An abdominoplasty or a tummy tuck, used to be the most painful and unpleasant plastic surgery procedure. Even the mention of it could cause patients to recoil! The myth is that it still is that miserable. Patients constantly fear they won't be able to bathe normally,  stand up straight, or return to work in a reasonable amount of time. Fortunately, newer techniques have made this operation much more tolerable.

In fact, friends of patients who accompany them to the office after surgery are so impressed with the results and the relative absence of the misery they expected to see often say, "I want to do that!." Here are some improvements in the procedure.

EFFICIENCY     Surgeons are much more efficient  than in the past.  There are many reasons for this, but the impact is great.  A typical abdominoplasty in the 90's might take 4 hours or more.  Now, most of mine are completed in under 2 hours.  Speed itself does not ensure a better result, but it absolutely reduces blood loss and the risk of blood clots (DVT.)

BETTER PAIN CONTROL     Anesthetics are now better able to have patients wake up smoothly  without ever experiencing horrible discomfort.  Additionally, many surgeons augment the general anesthetic  by using local anesthesia also. Finally, PCA's or patient controlled analgesia, allows the abdominoplasty patient to administer their own narcotic intravenously when they need it, without having to wait for a nurse.  When I visit patients the next morning, most report having a very tolerable night, something that used to be rare.

LESS MORBIDITY      This means patients just are not put through as much misery!   Plastic surgeons used to think "the tighter the better" when it came to abdominoplasty.  Due to experience with tissue expansion, surgeons learned  that being excessively tight does nothing positive for the long-term result.  It does cause significantly more pain,  lead to wider scars and increase the risk of tissue necrosis (death.)  Because patients are no longer excessively tight, I allow my patients to stand up straight the first night.  This permits patients to walk more normally and certainly prevents a lot of needless back pain!

SIMPLER WOUND CARE   Abdominoplasties used to require suture removal and dressing changes.  This is no longer the case. Many surgeons use absorbable sutures to avoid stitch marks and the misery of removing sutures.  Additionally, surgical glue called Dermabond can be applied in the OR so no bandages are needed after surgery.  Furthermore,  this lets me have patients shower the next day  so they can return to normal as soon as possible.

QUICKER RETURN TO NORMAL    Since patients have less pain and are more mobile earlier, they can recover faster. Patients who work in an office setting can usually return to work in ten days and patients can begin exercising in two weeks.

In short, abdominoplasty is a much easier procedure to undergo than in days gone by.   Despite these improvements in abdominoplasty, it remains a major surgical procedure.  While the upsides are great, make sure your plastic surgeon discusses the downsides before deciding to proceed.