Tummy Tuck In Richmond,Va
At our Richmond, Virginia plastic surgery facility, we are dedicated to providing an experience that exceeds expectations and provides results that will help improve your overall confidence. The goal of a tummy tuck (abdominoplasty) is to flatten, tighten, and reshape the abdomen, effectively creating a tighter and smoother appearance that enhances your body image and confidence.
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Abdominoplasty [Tummy Tuck]
This includes the removal of excess skin, fat, and the tightening of the deeper muscle layer that has been stretched from weight gain and/or childbirth. There are a number of options in the tummy tuck procedure, depending on the patient’s needs and desires.
This is going to be a quick overview of what a tummy tuck is. A tummy tuck or abdominoplasty is an operation that essentially does three things. It’s typically performed on patients who have finished having their children and have what we call rectus diastasis or separation of the abdominal wall muscles. They usually have excess skin from having the skin stretched out from having babies or from massive weight loss, and they have excess fat.
So the three things a tummy tuck does is tighten or repair the loose muscles, number one. Number two is remove the excess skin, and number three, remove the excess fat. That in a nutshell, is what a tummy tuck does.
Based upon your examination, Dr. Lynam will recommend the best option for you to achieve the desired end result. No amount of diet and exercise will shrink skin or tighten stomach muscles if they have been stretched after pregnancy.
While there are a few women who have no stretch marks after pregnancy and whose muscles have stayed together, most women – even if they get back to pre-pregnancy weight – will still notice a bulge and extra skin in the lower tummy region.
Preparing To Meet With Dr. Lynam – What To Expect
During your consultation for tummy tuck or abdominoplasty, We’re going to look at several things. We’re going to look at the areas that have extra skin, the areas that have extra fat, and evaluate you for hernias. You can have a hernia most commonly around your belly button after having children, or you could have a hernia at a prior incision, where you may have had your gallbladder removed, your appendix removed. So we want to evaluate those things.
We want to evaluate the amount of skin you have, extra, above your belly button and then below your belly button, and we need to look at the ratio of those areas, to determine how much skin you have, so we can plan on giving you a very low scar. It’s one of those operations that seems conceptually very easy, but technically, it’s somewhat challenging. You have to balance a lot of things. You’re tightening muscles, you’re tightening skin, and the key really, is doing this very safely, and creating a very natural appearance of the belly button and of the lower incision, we want it down by the hairline or the pubic area.
And people always ask, what do we do with your belly button? Well, we essentially keep it in the same place. We make an incision around it. It’s like a tree trunk with a route that goes into your abdominal wall, so we make a little incision around your belly button, save your belly button, then pull all the skin down, relocate your belly button through a new hole, but we keep your original belly button. Every once in a while, someone has a hernia, and if that’s the case, then we will remove your belly button, and actually make you a new one. So we can actually make you a new belly button, and sometimes, frankly, it looks better than the old belly button.
Who Is A Good Candidate For A Tummy Tuck?
Who are the ideal candidates for a tummy tuck or abdominoplasty? They’re typically someone who is finished having their children, not planning on having any more children, or they’ve had weight loss surgery, or just done a lot of hard work in the gym, and diet, and exercise, and have lost weight. Ideally, I like patients to be within about 10% or 10 to 15 pounds of their goal weight. If you have a lot of weight to lose and you think I’m going to do it for you, that’s really not possible because fat can be stored inside your body, what we call intra-abdominal fat, and I can’t access that. I can’t liposuction it. I can’t remove it. So having patients pretty close to their goal weight, within about 10, 15 pounds, really is ideal to then have a tummy tuck.
Tummy Tuck Patient Information
TUMMY TUCK – When Can I Start Exercising/Working Out Again?
You’ve spent a lot of time recovering from your tummy tuck and you’re itching to get back to the gym. You don’t want to lose what you’ve gained. You’ve been working out hard and you just had surgery, and the key really is not overdoing the exercise too soon. Again, we’ve tightened those muscles super tight. You don’t need to do any sit ups, you don’t need to do any crunches. Those muscles are tight, and it takes probably between two to three months before you should even try to do a sit up.
