by insurance?  And what does this all cost?


An abdominoplasty is an abdominal wall contouring procedure where the skin of the abdominal wall is lifted up, the abdominal wall muscles are tightened, and the belly button is moved to a new location. A panniculectomy is an excision of an overhanging skin ledge (pannus) from the lowest part of the abdomen. The abdominal wall skin is not lifted up and the rectus muscles are not tightened, and the belly button is typically not transposed to a new location. Typically, a panniculectomy is performed because the overhanging skin ledge (pannus) is causing rashes, skin irritation, or other problems. This may be covered by insurance, although documentation may be necessary. An abdominoplasty, or tummy tuck, is not typically covered by insurance and the patient is responsible for the tummy tuck cost. Dr. Hirsch’s team will work with you to help determine insurance coverage of your procedure when you see him for your consultation at his offices in Burbank and Encino.  Regarding the tummy tuck prices, Dr. Hirsch and his team will discuss this with you at the time of your consultation.  Financing options are available to help with the tummy tuck cost.
  

When can I start exercising again after abdominoplasty?


After most abdominoplasties, it is very important that you walk during the first night after surgery! This will help minimize the chance of blood clots and also decrease the risks of pneumonia. Once you get home, you should continue walking but avoid strenuous activity until Dr. Hirsch clears you to begin exercising again. This usually takes place around 6 weeks after surgery.
  

When can I go back to work after an abdominoplasty?


You should plan to be off of work for 1 week following abdominoplasty, and be prepared to be off work for an additional week as well.  If you work at job that requires a significant amount of heavy lifting, you might need to take additional time off work as well.
  

Will I have drains after an abdominoplasty?


In most cases, Dr. Hirsch will use 2 drains after your abdominoplasty.  This helps prevent a buildup of fluid in the surgical site after your procedure, which is called a seroma.  Usually the drains remain in place for a week or so.  However, occasionally Dr. Hirsch will perform a drainless abdominoplasty. During your consultation with Dr. Hirsch, you can ask him if a drainless abdominoplasty is a possibility for you.

Additional resources about abdominplasty



Feel free to browse the following links to learn more about abdominoplasty (tummy tuck)

http://www.plasticsurgery.org/cosmetic-procedures/tummy-tuck.html

Dr. Elliot Hirsch

Meet Dr. Elliot Hirsch

Los Angeles plastic surgeon Dr. Elliot M. Hirsch has been educated at some of the most prestigious institutions in the country, including Johns Hopkins University, the University of Southern California, and Northwestern University. He is an active researcher and has published over 40 original papers and book chapters, and holds patents for his inventions in plastic surgery. Dr. Hirsch’s specialties include not only aesthetic surgery, but reconstructive surgery with special attention to aesthetic detail to ensure that patients achieve the best possible results.

To read more about Dr. Hirsch, please visit his extended biography page.


Read Dr. Hirsch's Biography