Posted: February 23, 2018
Why can't I get rid of this "pooch"?
The term "pooch" is commonly used to describe an abdominal bulge seen below the navel. If you are asking this question, you are probably at a good weight and have tried exercise. The reason women have a bulge below the navel is because of a weakness in the abdominal muscles. If you have always had weak abdominals and have never been pregnant, core muscle exercises, such as Pilates, might still work. However, if you have gone through a pregnancy or a large weight gain and loss, then these muscles have likely been stretched and are no longer connected along the center of your abdomen. A tummy tuck, or abdominoplasty, will remove loose skin and tighten these muscles in the midline of your abdomen.
How do I know if I need liposuction or a tummy tuck?
The main difference between liposuction and a tummy tuck is that a tummy tuck, or abdominoplasty, removes skin and fat while liposuction removes only fat and relies on your body's ability to shrink the surrounding skin. A tummy tuck will also tighten the abdominal muscles that have been stretched out by pregnancy or excessive weight gain.
Two tests to try:
- Try to grab the skin and fat in your abdominal area below your navel. If you can wrap your hand completely around it, you probably need a tummy tuck because you have so much excess skin. If not, liposuction may be enough.
- Take a deep breath and try to hold in your stomach. This maneuver will hold in the fat that is under, but not above, your abdominal muscles. Any improvement you see may be accomplished by a tummy tuck but not liposuction alone.
These simple tests will give you some idea of what you may need, but the surest way to find out is through a consultation with a plastic surgeon.
What are the restrictions after a tummy tuck?
A tummy tuck is unique among the group of body contouring procedures in that it includes tightening the abdominal muscles with stitches. After surgery, this muscle repair must be protected for four to six weeks until it is fully healed. As a result, you will have to avoid any activities that would strain this muscle repair, such as strenuous exercise or lifting more than twenty pounds. Once you have reached the six-week post-op date, you will not have any restrictions. It may seem like a long time but it's worth it to have a flat tummy for years to come.
What are the risks of a tummy tuck?
Complications are rare after a tummy tuck. When they do occur, there are two categories:
- The general risks like those associated with use of a general anesthesia, possible bleeding, and possible infection. Excess bleeding will be treated promptly and antibiotics would be given for infection. Scar formation is not a "risk", as it's unavoidable whenever the skin is cut. Any scarring risk is in how exactly you will scar. Some people scar more quickly, easily, and unobtrusively than others. You may already know how your body deals with scarring. Dr. Fata will place incisions in unobtrusive locations, the better to hide the scar.
- The risks specific to a tummy tuck such as temporary fluid collection under the skin and numbness of the lower abdominal skin. Numbness typically improves over time but may not return to normal. There can be delays in healing along the incision line, which is more of a problem if you are a smoker so you will need to stop well before your surgery. Occasionally the scar may widen some because of the tightness of the repair but this can be corrected at a later time.
There is a rare but serious risk of a tummy tuck known as deep venous thrombosis. This is the formation of blood clots in your leg, which can break off and migrate to your lung (pulmonary embolism). Dr. Fata will minimize this risk by using elastic stockings and compression devices around your lower legs to keep the blood flowing normally. After surgery, you will need to drink lots of fluid and walk around often, as much as six times a day for ten minutes each time. This will help to further minimize this risk. If you are taking birth control pills or are on hormone replacement, you should discontinue those to decrease the risk of blood clots.
What kind of a tummy tuck will I need?
If the bulge in your abdomen is confined to the area below the navel, then a mini-tummy tuck, or mini-abdominoplasty, will be adequate. This technique has the shortest scar and tightens the muscles only below the navel. If you also have some loose skin just above the navel, then an extended mini-tummy tuck can be used, in which the skin and muscles surrounding the navel are tightened.
If you have an overhanging "apron" of excess skin or fat, or if you have a large amount of fullness above the navel, you will probably need a full abdominoplasty or tummy tuck. In cases of large amounts of weight loss such as after gastric bypass surgery, an extended tummy tuck (extended abdominoplasty), which has a longer scar, may be necessary to correct the loose skin around the sides of your trunk.
Dr. Fata's cosmetic surgery office in Indianapolis, IN, is a busy place, with many happy patients, but not so busy that we couldn't spend lots of time with you. Please contact Renaissance Plastic Surgery online or call 317-575-9152 to set up a consultation. Dr. Fata can answer questions and make suggestions for your particular situation.