1206 Somerville Rd
Decatur, AL 35603
The basic goal of an abdominoplasty is to re-contour the abdomen by removing the roll of fat and skin that is located below the belly button. It is a combination of a skin and fat excision and in some cases tightening of the abdomen muscles . The roll of fat and skin under the belly button is removed and the upper abdominal skin is used to re-contour the front of the abdomen. The waist line is contoured with liposuction. The belly button is re-constructed.
The first mark that is made is for the lower skin incision. The incision length is a little variable and must be long enough to have the end of the incision close smoothly. A second incision is marked just above the belly button. These two incisions mark the lower roll of fat and skin that will be removed. When the roll is removed, the upper abdomen skin is lifted which allows access to tighten the front abdominal muscles if needed. The upper abdomen skin is then pulled downward and sutured to the lower incision. This creates a curved scar on the lower abdomen. The length of the scar is variable. The belly button is brought through a new hole.
During your initial consultation we will discuss all of the aspects of the operation and how it relates to you. We will have a second visit that is the pre-operative visit where I will answer all of your final questions, write the prescriptions for the medicines you will need after the surgery and you will do your pre-operative visit at the hospital.
Abdominoplasty is almost always a cosmetic procedure. There is a possibility of insurance coverage if there has been massive weight loss creating an abdominal skin flap that hangs down to the level of the upper thigh, completely covers the pubic area on the frontal photograph and causes sever hygiene problems under the roll. Massive weight loss patients are at the bottom of this page
The operation is done as an outpatient procedure at Decatur Morgan Hospital using general anesthesia. It is done in the main operating rooms at Decatur Morgan Hospital and takes just about 3 hours to perform. If muscle tightening is performed I inject the muscles and the skin incision with a long acting numbing medicine. This numbing medicine lasts about 72 hours. We do the operation in the morning and you will get discharged to home late in the afternoon or the early evening. You will go home with 3 or 4 drainage tubes to remove postoperative blood and fluid so it does not accumulate under the abdominal skin. I discharge you from the hospital with a prescription for narcotic pain medication, an antibiotic and a nausea medication. You will be taught how to empty and measure your drain output.
The abdominoplasty procedure can also be performed at the same operative setting as gynecology procedures. This includes removal of the uterus, ovaries, tubal ligation and bladder tacks. When I do this procedure along with your gynecologist, the morning of surgery I will draw the abdominoplasty marks on you. When you go to sleep in the operating room I discuses the marks with your gynecologist and help mark the incision. When your gynecologist is finished I come into the operating room and do the abdominoplasty. This has the benefit of having your postoperative recovery include both procedures. The gynecology procedure will be insurance covered and the abdominoplasty will be cosmetic. Therefore, if you have to take time off from work for your gynecology procedure, you can use the time to also recovery from your abdominoplasty procedure.
All patients are unique and the response to post-operative discomfort is variable. Most patients state that the incision discomfort feels like tightness and burning in the lower abdomen. When muscle tightening is done the muscles in the front of the abdomen are very sore for a few days. The use of the long acting numbing medicine injected into the muscles makes it much less painful than it was years ago before this medicine was available. It is sore when you move around. You will feel tight and you will need to walk bent over. You will gradually be able to straighten up over 1 to 2 weeks. Most patients take the narcotic medicine for a week or two and then switch to Tylenol for pain. Some patients will get muscle spasm pain and need an additional muscle relaxing medicine to control that problem. Some patients take a narcotic medicine for 3 or 4 weeks after the surgery. As I said, patients are all unique and their pain tolerance is very different. Almost all patients feel normal by 3 weeks.
If muscles are not tightened the post-operative discomfort is much less. Most patients take the narcotic medicine for a week and then switch to Tylenol for pain. Some patients take a narcotic medicine for 2 or 3 weeks after the surgery. Almost all patients feel normal by 3 weeks.
You will wear an abdominal binder for support and to keep light pressure on your abdomen for about 6 weeks.
For a desk job that does not require any heavy lifting you should expect to be away from work for 2 weeks for a skin only abdominoplasty, when muscle tightening is done you should plan for 3 weeks away from work. Some women have gone back to a desk job in as little a 1 week, even with their drain tubes still in place.
For a job that requires physical exertion or heavy lifting you should expect to be away from work for 3 to 4 weeks when no muscle tightening is done. You will have to be off for 6 to 8 weeks when muscle tightening is done because this is how long it takes for the muscle to heal. If there are any small skin healing problems with your abdomen we may keep you off of work for an additional 1 week or consider a light duty for a week if that is available at your job.
You will need to come to the office the 2 days after your surgery and you need to arrange for someone to drive you to this appointment because you will be sore and on narcotic medications. At this first postoperative check I will change your dressings and begin removing your drain tubes. Removing the tubes pinches a little but is not terribly painful. Drain removal depends on the drain outputs you record at home. We will remove a drain about every 2 to 3 days until all of your drains are out.
After your last drain is removed you will go home with a light gauze dressing. You can take a full shower 24 hours after your last drain is removed. You will take off your binder and dressings and shower. Soapy water will not hurt your incisions, pat yourself dry and replace your binder. The only sutures that need to be removed are the ones around your belly button. All of the other sutures will be dissolvable.
After your drains are all removed your next appointment will be in approximately 2 weeks. If you did not have muscle tightening performed we will discuss return to work issues. After that I will see you again in approximately 1 month.
If you had muscle tightening performed and do a labor intensive job we will discuss return to work issues at about 7 weeks. I will see you at 6 months and 12 months after your surgery and do a final assessment of your size and shape, assess the quality of your scars and get your final opinion on the surgery.
When muscle tightening has been performed you must not do anything strenuous for 8 weeks after your surgery because it takes longer for the muscle to heal than for the skin to heal. When no muscle tightening has been performed and if there are no wound problems you can resume normal activity in 3 to 4 weeks after the surgery. This could be delayed slightly if there are any wound healing problems.