Abdominoplasty for a Firmer, Flatter Stomach
Abdominoplasty, or “tummy tuck,” is a surgical procedure designed to flatten and contour an abdomen that will not respond to diet or exercise efforts. The procedure involves removing excess fat and skin, repairing the abdominal muscles and tightening sagging skin. The procedure is modified to the patient’s specific needs.
One of the most commonly performed cosmetic enhancement procedures, tummy tuck has helped millions of people enjoy the toned physique they desire and deserve. With over two decades of plastic surgery experience, board-certified plastic surgeon Dr. Mark H. Schwartz is one of New York’s most trusted tummy tuck surgeons.
Tummy Tuck Candidates
Most candidates for tummy tuck have noticed changes in their abdomen due to pregnancy, fluctuation in weight, age, or simply the effects of gravity.
Generally, tummy tuck candidates are:
- Physically and psychologically healthy
- Non-smokers
- Free of uncontrolled medical issues that could raise the surgical risks
- At, or close to, their goal weight
- Not planning to become pregnant or gain weight in the future
- Aware of all possible surgical outcomes
- Committed to maintaining the results through a good diet and regular exercise
During a consultation, Dr. Schwartz evaluates each candidate on an individual basis. He takes a detailed medical history and asks questions about the candidate’s health history (including any previous abdominal surgeries). He inquiries about the candidate’s ideal cosmetic outcome, and any lifestyle factors that could affect the results.
Dr. Mark H. Schwartz performs a physical examination of the candidate’s abdomen, noting the amount of fat present, the elasticity of the skin and the condition of the abdominal muscles. This information helps him plan the course of treatment.
Procedural Details
There are several different types of tummy tuck procedures, and Dr. Schwartz selects his approach based on the particular patient and his/her anatomy and needs.
Tummy tuck is usually performed on an outpatient basis in Dr. Schwartz’s personal operating suite. Patients are monitored during the entire procedure by a board-certified anesthesiologist, so they remain safe and comfortable at all times.
To begin, Dr. Mark H. Schwartz makes a horizontal incision across the lower abdomen (just beneath the pubic area). The “classic” abdominoplasty incision extends across the abdomen. Through the incision, he corrects loose, separated or weakened abdominal muscles and stitches them together, making an internal “corset” to narrow the waistline. Dr. Schwartz also removes loose skin and tightens the remaining skin. For some patients, this improves or eliminates bothersome stretch marks on the lower abdomen. An additional incision is placed within the navel to position it in the most aesthetically pleasing location. If necessary, he may also use liposuction to remove surplus fat deposits around the abdomen, flanks, and other areas.
When Dr. Schwartz is finished making the necessary surgical modifications, he closes the incisions with absorbable sutures and dresses the area with sterile gauze. He places a supportive compression garment over the lower abdomen to help the tissues as they heal.
There are several variations from the “classic” tummy tuck described above.
A “mini tummy tuck” is similar to the regular tummy tuck procedure, except it involves a shorter incision and the skin is only lifted to the umbilicus, which does not have to be moved. This procedure is ideal for patients who need minimal improvement limited to the lower abdomen.
With an “extended” abdominoplasty, the incision continues to the flanks and enables additional removal of skin and fat. A “fleur-de-lis” abdominoplasty includes a vertical scar in addition to the horizontal hairline scar allowing for removal of skin in a side-to-side fashion. Both of these procedures are more extensive than the “classic” abdominoplasty but may provide improved contour when necessary.
Recovering from Tummy Tuck
Right after surgery, the patient rests in the recovery suite before being released to the care of a nurse or a responsible adult. The patient is escorted home or to a local hotel. They are placed into a comfortable position close to fluids, food, blankets and medication.
The first day or two of a tummy tuck recovery are the most challenging. Patient mobility is generally limited, and most report feeling tight and sore. Short walks are encouraged to promote good circulation as the body heals.
The patient must refrain from bending, lifting or straining during their initial recovery. They should rest as much as possible and take oral medication as needed for any discomfort. Dr. Schwartz provides instructions for taking care of the surgical incision, keeping the compression garment in place and returning to the office for follow-up visits.
