The Surgeon Minute

What You Need to Know When You’re Ready For A Tummy Tuck

What You Need to Know When You’re Ready For A Tummy Tuck

Pregnancy, weight changes and even aging can leave you with sagging skin and an abdomen that sticks out because of over stretched muscles. This area of the body can be stubborn. No matter how many times you hit the gym or stick to a diet there is no fixing the problem. For all of these reasons, tummy tucks were one of the top five plastic surgery procedures in 2013, according to the American Society for Aesthetic Plastic Surgery. Dr. Rick Zeinowicz, who practices in Rhode Island, discusses the evolution of the tummy tuck and how patients are seeing dramatic, long-lasting results while experiencing less pain.

By: Richard Zienowicz, MD
and Dawn Tongish

a63690423891d80b2c3585380ce8a07dTummy Tuck: “Not One Size Fits All”

It is important to be prepared before leaping into what will often be life-changing benefits of a tummy tuck operation. The tummy tuck (also known as an abdominoplasty) flattens the stomach by removing extra fat and skin. Muscles in the abdominal wall are also tightened. It is critical that a patient know what to expect to make an informed decision because the operation can vary patient to patient.

“It isn’t a one size fits all surgery,” says Dr. Zienowicz. “Everyone is different, but that is not to say there aren’t classes of people who fall into the same category.”

A tummy tuck may have to be custom-designed to meet the needs, wants and special goals of each patient. Dr. Zienowicz says the procedure and outcome could also be determined by a person’s background, body and/or history.

“If you have been really stretched out with pregnancy or just because of your genes, the best thing we can try to do is make the stretch marks less noticeable.” Experts say that tremendous weight fluctuations, followed by pregnancy, can have an impact on the outcome of a tummy tuck. If you are planning to lose a lot of weight or considering getting pregnant, it may be wise to hold off on having a tummy tuck until after the life-changing events have occurred.

Should I get a Mini Tummy Tuck?

A tummy tuck is major surgery and there are several procedures to consider. “Mini, or lower, tummy tuck is appropriate for someone who doesn’t have loose skin above the belly button,” says Dr. Zienowicz. “They have generally been stretched from the breasts to the lower area.” Dr. Zienowicz says this operation leaves just a short scar.

A full or standard tummy tuck requires tightening all of the abdominal wall skin and muscles above and below the bellybutton. There are also extended tummy tucks that involve more areas. Dr. Zienowicz also chooses to place the incision lower in the pubic area, so the scar is hidden.

“That allows the patient for the rest of their life to have complete concealment.” Dr. Zienowicz says not every plastic surgeon applies this practice.


What About Recovery?

Pain immediately after the surgery is usually a concern for most patients. A new drug is helping patients manage the pain better post-op, according to Dr. Zienowicz. “One of the things that has been truly magical is the introduction of Exparel. It is a long-acting local anesthetic injected into the abdominal muscle wall. It lasts a full 3 days, so there is none of the pain that patients have experienced in the past.”

In general, patients may experience some numbness, bruising and overall tiredness. Some doctors prescribe a painkiller, or the use of a pain pump. Dr. Zienowicz says with Exparel he has seen unheard of results in the operating room. “While monitoring their pain, they say they don’t have any. That is unbelievable for this kind of operation.” He even described a tummy tuck patient who went shopping just hours post-op.

“She was seen in the mall just a day after surgery. We wouldn’t recommend that of course, but she felt so good that she thought she could go to the mall.”

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