Abdominoplasty (Tummy Tucks)

Abdominoplasty

Types of Tummy Tucks

Abdominoplasty, or “tummy tuck”, is a common procedure in both men and women. It is designed to reduce fat, remove excess skin, and recreate a youthful shape and contour to the abdomen, specifically between the rib cage and the pelvic bones. This is one of the most common procedures undertaken in the United States, and it offers outstanding patient satisfaction with a durable result. As this is a very common procedure, many people are under the impression that a “tummy tuck” is a constant procedure that everyone offers in a similar fashion. Nothing could be further from the truth. In reality, the term “tummy tuck”, or abdominoplasty, refers to an entire class of body contouring procedures.

Mini tummy tuck, or lower tummy tuck

This type of tummy tuck focuses on the skin and fat below the belly button only. It is for men and women who have a bowing of the muscle and/or skin in the lower abdomen. It is done through a smaller incision, and has less recovery time than other abdominoplasty procedures. With this procedure, there is no incision or scar placed around the belly button.

This procedure is designed for men and women who have isolated abdominal issues below the belly button. It is almost always combined with power assist liposuction to the upper abdomen and flanks. This procedure does involve tightening of the abdominal muscles, but only from the level of the umbilicus (aka belly button) down to the pelvic bone. This technique is very common in both men and women, and is best when combined with liposuction of some form. We personally prefer power assist liposuction due to its safety profile.

PROS

Smaller incision
Quicker recovery time (5-7 days)
Does not always require drains
Lower cost

CONS

Will not shrink the hips, only the lower stomach

Standard Abdominoplasty

The standard abdominoplasty is the most common form of tummy tuck, or abdominoplasty undertaken today. The goal of this procedure is a direct reduction of the anterior (or front) of the abdomen with tightening of the entire muscle plane, removal of excess fat below the belly button, and tightening the skin across the abdomen but not the lateral flanks. In this procedure, the primary goal of surgery is a flat tummy. Liposuction can be used in combination with this treatment to accentuate and contour the hips and flanks.

In the standard abdominoplasty, an incision is made from the inside of one hip to the other. The incision itself is a gently curving straight line. In this procedure, an incision is also made around the belly button, and a new belly button appearance is created. This procedure will tighten and reduce the skin and fat above the belly button as well, but not as drastically as below the belly button due to the movement and position of the lower rib cage.

Standard abdominoplasties are the most common procedure undertaken by men for body contouring. As well, they are ideally suited for curvier women who are happy with their hips, but want a tighter, firmer abdomen.

PROS

Straight incision between hips, easy to cover with Brazilian cut swimwear
Comprehensive tighenting of core muscles
Complete tightening of abdominal skin
Direct, comprehensive reduction of fat in the lower abdomen
Permanent tightening of lower abdomen
Can be combined with liposuction for enhanced results

CONS

Will not shrink the hips, only the lower stomach
Incision travels from hip to hip
Drains are required for 2-4 days

Umbilical Float Abdominoplasty

This is a niche procedure for body contouring, as it is best suited for taller women with more of a muscle bulge than excess skin. This specific procedure leaves NO visible incisions on the abdomen, but still creates the same result of a standard or an Ocean Drive Abdominoplasty®. In this procedure, the belly button position Is moved 1.5-2cm (about 2/3 an inch) down the abdomen by sectioning the stalk from the abdominal muscles. The stalk is then transposed down the abdomen, and is re-anchored into its new, lower position.

As a result of this approach, the abdomen has no external incisions in the visible areas, but the upper abdomen can still be aggressively tightened. The incision used with this technique can be tailored to the patient’s request. Recovery time for this approach is similar to a standard or Ocean Drive Abdominoplasty®.

This procedure is super ideal for fit women with moderate excess skin above and below the belly button. We use this procedure in women primarily. Women who are candidates for this fall into a number of groups. The most common indication for this procedure is in women who have moderate excess skin above and below the belly button, but not enough excess skin for a full abdominoplasty. It is also very useful in athletically inclined women who want the best possible contour to their abdomen. This procedure takes approximately 2 hours, and is almost always associated with liposuction. Recovery from this procedure is similar to abdominoplasty, with most patients returning to normal activities at 7-10 days. We do mandate overnight care for these procedures, as patients who stay with us overnight have mimimal risk for blood clots, experience better pain relief, and are better prepared for the activities of daily living after we mobilize you in house.