During the follow-up visits, Dr. Schwartz examines the treated area to evaluate its healing progress. He advises when it is safe to return to work, and exercise. Every patient is different, but most return to work after about two weeks, and exercise after six to eight weeks. Regular exercise and a healthy diet both help the tummy tuck results to last for many years to come.
Typical Tummy Tuck Results
Patients see initial improvement in the abdomen almost immediately after surgery. The area may be swollen, but looks flatter and firmer.
After making a full recovery from tummy tuck, patients see a tighter and more toned-looking abdomen. They look slimmer and leaner from the side profile view, and the waist looks narrower. Stretch marks may have improved in appearance, or disappeared altogether. The skin tightly hugs the abdominal contour.
Scarring fades over time with the proper care, but it will not disappear completely. However, the scar is low enough to be concealed underneath a bathing suit bottom or panty.
Can Other Procedures be Combined with a Tummy Tuck?
Other procedures are frequently combined with a tummy tuck depending on specific patient goals, body type, and operating times. Liposuction of the flanks and thighs are commonly performed during a tummy tuck to enhance the contours. Breast implants may be performed together as well depending on the extent of the tummy tuck. Some patients choose to have their tummy tuck combined with a hernia repair or gynecologic surgery. These may be performed in conjunction with your general surgeon or gynecologist in New York City.
Why Choose Dr. Mark H. Schwartz for Tummy Tuck?
There are many reasons patients trust Dr. Schwartz with tummy tuck surgery. He offers the ideal blend of experience, skill and a warm bedside manner.
- Dr. Schwartz has over 20 years of experience performing the abdominoplasty procedure, and a long record of happy, satisfied patients. His attention to detail is a tremendous asset that helps him deliver beautiful, natural-looking results. He uses special techniques and technology to enhance the precision and safety of the surgery.
- Honored as one of Castle Connolly’s prestigious “Best Doctors in the New York Area” and selected for the coveted New York Magazine Best Doctors.
- Dr. Schwartz is certified by the American Board of Plastic Surgery and is recognized as one of “America’s Top Plastic Surgeons” by the Consumer Research Council of America.
- Dr. Schwartz shares his expansive knowledge with medical students and resident doctors as a Clinical Assistant Professor of Plastic Surgery at Weill Medical College of Cornell University. He also holds long-term hospital appointments at New York Presbyterian Hospital-Weill Cornell Medical Center (rated the best hospital in NY by US News & World Report), Hospital for Special Surgery and Lenox Hill Hospital, offering patients the combination of expert surgical skill and access to the best hospitals in the country.
- He also operates at his office facility, which is fully accredited by the American Association for Accreditation of Ambulatory Surgical Facilities (AAAASF).
- In addition to his refined technical skill, Dr. Schwartz is also a compassionate physician with a warm and friendly team. His patients have remarked on how caring and approachable he is, and they appreciate how he makes the surgical experience less intimidating. Dr. Schwartz believes in treating his patients the way he would treat a family member. He is committed to helping his patients achieve the look they desire, without changing who they are.
Tummy Tuck FAQs
What are the benefits of a tummy tuck?
The main objective of a tummy tuck is to improve the overall contour of the abdominal region. This is accomplished by removing excess skin and tightening the underlying muscles. Liposuction may also be performed during a tummy tuck to help contour the waist, flanks, and lower back. In addition to improved abdominal appearance, a tummy tuck can reduce or eliminate the incidence of stress urinary incontinence and improve posture.
A tummy tuck can also help with weight management. A 2013 study published in the journal Plastic and Reconstructive Surgery found evidence of short- and long-term weight loss in women who underwent a tummy tuck. One year after surgery, 14 of the 20 women studied lost more than five pounds. According to the study, the more tissue removed during the tummy tuck, the greater the likelihood of long-term weight loss. The mechanism involved is related to the removal of fat cells that can change the hormonal activity affecting appetite.
How do I decide if a tummy tuck is the right procedure for me?
A tummy tuck is the best choice for patients who have loss of skin elasticity with an overhanging skin fold. This is often associated with underlying abdominal muscle weakness, also known as rectus diastasis, which is commonly seen after childbirth or weight fluctuations.
