Category Archives: incision

Recovery after Tummy Tuck Surgery

We get this very important question a lot. In fact after “how much does a tummy tuck cost,” our next most common question is “what’s the recovery like after tummy tuck.”

This is a difficult question because of the complexities of the surgery and the uniqueness of each patient. In fact there are several different types of tummy tucks too. But I’ll try to simplify the answers as much as possible.

Disclaimer: please talk to your plastic surgeon in person. My answers here are based on discussions with our Modesto Plastic Surgeon: Dr. Tammy Wu.

There’s recovery factors of pain

Patients usually are somewhat uncomfortable and taking pain killers for about 2 weeks after the procedure. We do encourage the use of a pain pump after surgery which will lessen the worst part of the pain after surgery which is the first few days after the tummy tuck surgery.

When can one drive after Tummy Tuck surgery

Basically when one doesn’t feel the pain and is off the pain killers. Plus one would need unrestricted movement so that one can see around the car. Thus for most patients it’s about 3 weeks after the tummy tuck surgery – but everyone is different. But if it’s driving a vehicle that requires much getting in and out of the car – such as a forklift – one would usually want to wait 6 weeks. Getting in and out of a vehicle requires activation of core muscles which could potentially disrupt tummy tuck sutures. See what I mean about this being a complex question with complex answers?

When can one go back to work after Tummy Tuck surgery?

Desk work only: 2-3 weeks.
Heavy lifting greater than 10 pounds: 6 weeks.

These are just rough guidelines.

When can one go back to lifting greater than 10 lbs?

After 6 weeks.

When can one go back to doing core exercises such as sit ups?

After 6 weeks.

What exercises can I do during the first 6 weeks after a Tummy Tuck?

Mainly walking. In fact we encourage walking the day of your tummy tuck surgery – the same day – after the surgery.

See explanations at these valuable posts we made regarding core exercises, lifting, and going to work after Tummy Tuck Surgery:

When can I lift after Tummy Tuck Surgery
When can I do sit ups after Tummy Tuck Surgery – these aren’t required after tummy tuck surgery, but we have so many patients who are eager to do them.
When can I go back to work after Tummy Tuck Surgery

So quick answers to the question: What’s the Recovery like after Tummy Tuck?

Back to desk work in 2-3 weeks
Back to usual activity lifting more than 10 lbs and exercising again in 6 weeks.

Please see us or your tummy tuck plastic surgeon to discuss your individual case. Above info is just a generallization.

Dr. Tammy Wu & Dr. Calvin Lee.
Surgical Artistry, Modesto, CA.
www.SurgeryToday.com
(209) 551-1888

Tattoos and Tummy Tucks

The Abdomen as a Tattoo Artist’s Canvas

People have large tattoos over their abdomen. Some have it just for the looks, others use it for a combination of looks and for the purpose of covering up some scars or stretch marks. Both scars and stretch marks are common after child birth for women. For men, it might be due to trauma. However because of the location of the tummy tuck incisions that need to be made and the foot-ball shaped skin/adipose tissue removal, the tattoo will be partially removed, and misaligned etc. In the end, the tattoo will be altered at the belly button and at the lower incision that goes from side to side (horizontal). For some abdominoplasties (tummy tuck surgeries) a vertical incision is needed and thus adds another component to an altered tattoo.

Consider redoing the Tattoo after the Tummy Tuck surgery

We think that after the Tummy Tuck surgery, perhaps one can choose to touch up the abdominal tattoo and make it into a new piece of art.

Talk to your surgeon and have them mark out the areas of removal, and the areas of reconnection on your Tattoo. Perhaps most of your tattoo (and stretch marks) can be removed with the abdominoplasty (tummy tuck). In general we prefer that patients did not get a tattoo on their abdominal wall before having abdominal cosmetic surgery. However, if a tattoo is present, we feel bad about having to alter the tattoo, but we will do our best to discuss options with you regarding preservation of sections of the tattoo and part of the discussion will involve necessary sacrifices in order to obtain optimal contouring with a tummy tuck.

How long is the Tummy Tuck incision?

Length of the Tummy Tuck Incision

The length of the tummy tuck incision varies depending on the amount of tissue needed to be removed. The greater the amount of tissue removed, the longer the scar. The incision discussed here is the horizontal incision that is located very low on the bottom of the abdomen.

Short incision are usually found in the mini tummy tuck where the belly button is left alone, and thus the area of removal is relatively lesser than a full tummy tuck. In the mini tummy tuck the “shorter” incision is probably within the hip bones. This could probably be less than 12 inches.