What does that mean for getting back to the gym? It means the first week, walk around the house. Second week, walk around the neighborhood. Third week, you may do some jogging, you may do some more lighter exercise, but it’s going to be pretty light. Fourth week, you’re probably able to run at four weeks, maybe not full speed, but you certainly can do a treadmill, you can certainly do a stair climber. You can do a pretty good amount of aerobic exercise, but you just can’t do anything that really uses those core muscles. Unfortunately, any heavy lifting activates those core muscles.
So it’s really something that for about the first two months, you really have to baby those core muscles and don’t overdo it. Let pain be your guide. If something is hurting, you don’t want to do it, you want to ease off. But in terms of burning calories, getting to the gym, doing some stretching and doing some yoga, burning some calories, probably going to be around two to three weeks.
TUMMY TUCK – Secrets For A Great Result
Let’s talk about what makes a superb tummy tuck result. The keys really are to have a very natural looking belly button and to have a very low scar. We don’t want a scar that you’re wearing your pants and it’s floating in the breeze and everyone sees it. So, it takes a lot of artistic talent and a lot of surgical skill to make sure that you realize where to put the scar, how much tension or how tight you can pull the skin down. And again, I think having a scar that is very low and concealed is ultimately one of the tenets of making an abdominoplasty or tummy tuck an excellent result for your patient.
TUMMY TUCK – Does It Hurt?? How do you manage pain and swelling post-op?
Because a tummy tuck is a more painful operation because we’ve tightened those muscles and we removed that extra skin and that extra fat, we really have a multimodal approach to pain control. We all live in a world where we’re trying to diminish and decrease the use of narcotics, so our office has a great plan to help that. We do use some narcotics but short period of time. We also use some specific anti-inflammatories to help with the recovery process, and we also use some specific muscle relaxants to help with recovery. So we do use a multimodal approach to pain control and pain management, and we try to get you off narcotics within about a week.
We also, during the surgery, infuse or inject into the tissue a product called EXPAREL. EXPAREL is a liposomal, meaning it’s got little fat globules around it and they break over time spontaneously of a long lasting local anesthetic called bupivacaine. We can inject this into the muscle, into the areas, and it helps keep the area comfortable and numb for about two-and-a half to three days. And again, I think that’s really something that’s ideal to have at the time of a tummy tuck. It can be used for other procedures, but the mainstay for me is during all my abdominoplasties or tummy tucks should have that liposomal Marcaine called EXPAREL.
TUMMY TUCK – Recovery From Surgery – What To Expect
A few more items we can talk about the day of surgery. We typically perform your surgery in the Stony Point Surgery Center. It’s about a hundred yards away from my office and surprisingly people are amazed, but the operation takes me about two to two and a half hours. That’s a little unusual because many surgeons take four, five, and six hours and they will keep you overnight in the hospital. I think that’s a big mistake because we all know that hospitals are dirty places with a high rate of infection and so I never want any of my patients to spend the night in the hospital and I think that’s a real, real key issue for me is that I want all my patients to have their surgery and go home because your home is a much better place to recover.
We can have you do a couple of other things at home to help recovery. Have you sleep in a La-Z-Boy chair or a power lift chair., some of my patients have, but it is a real recovery. It is a recovery that probably takes about a month before you’re feeling pretty much back to normal. So the first week you probably are not going to drive a car and I probably think no one should try to drive a car the first week. The second week, most people are driving again and they’re moving slowly and they may finally stand up fully or straight because we’ve tightened those muscles so tight. So the end of the second week is a pretty big goal to reach, people feeling much better. Third week you feel much better. In the end of the fourth week, people really feel pretty much back to normal. They’re not going to the gym, they’re not working out, but they really are able to do most of their daily activities without much of a problem.
Candidates for Tummy Tuck (Abdominoplasty) Procedure
Good candidates for this procedureare healthy non-smokers with a positive outlook and realistic goals.
At the time of your consultation we will discuss your goals, the procedure, and the routine post-operative healing process. Your medical history will be reviewed to ensure you are a healthy candidate for surgery and we will answer any questions you may have about this procedure.
