Tummy Tuck "Abdominoplasty" Without Drains! And now, much less discomfort and quicker recovery too!!!
WHat is a Tummy Tuck (abdominoplasty)?
Dr. Mark Epstein performs tummy tuck surgery at his plastic surgery office in Long Island. Tummy tuck surgery helps to flatten and shape the abdomen and waist by removing excess skin and fat while also tightening the abdominal muscles. This is in contradistinction to liposuction, which is removal of fat alone without the removal of skin. The best candidate for this procedure has excess skin without too much excess fat. The procedure can also be useful for women with stretched skin and lax abdominal muscles from pregnancy.
the ideal Tummy Tuck candidate
The ideal candidate for a Tummy Tuck (Abdominoplasty) is someone in good physical health. They have excess, loose abdominal skin, or at the very least, laxity of the abdominal wall that hasn’t improved following diet and exercise. It is best that they are not obese (body mass index – BMI – <30). Most candidates for this procedure are women who have finished bearing children, although occasionally men are candidates for this procedure. Other indications for this procedure include significant weight loss with resultant excess skin remaining.
The very best candidate is someone who has excess skin with little, if any, excess subcutaneous fat, although most patients who undergo abdominoplasty have a combination of excess skin and subcutaneous fat. Subcutaneous fat is the layer of fat that lies between the skin above and the muscles below. Individuals who have good quality skin without excess and whose ONLY problem is excess subcutaneous fat would most likely better be served undergoing liposuction.
For those who have a combination of excess skin and fat, Dr. Epstein performs a 4D VASER Lipo-abdominoplasty (discussed later on) which combines liposuction to pre-contour the skin by reducing the thickness of the subcutaneous fat layer with abdominoplasty to remove excess skin and tighten the abdominal musculature.
Dr. Epstein and his entire staff are incredible, patient and kind. There is always someone to speak to and you never feel like you are being rushed.
What should i know before the Tummy Tuck procedure?
Women with stretched skin and muscles from pregnancy often benefit from a tummy tuck. As pregnancy will stretch abdominal skin, Dr. Epstein advises patients who plan to become pregnant to consider postponing this procedure until they are done having children. Dr. Epstein also recommends that the patient be at their ideal weight prior to surgery, so as to achieve the very best contouring result.
Patients who intend to lose weight should do so before undergoing the procedure. If you lose weight after the procedure, there may be additional laxity of the skin. Dr. Epstein requires that the patient not be a smoker, as nicotine interferes with the circulation of blood in the tissues after surgery and can increase the risk of complications substantially.
How tO prepare for A TUMMY TUCK
Before your Tummy Tuck surgery, we give you a very extensive handbook that includes preoperative and postoperative instructions. This includes showers with antibacterial soap and avoidance of certain over the counter medications.
Are there any risks involved?
Fortunately serious complications are very rare. More common complications include a small fluid collection under the abdominal skin, irregularities in the contour at the very ends of the incision which are easily fixed under local anesthesia later. The preoperative handbook lists the risks in greater detail.
The tUMMY tuCK Procedure
These procedures may be performed on an outpatient or inpatient basis depending on your anatomy, the complexity of your surgery, your personal preferences and your overall medical health.The procedure takes approximately two to three hours and is performed with general anesthesia. First, the abdominal skin and flanks are recontoured with VASER liposuction. After the abdominal skin is elevated off the abdominal wall and is tightened (“tightening the muscles” – really a misnomer – you cannot tighten muscles). Afterwards, the excess skin is removed and the wound is closed. The belly button is then relocated if needed.
Managing Post Surgery Pain
Exparel, a non-narcotic local anesthetic that typically provides numbness in the abdominal wall for a few days will result in dramatically less post-operative discomfort and reduce the need for narcotics after surgery. Narcotics frequently are responsible for post-operative nausea, vomiting and constipation. While using Exparel, there is dramatically less post operative discomfort than we have seen in the past! Several of our recent patients have noted ambulating with ease the same day as surgery and take only a few (2 or 3 to be exact!) pain pills the first couple of days.
Watch this brief video that describes how Dr. Epstein reduces pain after a tummy tuck
The Abdominoplasty recovery Process
Recovery time from a Tummy Tuck ranges from two to six weeks. Of course, recovery is an ongoing process, so you will be able to do more and more gradually, but as a general guideline, we see patients driving in one to two weeks, and back at work in one to three weeks. Some do take longer to achieve these goals. It all depends on the individual, how motivated you are, and what type of work you do. The abdominal muscles are tightened in almost every case. In order to protect that muscle repair, we recommend not lifting more than 25 pounds or doing strenuous exercise for six to eight weeks.
When will i see results and how long do they last?
You will see results immediately, but swelling will also commence immediately. It will take 4 – 6 months to see the final results. We often incorporate the services of a massage therapist to facilitate the removal of fluid from your tissues. With a balanced diet and regular exercise, results are long-lasting. The incision for abdominoplasty will leave a permanent scar extending from hip to hip, although it should be low enough that most items of clothing will conceal it.
Dr. Epstein's tUMMY tuCK Technique
Since 2011, Dr. Epstein has performed the tummy tuck abdominoplasty procedure using a new technique in which bothersome drainage tubes (usually two of them) are no longer required after surgery! You will feel better, no longer encumbered by drainage tubes coming out of your body as well as needing to regularly empty them and record the amount of drainage. He uses no bulky bandage dressings for the abdominoplasty (if you have liposuction of your flanks, there is a small dressing on your back). The incision is dressed with a thin mesh tape that acts as a water and bacteria resistant barrier. You can even shower the next morning after your procedure if you like. You will recover faster, more pleasurably and heal faster too.
The most common way that Dr. Epstein performs abdominoplasty is to combine the procedure with 4D VASER liposuction of the abdomen, a procedure called a 4D VASER lipoabdominoplasty. This is the most state of the art procedure for recontouring the abdomen. Most of the time 4D VASER lipoabdominoplasty is combined with VASER lipo of the flanks,back, arms,thighs, and fat transfer to the buttocks and hips. These procedures give the best results for contouring your entire trunk, and will be discussed later on in the section entitled "4D VASER lipoabdominoplasty".
Dr. Epstein's Guide to recontouring your abdomen
When I see patients in consultation for abdominal recontouring, I spend a fair amount of time with them to educate them. In an effort to enhance the patients understanding of what I am describing, I thought that a more detailed visual aid would be worthwhile, one that could be reviewed by the patient prior to meeting with me. That is how this section came to be. I have made extensive use of illustrations that I created with my medical illustrator, Kathleen Gebhart, to enhance the readers understanding of the textual information. I strongly encourage anyone considering undergoing this procedure to read through the information contained within so as to have not only a better understanding of the procedure, but this knowledge will enhance the value of your consultation experience with your surgeon. In short, reading the information I prepared here will be time very well spent.
Schedule a consultation
If you are interested in a tummy tuck, and would like to see if you are a good candidate, call (631) 689-1100 to schedule a consultation with Long Island Plastic Surgeon, Dr. Mark Epstein.