Longer incisions are found in the full tummy tuck. The longer incision accommodates a wider elliptical shape of the tissue removed (skin and the underlying adipose tissue, adipose = fat). This could be from one side to the other side. Sometimes the surgeons say it’s from one side of the table to the other side of the table.

And in some cases the incision can go all the way around the body, but this gets into a discussion of belt lipectomy which is a different operation. So in general if you’re looking for a tummy tuck, this all around incision isn’t what’s in store.

Of course, this discussion about abdominoplasty incision length is a personal one which depends on your surgeon’s preferences as well. So this discussion is best done personally one-on-one with your plastic surgeon. If you’re in Modesto or close to us in Modesto, CA – we hope you’ll have a chance to visit us for a Tummy Tuck consultation.

Dr. Tammy Wu & Dr. Calvin Lee.
Surgical Artistry, Modesto, CA.
www.SurgeryToday.com
(209) 551-1888

Cost of the Tummy Tuck Pain Pump

Price of the Pain Pump used for Tummy Tucks

Cash prices vary, and they can be different than insurance prices for Pain Pumps. One of the hospitals in Modesto, Stanislaus Surgical Hospital has recently quoted us $160.00 (in 2013) for the On-Q PainBuster Post-Op Pain Relief System. This price was just updated and verified for June 2013 – please call for updated prices!. Please check with us for more specific prices. They will probably tend to go up with inflation, but this price will serve as a rough guideline. For our plastic surgical practice in Modesto, CA, this is a pass through directly to the patient without any mark up from us. We are happy to implant this pain pump for you after the surgery and you will discuss this in detail at your Tummy Tuck consultation with Dr. Tammy Wu if you were to become a patient of ours.

What are these pain pumps?

They are small external pumps filled with pain medicine such as marcaine or lidocaine with a tubing that goes through the skin and into the painful incisions and muscle tightening areas of the tummy tuck surgery. The exit site of this pump is very similar to the drains which my be placed with Tummy Tuck surgery. These pain pumps are made by various companies. On-Q PainBuster is one of the brands of pain pumps which we use. These pain pumps are also used after other surgeries. They are not specific to tummy tuck surgery.

Size of the pain pump?

The size of the pain pump is about the size of a single fist. Most of the time there is a pouch with a zipper that hides it all and it is battery operated.

When is the pain pump removed after Tummy Tuck Surgery?

It is usually empty after about 4 days. This gives you added support to your pain management for about 4 days after your tummy tuck procedure.

Dr. Tammy Wu & Dr. Calvin Lee.
Surgical Artistry, Modesto, CA.
www.SurgeryToday.com
(209) 551-1888

Drains after Tummy Tuck

Drains are commonly used for Tummy Tuck Surgery

This article describes the post operative experience of having drains in place.

Description of the drains

The drains use vary somewhat, but the most common drains have either a canal along a tube pattern or holes along a slender hollow piece of tubing. At the end of the tubing which is outside the body is a suction bulb. The suction bulb of the drain is placed in a squeezed down position and sealed; thus providing negative pressure. These are closed drains as opposed to drains which are open to the air. Blake drains is one type of drain and the other type of drain is none as a Jackson Pratt drain – but these are technical terms usually reserved for the surgeon to communicate with the rest of the team.

Usage of the drains

These drains with bulbs at the end (sometimes they are affectionately called grenades) are placed under the skin of the tummy tuck flap, across the abdomen. In our Modesto, California practice we are in the routine of using two drains. And we have the drains come out of separate incisions. This is separate from the Tummy Tuck incision as a strategy to avoid infection. The tubes of the drains are sutured securely to the skin.

Reason for the drains

The body normally tends to collect fluid – sometimes called seroma. This seroma gets in the way of healing and creates unfavorable contours. Thus the drains are used to drain away the seroma which the body normal creates. Sometimes the drains are also used to indicate if there is any postoperative bleeding after tummy tuck surgery.

Removal of the surgical drains

In our Modesto, California Plastic Surgery practice, Dr. Tammy Wu has instructed her patients to record their daily outputs. She uses less than 30 cc’s per day of drainage fluid to be a possible indication for removal. She usually considers removing one drain at a time. During this post operative period after the tummy tuck surgery, patients are in close contact with Dr. Tammy Wu, Modesto Plastic Surgeon. The drains are removed in the office. Most patients report minimal discomfort, and are usually glad that they are out.

How long are surgical drains in place?

The time varies tremendously between individuals as to how long the drains are in place. Sometimes they are in for 1 week, and other times they are in for a month. During this time period, we usually consider orally taken antibiotics.