TUMMY TUCK – What To Expect On
Your Day Of Surgery
The day of your tummy tuck is a very big important day. And there’s a lot of things we have to manage before you have your tummy tuck, and on the day of surgery. The day or two before your tummy tuck, we’ll have you maybe on a low residue diet trying to clean out your intestinal tract because constipation is very common after a tummy tuck.
So the day of surgery you’ll be at the surgery center about an hour before we start, you’ll get all prepared by the nurses and anesthesiologists. I will stand you up and draw a few lines on your abdominal wall. Typically where we’re going to do the surgery. I’ll oftentimes put some circles on your hips or waist or other areas that we may be doing a little bit of liposuction. And so we’ll mark you before surgery.
You’ll have some devices placed on your legs called sequential hose that are stockings. And also we’ll have some devices called sequential compression devices, which squeeze your calves during surgery. And those will be continuously used throughout surgery and even in the recovery room until you go home. And then you’ll go home with the stockings.
A tummy tuck. We do all of these things because it has a higher risk of what’s called DVT, or deep venous thrombosis. And that in itself is a problem. But when that blood clot breaks free, it can go to your lungs or your pulmonary arteries and it’s called a pulmonary embolus. And that can be fatal. So one of the things we do for all our patients is we use those sequential devices and we also put them on a blood thinner. One is called Lovenox. It’s a shot you give once a day. The others called Xarelto, which is a pill you take once a day. And most of our patients take that for about seven days after surgery.
One of the things we like to do is evaluate our patients very quickly and every week. So we are going to see our patients every week for the first month after abdominoplasty. Because it really does have some significant downtime and patients have a lot of questions they need to have answered. And we want to be there for them every week to make sure they’re on the right track and everything’s moving in the right direction.
The Tummy Tuck (Abdominoplasty) Procedure
Dr. Lynam of our Richmond, Virginia facility offers a number of options. The first procedure is the traditional tummy tuck (abdominoplasty) that removes the skin from just above the belly button down to the pubic hair region. The belly button is saved and reinserted through the skin that has been pulled down. The abdominal muscles are tightened and some minimal liposuction may be performed.
Tummy Tucks are done on an outpatient basis under general anesthesia and take approximately 3 hours. Two small drains, known as Jackson-Pratt drains, are placed to remove any small amount of fluid collection for 7-10 days following surgery. As an added benefit to our patients, Dr. Lynam recommends a long-lasting numbing medication called Exparel. This non-narcotic medication is injected by Dr. Lynam at the time of surgery to help reduce overall pain allowing your body to have more energy to heal. Ask Dr. Lynam about using Exparel for your abdominoplasty.
The second option is a mini-abdominoplasty. This is an operation that removes a crescent of skin and fat from the bikini line region, tightening the lower abdominal muscles and leaving the belly button in place.
Liposuction is performed above and laterally. The mini-abdominoplasty is done on an outpatient basis, taking 2-3 hours and is also performed under general anesthesia. Two drains are placed to remove any small amount of fluid collection for 5-7 days following surgery.
The third option is an endoscopic tummy tuck, an operation for those who need tightening of the muscles and liposuction but do not need skin removed. This procedure is minimally invasive using endoscopic techniques. A small incision in the bikini line is all that is needed. The endoscopic tummy tuck is done on an outpatient basis taking 1-2 hours and is performed under general anesthesia.
After Tummy Tuck (Abdominoplasty) Surgery
Your abdomen may be swollen, bruised, and sore for several weeks. One week after your surgery, you will be placed in an abdominal binder. You will wear this binder 12 hours per day for four weeks to aid in the healing process. Scars created to perform the tummy tuck (abdominoplasty) are permanent but will fade with time. It may be difficult to stand up straight for 7-10 days as your body adjusts to the newly tightened skin and muscle. Vigorous exercise routines may resume as early as 6-8 weeks following surgery. Most patients return to work within 2 weeks.
Some patients may elect to spend the night in a hospital or have a nurse go home with them. We can assist you in arranging this post-operative careif you wish.
The best way to determine if you are a good candidate for the tummy tuck procedure is to schedule a consultation. During your consultation with Dr. Lynam, you may discuss your desires and you will learn what to reasonably expect.