PROS

Straight incision between hips, easy to cover with Brazilian cut swimwear
Comprehensive tighenting of core muscles
Complete tightening of abdominal skin without an incision around the belly button
Direct, comprehensive reduction of fat in the lower abdomen
Permanent tightening of lower abdomen
Can be combined with liposuction for enhanced results

CONS

Will not shrink the hips, only the lower stomach
Incision travels from hip to hip
Drains are required for 2-4 days

The Ocean Drive Abdominoplasty

Our signature body contouring procedure, the Ocean Drive Abdominoplasty® offers our best result to the female abdomen. This procedure is designed to maximize the feminine curves and flatten the abdomen. This specific procedure was designed at Ocean Drive, but it is based on principles that Dr. Durkin learned while he was lecturing in Bogota’, Colombia. Dr Durkin was flown to Bogota’ by Johnson and Johnson to lecture on silicone breast implants. While he was there, he developed a number of relationships with the Colombian plastic surgeons. Those surgeons were kind enough to show Dr. Durkin their approaches to body contouring, and given the fact that South America is a hotbed for body contouring, this opportunity was not lost by Dr. Durkin. Rather, it redefined how he looked at the female abdomen, leading him to develop the Ocean Drive Abdominoplasty®.

The Ocean Drive Abdominoplasty® balances the flatness of the tummy with the curviness of the hips. As a distinction from a Standard Abdominoplasty, this procedure requires a slightly longer incision past the hip bone, but the extra incision allows us to medialize (or turn inwards) the midportion of the waist. This results in a very feminine, curvy appearance along the hips and flanks in conjunction with a flat tummy. Power assist liposuction is always used with this procedure, as it allows us to further delineate and define the flanks and upper abdomen.

In this procedure, incisions are made in the lower abdomen, and around the belly button. The belly button is transformed from an upside down frowny-face look into a vertical, small, and attractive accessory structure. This procedure is ideally suited for anyone who has excess skin and fat above and below the belly button, and has a loose abdominal wall.

The procedure will remove all of the excess skin from the lower abdomen, and will offer the maximum possible tightness to the upper abdomen. The core muscles are markedly tightened, and the new umbilicus described above is created simultaneously. The procedure takes around 2.5 hours on average to complete. We do mandate that patients stay overnight with us after this procedure both for their safety and comfort.

PROS

Exclusively for female patients, designed specifically for female contours
Create or accentuate the natural female curves and contours of the abdomen and obliques
Comprehensive tightening of core muscles
A new, smaller, and vertically oriented belly button indicative of youth and vitality
Direct, comprehensive reduction of fat in the lower abdomen
Permanent tightening of lower abdomen
Can be combined with liposuction for enhanced results

CONS

Incision is required around the belly button
Incision travels across each hip and deviates up on the lateral hips
Drains are required for 2-4 days
Recovery time of 7-10 days is normal

Circumferential Body Lift

Circumferential body lifts have come into vogue over the last two decades. In this procedure, the incision is carried 360 degrees around the abdomen. This specific procedure literally erases your lower abdomen and flanks, as well as any lower back fat rolls. This procedure is designed primarily for the “apple” shaped men and women. Similar to the Ocean Drive Abdominoplasty® and a Standard Abdominoplasty, the core abdominal muscles are comprehensively tightened, the excess fat and skin is removed from the lower abdomen, and there is a moderate tightening to the upper abdominal skin. The real difference for this procedure is that all of the excess skin in the back part of the flank and back is also erased, as the incision travels all the way around you.

Circumferential body lifts require the largest incision, as it travels around your entire abdomen. This procedure is absolutely ideal for both men and women, especially if they have undergone significant weight loss and have developed skin. For patients who have undergone weight loss surgery, this procedure is very commonly utilized, as this is the only procedure that will directly reduce excess back skin, which can develop following weight loss greater than 90 pounds.

The only drawback of this procedure is that you have to limit the amount of tension on the front part of the abdomen. With this procedure, we cannot tighten as aggressively as with an Ocean Drive Abdominoplasty®because if we did, it would result in dehiscence (or opening) of the back incision, which would lead to infection. As such, body lifts are not really for people looking for their “best tummy”. It is more for people who have a balance of excess skin in front and in back.

PROS

Directly addresses back skin and lower back fat
Create or accentuate the natural female curves and contours of the abdomen and obliques
Comprehensive tightening of core muscles
A new, smaller, and vertically oriented belly button indicative of youth and vitality
Direct, comprehensive reduction of fat in the lower abdomen
Permanent tightening of lower abdomen
Can be combined with liposuction for enhanced results

CONS

Incision is required around the belly button
Incision travels across each hip and deviates up on the lateral hips
Drains are required for 2-4 days
Recovery time of 7-10 days is normal

Before

Before Mini Abdominoplasty
Before Mini Abdominoplasty

After

After Mini Abdominoplasty
After Mini Abdominoplasty

Before

Before Standard Abdominoplasty
Before Standard Abdominoplasty

After

After Standard Abdominoplasty
After Standard Abdominoplasty

Before

Before Ocean Drive Abdominoplasty
Before Ocean Drive Abdominoplasty

After

After Ocean Drive Abdominoplasty
After Ocean Drive Abdominoplasty

Before

Before Standard Abdominoplasty
Before Standard Abdominoplasty

After

After Standard Abdominoplasty
After Standard Abdominoplasty

Post Op Instructions

Swelling

Every operation, no matter how minor, is accompanied by swelling of the surrounding tissues. The amount varies from minimal to extensive. Sometimes the swelling becomes a little greater 48 hours after your operation and will gradually decrease. Wearing your garment will help control this swelling. Under no circumstances should ASPIRIN, IBUPROFEN, or medications containing aspirin or salicylates or ibuprofen, be taken without first consulting us.