Dr. Tammy Wu & Dr. Calvin Lee.
Surgical Artistry, Modesto, CA.
www.SurgeryToday.com
(209) 551-1888

Muscle Tightening with Full Tummy Tuck

The purpose of this page is to discuss in some introductory detail about the muscle tightening option portion of a Tummy Tuck procedure. For most plastic surgery patients, this is considered a crucial part of a Tummy Tuck, according to Dr. Tammy Wu, Modesto Plastic Surgeon.

Before discussing muscle tightening, let’s discuss some anatomical features of the anterior part of the abdomen.

Rectus Abdominus Muscle

This is the muscle that runs up and down the front of the abdomen
When very toned, it gives a person a “6-pack” or some other variable number.
It is separated by a thin fascia (sometimes known as the linea alba) that connects the left and right sides of this muscle.

Rectus Diastasis

Sometimes this thin fascia in the middle of the Rectus Abdominus Muscle (Linea Alba) can start to separate due to pregnancy or being over weight.
This is not a hernia
It is sometimes thought to be a hernia. Detailed surgical examination, physical exam, patient surgical history and radiological studies can sometimes help us determine if it’s a hernia or rectus diastasis. We consider a hernia a medical problem, but a rectus diastasis to be cosmetic issue.

Muscle Tightening of the Rectus Abdominus Muscle

This is commonly done with a Tummy Tuck.
Involves bringing the muscle closer together on the midline – called plication.
Various methods are used with sutures.
We prefer interrupted, separate sutures which are of a permanent material, but soft.
The plication occurs for the entire length (vertically – up and down) of the abdomen in the middle.
No separate skin incision is needed for this. Through the lower incision used in the Tummy Tuck (left and right / horizontal) incision, we dissect through that incision to be able to reach all the way up to nearly the xiphoid process, which is the bottom of the chest bone (sternum).
There is no entry into the abdominal cavity (peritoneum) with these sutures. It’s just in the muscle layer only.

Muscle Tightening narrows the abdominal girth in the middle of the abdomen

It gives more of that hour glass shape
Muscle tightening is not part of a panniculectomy procedure (which is a “tummy tuck – like” procedure that simply removes the skin and fat tissue).
But muscle tightening is certainly an option considered in Tummy Tuck procedure.

Post Operative Discomfort

It does add to some more post operative discomfort, but we like to recommend that patients have us use a disposable pain pump to conteract the possible added discomfort with muscle tightening
The pain pump is available, usually for a separate cost, paid directly to our Modesto Area Hospitals which we currently operate in.
Most of our Tummy Tucks in Modesto, CA are with the muscle tightening procedure option.

Dr. Tammy Wu & Dr. Calvin Lee.
Surgical Artistry, Modesto, CA.
www.SurgeryToday.com
(209) 551-1888

Tummy Tuck Skin Incisions

Location of Tummy Tuck Skin Incisions

Incision for the removal of skin and adipose tissue

There are actual a few choices for the incisions.

If there are existing incisions, your plastic surgeon may consider either excising the old incision or going through the old incision. Existing incisions would be possibly from a cesarean section.

Most Tummy Tuck incisions go from left to right. Some are shorter than other incisions. But for most patients our incisions go from one side to the other and we try to hide them near or below underwear/bikini lines whenever possible

Dog ears at the ends of Tummy Tuck incisions?

At the sides of the incision, some challenges exist such as bump that can form. Sometimes we call these dog ears. They are usually managed at the initial operation by some further excision, but sometimes a stage procedure is needed to remove these at a later date and sometimes these “dog ears” disappear on their own.

All around incision? – like a belt

For some other patients, a tummy tuck is done in the front and then the same type of procedure is done on the back side, and this results in something known as a belt-lipectomy. We’ll talk about this procedure in another page. Belt-lipectomy, like it sounds, is a all around procedure, like a belt that goes around the body.

Vertical Incision?

There may be some patients who need a skin incision vertically – up and down, this is possibly needed for someone with extremely loose skin. For some patients it goes the full length of the abdomen and for some it is only from the belly button down.

This is rare in our practice as we try to keep this type of incision to a minimum.

Belly button incision – an outline of the belly button.

Because of the amount of skin and adipose tissue which we pull down, the belly button needs to be re-arranged a bit. The stalk of the belly button stays in place but the skin surface – a new “button hole” needs to be made, and we try to keep this on the narrow side. Thus when we’re done, there is a separate incision which outlines the belly button

The decision making process of incision placement in Tummy Tuck surgery is complex.

There is a lot more that goes into the decision making process of placement of incisions, but this page was designed to give you a brief introduction and overview of the incisions used for Tummy Tuck surgeries. At your consultation with your surgeon, much of this will be discussed.