Tummy Tucks may Help Correct the Pull of Gravity and Low Back Pain
...99...100. Breathing a little heavier, glistening (as they say in the South) with perspiration, and feeling the "burn" after struggling through those dreaded sit-ups, you’re hoping that the image staring back at you in the full length mirror will have miraculously shed the unwanted pounds and will show off the desired sleek torso. Once again, you’re disappointed and frustrated with the "paunch" that defies everything but gravity.
Just about everyone sees something they don’t like when they look in the mirror. In fact, research study after study reports that the majority of us -- that’s more than 50 percent of both men and women -- are dissatisfied with our body image. The main source of this dissatisfaction is more often than not the hips and abdomen.
Body image plays a major role in how we see ourselves, and can color our perception of how we think others see us. If this overall image is negative, it can drag down self-esteem, cause depression, interfere with intimate relationships, and generally get in the way of day-to-day life. Reinforcing this self- absorbed misery is the media’s message that the fountain of youth, health and happiness is accessible only to those who are thin. Every now and then, in obvious disregard for the "rules," a happy, well adjusted, full-figured model like Elle will appear on the scene, but they are sadly outnumbered and eclipsed by the legions of anorexic McBeal-lookalikes.
In today’s fitness and appearance-obsessed society, many women reaching their middle years simply want to regain a more youthful appearance. Unfortunately, after having several children and gaining and losing the same 20 pounds over the years, they soon catch on that neither dieting nor exercise will restore the desired profile. When the skin is badly stretched and abdominal muscles separate at the midline, they finally discover that no amount of sit-ups will fix the problem.
Abdominoplasty, the medical term for tummy tuck, can be performed to remove excess abdominal skin and to tighten underlying muscles that have stretched apart to the point where they provide little or no support for internal organs. The surgery -- which is designed to improve the contour of the body by flattening the abdomen and narrowing the waist-- is a major surgical procedure that is usually performed in a hospital setting under general anesthesia. A tummy tuck is not, however, a substitute for weight reduction.
Women (and yes, men too) who are in relatively good shape but have weak abdominal muscles and localized excess skin and fat make the best candidates for the tummy tuck procedure. It can be especially helpful for women who have had multiple pregnancies which stretched skin and muscles to the point that no other remedy can return them to normal. There are some other factors -- age, obesity, skin tone and whether or not the patient smokes -- which can have an impact on the results of the surgery. These are just some of the topics that are discussed with the patient during the initial consultation. In some cases, these factors could have such a negative impact on the possible outcome that the patient would not be considered a good candidate for this elective procedure.
According to plastic and reconstructive surgeon Michael V. Kelly, II, M.D., "If someone is going to undergo surgery to improve their appearance and to flatten their tummy, they are certainly going to want the scars to be minimal. While there are many surgical techniques for performing abdominoplasty, I use a special incision that allows good access to the surgical field and is especially conducive to repair. I also sculpt the fat away from the umbilicus (belly button) and ‘replant’ it in such a way to provide a trim, lean and muscular appearance that so many of my patients request. In the pre-operative consultation, we go over the specific details of what a patient might expect -- the technique, the risks, what kind of anesthetic will be used, the costs, and a candid evaluation of what the surgery can accomplish -- so patients can make an informed decision."
"I cannot stress strongly enough that while this procedure can indeed enhance a person’s appearance," cautioned the surgeon, "it cannot change their life...it cannot change the way others treat them or care about them. That’s why I urge patients to really think about and analyze their expectations and motivation for this surgery so we can have a candid discussion about this during the initial consultation."
There are some preparations -- eating, drinking, smoking and avoiding certain vitamins or medications, for example -- necessary before surgery. Once in the surgical suite, the anesthesia is administered and the procedure begins. Abdominoplasty usually takes two-and-a-half to three hours, depending on the extent of the work to be done.
Once the incision is made, the skin and fat are separated from the abdominal wall and lifted to expose the abdominal muscles. The muscles that are loose and stretched apart are sutured together to tighten them up. Then, the skin flap is lowered over the abdomen and the excess skin and fat are cut away. Before closing the incision, the navel is reconstructed. After the sutures are in place, a firm elastic bandage is applied to the area.
"Patients usually remain in the hospital for two days," explained Dr. Kelly. "Sutures are removed about two weeks after surgery and, as soon as appropriate, the bandages are replaced with an abdominal support garment which is then worn for several weeks."
After the surgery, it is important for patients to refrain from any heavy lifting, straining, or over-activity. While most patients are up and around one or two days after surgery, each case is different. It is therefore important to follow the physician’s recommendations about when normal activity can be resumed.
There are thousands of abdominoplasties successfully performed each year. The amount of improvement depends on the extent of the surgery, the patient’s body build and the individual’s healing process. Complications are relatively rare and are thoroughly discussed with the patient before the surgery.
"This is one surgery where following the doctor’s orders can really make a difference in the recovery period," said Dr. Kelly. "Patients often feel so good they are anxious to resume their normal activities earlier than they should. Taking it slow and easy is usually best, but if the patient has any questions about whether or not an activity is OK, they should contact their surgeon."
Abdominoplasty is a cosmetic procedure. Sometimes it is scheduled in conjunction with gynecological surgeries such as bladder re-suspension or hysterectomy. This minimizes the patient’s expenditures for the operating facility and anesthesia, and requires only one recovery period instead of two.
"In scheduling this or any other plastic surgery procedure," Dr. Kelly advised, "patients should try to be realistic in their expectations. The goal is improvement, not perfection."