 

Pain

You will receive a prescribed pain medication and it can often cause sensations of light- headedness or sleepiness, particularly in the immediate post-operative period. Under no circumstances should ASPIRIN, IBUPROFEN, or medications containing aspirin or salicylates or ibuprofen, be taken without first consulting us. If the pain is severe and the prescribed pain medication is not helping, please do not increase the recommended dosage or supplement with your own medications. Notify our office and we will evaluate the next step in controlling your pain. You may want to purchase a stool softener such as Colace or Ducolox and use it on a daily basis. Pain medication can cause constipation and you want to avoid any straining.

 

Care of Surgical Site

You will not be able to shower until cleared by Dr. Durkin or after drains are removed. Please wear your surgical garment at all times. Only remove it to shower when told to do so. Your garments must be hand washed and hung to dry. Remove stains by rubbing baking soda on the affected area(s). You will wear the garment for 6-8 weeks, or as prescribed by Dr. Durkin. You may be discharged with drains. It is important to remember to keep them secure as you do not want to have these accidently pulled out. You will need to empty the collection reservoirs at least twice a day or when they become full. You will be given instructions and shown how to empty the drains by the nurse prior to discharge. You have received a log to write down the amount of output for each drain. Please bring this log with you to your appointments. An antibiotic has been given to you. Please start the antibiotic the day after surgery and continued until gone. Under no circumstances should ASPIRIN, IBUPROFEN, or medications containing aspirin or salicylates or ibuprofen, be taken without first consulting us.

 

Removal of Dressing

The dressing you have is to be left in place until your first post-op visit. If it becomes saturated with blood and/or other fluids before your first visit, please contact the office.

 

Sleeping

We ask that you sleep on your back with 2 pillows under your knees and 2 pillows behind your back to create a jackknifed position

 

Activity

On the day of surgery and for the first few days afterwards, walk in a slightly bent position to prevent excessive pulling on your abdominal sutures. Straighten up a little each day so that you are walking straight after about 3-4 days. You will have restricted activity and exercise
for the first 6 weeks after your surgery. Do not lift anything heavier than 10 pounds (a gallon of milk) for the first 2 weeks. Depending on your healing, Dr. Durkin will determine when to increase your level of activity. Please wear the white stockings that we gave you until you are up and around most of the day. These stockings prevent blood clots from forming in your legs while you are recovering. We will inform you as to when you will be able to get back to a regular exercise routine.

 

Returning to Work and Resuming Social Activities

When you should return to work depends on the amount of physical activity and public contact your job involves. Do not drive until you are given permission from Dr. Durkin.

 

Medication Instructions

Every post-op patient will recieve the following four meds which may be adjusted due to medication allergies etc.

  • Antibiotic to start the following day aftersurgery
  • Muscle relaxer typically this is Diazepan.Take one tablet every 12 hours as needed. Please take this one hour apart from your pain medication. This can be sedative do not drive while taking.
  • Pain medication to be taken with food you may start once you get home after surgery. We advise you to take a stool softner as your pain medication may cause constipation. You may alternatively take Tylenol if you chose. DO NOT take IBUPROFEN or ASPRIN.
  • You are given a packet of Ondansetron for nausea. this is to take only as needed. Once every 8 hours. If symptoms do not resolve contact office.

Diet

A normal diet is permissible providing there is no nausea. The night of your surgery you may feel nauseated. We have provided you with anti- nausea medication. You can take the medication and only take a few ounces of clear fluids until the nausea passes. Under no circumstances should ASPIRIN, IBUPROFEN, or medications containing aspirin or salicylates or ibuprofen, be taken without first consulting us. Please no drinking of alcohol for the first 3 weeks and/ or while taking the pain medication and the anti- anxiety medication. Alcohol may raise the blood pressure and initiate bleeding.

 

Finally

Remember these things:

  1. You will need a responsible adult to drive you home and remain with you for 24 hours after yourprocedure.
  2. You must wear your surgical garment at all times except when showering
  3. Walk in a slightly bent position for the first few days and sleep with 2 pillows under your knees and2 pillows under your back.
  4. No driving until released to do so by Dr. Durkin
  5. Restrict your activity to light walking for the first 2 weeks. Dr. Durkin will increase your activity levelas you heal.
  6. Under no circumstances should ASPIRIN, IBUPROFEN, or medications containing aspirin orsalicylates or ibuprofen, be taken without first consulting us.
  7. Report…(a)Temperature elevation
    (b) Sudden swelling or discoloration
    (c) Discharge from wound or other evidence of infection (d) Bleeding
    (e) Development of any drug reaction

If you have any questions or concerns, please do not hesitate to contact the office at (772) 234.3700. If you have an emergency after regular office hours, please call 911 or go to your local emergency room.

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