The Surgeon Minute

A New and Improved Tummy Tuck

A New and Improved Tummy Tuck

If you ask any woman what she dislikes about her body, chances are that the answer will start and stop with her abdomen. While everyone is genetically inclined to carry weight in different areas, childbirth, age, weight gain/loss and changing hormone levels can all have an adverse effect on the skin and tissues of the stomach in particular. Hanging loose skin, excess pockets of fat, and loose muscles unphased by exercise can severely limit the ability to wear the clothes that patients would like. It’s also not a look that makes any of us feel good in our skin, especially when it used to not be that way.

An abdominoplasty, or tummy tuck, is a surgical procedure aimed to lift and tighten the skin and muscles of the stomach. While it has always been an extremely popular procedure, recent advancements have made way for an improved tummy tuck that drastically improves recovery times and results. Board certified plastic surgeon Dr. Louis Bucky of Philadelphia walks through the new cutting edge techniques that make the improved tummy tuck both painless and drainless.

Tummy Tuck & Mommy Makeover

“There is a lot of conversation today about the so called Mommy Makeover,” says Dr. Bucky. Pregnancy and significant weight gain/loss are two of the main contributors to extra tissue in the mid-section. This loose, sagging skin is often resistant to diet and exercise, and the situation can be made dramatically worse by loose abdominal muscles that will never return to their pre-pregnancy state without surgery. The conditions make women self-conscious when naked or in a bathing suit, but perhaps more importantly, can affect how regular clothes fit.

Improved tummy tuck before and after.

Since the lower half of a mommy makeover is the tummy tuck or abdominoplasty, this has made the procedure even more popular. While the tummy tuck has been around for many years and most women are very happy with their results, “there have not been a lot of advances to make what’s a good operation, great until just recently,” explains Dr. Bucky. However, two recent advances in abdominoplasty surgery are doing just that: the absence of drains and a reduction in post-op pain.

Improved tummy tuck - no drains and reduced pain.

The Improved Tummy Tuck, Part 1: Goodbye Drains

Historically, the two big limitations for a tummy tuck have been discomfort and a prolonged recovery. While plastic surgeons are still working on improving the latter, there have been huge advancements in decreasing the discomfort often associated with tummy tuck surgery. The first is making your tummy tuck drainless.

Drains have been necessary in the tummy tuck procedure to remove the fluid that builds up between the abdominal wall and the newly lifted tissue. Patients hate drains because they find them to be:

  • cumbersome
  • uncomfortable, bordering on painful
  • limiting in terms of what clothing can be worn
  • obvious; patients often refrain from going out

Today, there are two techniques that allow surgeons to perform a tummy tuck without drains.

Progressive Tissue Stitches & TissuGlu

The first technique is the use of what’s called, “progressive tension sutures.” Instead of laying the tissues back down on top of the corrected abdominal muscles and only suturing it at the base (where the tummy tuck scar exists), surgeons employ progressive tension sutures to quilt the tissue back down to the muscle layer. “They allow the abdominal skin to be secured to the underlying tissues and, more importantly, it allows us to make the incision really low,” explains Dr. Bucky. A better placed incision is easier to hide so it allows the patient to wear low cut bathing suits, pants or underwear. Also, by taking the tension off the incisions, the scars are less visible. “That’s a two for one.”

Improved tummy tuck - progressive tension sutures.

The second technique is the use of a tissue adhesive called TissuGlu. This “glue” allows surgeons to literally glue the underlying and overlying tissues in the abdomen so that there is no pocket in which fluid can build up. “We are very excited about the use of TissuGlu with progression tension sutures,” shares Bucky. “Those two things together should make the aesthetics of a tummy tuck better, allow the patient to not have to manage their drain and lead to less discomfort.”

Improved tummy tuck - TissuGlu.

The Improved Tummy Tuck, Part 2: Reducing Post-Op Pain

The element that helps contribute to an improved tummy tuck is there are newer, long-acting pain medications administered during surgery. The long-acting medicine allows patients to avoid discomfort in the first few days following surgery, some of the most critical time of healing for tummy tuck patients. When a patient isn’t in pain, he or she can get out of bed sooner and walk more quickly. This gets the blood flowing, helping to speed recovery while making the patient feel a bit better. Furthermore, if you aren’t in as much pain then you may not need prescription pain meds. This means that you can return to driving and other normal life activities much faster.

Tummy tuck patient - Dr. Bucky.

Prolonged Recovery

Eliminating the need for drains and getting the patient out of pain faster both help to greatly reduce a patient’s recovery time. However, “a well performed tummy tuck still needs about two weeks time for a patient to recover,” explains Dr. Bucky.

Improved tummy tuck results.

The surgeon’s job is to make those two weeks as comfortable as possible. “I think where we are with tummy tucks today is really no drain and no pain,” Bucky muses. “We can avoid drains and now we have better things to help with pain, and that’s a big advancement in tummy tucks today.”

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