Liposuction is an effective technique to target stubborn pockets of fat that remain despite diet and exercise efforts. Liposuction by itself works best in patients that have good skin elasticity and no skin folds. Aside from the abdomen, patients commonly seek liposuction of the thighs, hips, buttocks, arms, neck or back.
In some cases, it may be appropriate to combine tummy tuck and liposuction in a procedure known as lipoabdominoplasty. This surgery allows for removal of stubborn fat pockets and excess skin and tightening of the muscles in a single procedure. Combining both techniques allows the surgeon maximal flexibility in contouring the abdomen and surrounding areas.
How soon after giving birth can I have tummy tuck?
It is recommended that women wait at least six months after they give birth before undergoing a tummy tuck. This allows time for the skin, muscle and uterus to regain their normal size and shape, and for weight to return to baseline. In addition, women who are breastfeeding should wait several months after a baby is weaned before undergoing any procedure with anesthesia.
Will a pregnancy affect the results of a prior tummy tuck?
Yes, a pregnancy can affect the results of a tummy tuck that was performed prior to the pregnancy, or in between pregnancies. During pregnancy, the abdominal muscles are stretched and weight gain is expected; the muscles that were repaired can separate, and the tightened skin can loosen. With a few exceptions, it is strongly recommended that women wait until after their final pregnancy before undergoing a tummy tuck.
Will a tummy tuck eliminate stretch marks?
Stretch marks are indentations within the skin that result from damage in the dermal layer of skin. The only effective permanent “cure” for stretch marks caused by rapid weight gain, weight loss or pregnancy is skin removal. If your stretch marks are located in the lower abdomen, a tummy tuck will eliminate them because the skin is surgically removed. Stretch marks on the middle and upper abdomen may be improved but not eliminated, since this skin is pulled down and tightened during the procedure.
Will I keep my belly button?
Yes, of course you will keep your belly button. With a traditional tummy tuck the belly button is separated from the surrounding skin through an incision within the inner border of the belly button. The muscles are tightened, the excess skin is removed and the remaining skin is pulled down. A separate incision is made overlying the natural position of the belly button and it is sewn in place. The scar is hidden within the belly button.
How soon will I be able to exercise?
Exercising after a tummy tuck is a gradual process and begins by simply getting out of bed and walking around your home the day after the surgery. For the first week or so, most patients walk slowly, leaning slightly forward to take tension off of the incision. After 3-4 weeks, you can begin low-impact aerobic activity, including extended walking and the gentle use of a recumbent exercise bicycle.
After 6-8 weeks, you can begin to perform moderate aerobic activity, including brisk walks and the extended use of a recumbent exercise bicycle. You can lift light weights with your upper body or legs, as long as no strain is placed on the abdominal muscles. After 2-3 months, you may engage in more strenuous activity, including more significant weightlifting and high-impact aerobic exercises. At this time, you can begin gentle abdominal and core exercises and advance slowly.
When can I return to work?
Most patients are ready to return to work two weeks after surgery. If your job involves any heavy lifting, you will need to request “light duty” or take additional time off. However, if you are able to work from home on the phone or computer, you will be ready much sooner, usually within the first post-operative week.
Since a tummy tuck has a longer recovery relative to other procedures, I recommend that patients undergo this procedure at a “low-stress” time at home or work.
How will I feel after tummy tuck?
Since a tummy tuck involves the removal of skin and repair of the abdominal muscle separation (rectus diastasis), patients feel tight and sore for the first few days after the surgery. In addition to standard post-operative pain medication, I use a non-narcotic, long-acting local anesthetic called Exparel, which is administered during the procedure and helps to control pain before you feel it.
Will I have scarring after tummy tuck?
Since a tummy tuck requires an incision in the lower abdomen to remove excess skin, scars are unavoidable. I am careful to make the incision in the least noticeable area, beneath the bikini line. In a standard tummy tuck, the incision will be a gentle curve that follows the skin creases from hip to hip, and the length will depend on the amount of extra skin. There is also a small scar within the belly button, but this is not easily visible.
The “silver lining” with tummy tuck scars is that they fade with time. Depending on your genetic predisposition to scarring, most fade within 6-12 months and can be treated with lasers to improve their appearance if needed.
Learn More About Abdominoplasty in NYC
To schedule a tummy tuck consultation with Dr. Mark Schwartz, contact us today.
