Tummy Tuck

Tummy Tuck

What is Tummy Tuck
Surgery?

Newmarket plastic surgeon Dr. Deborah vanVliet performs abdominoplasty, also referred to as a tummy tuck, to remove excess skin and fat from the abdomen for our patients from Barrie, Markham, Richmond Hill, Vaughan, and other nearby Toronto communities who want a smoother, firmer midsection. She can also tighten lax or separated abdominal wall muscles or include liposuction to create a flatter, firmer, and improved belly contour.

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Abdominoplasty surgery is helpful for women who are bothered by a protruding abdomen or a loose skin envelope that has not responded to diet and exercise. Pregnancy, fluctuations in weight or massive weight loss, as well as hormonal changes and age all contribute to this issue of lax abdominal wall skin. The ideal surgical candidate:

  • A nonsmoker
  • Older than 18 years of age
  • Close to his or her ideal body weight with a BMI less than 35
  • At a stable weight
  • In good physical and mental health
  • Realistic about extensive abdominal wall scars
  • Not planning a future pregnancy
  • Without a history of thrombo-embolic disease (clots in legs or lungs) or bleeding disorders

Dr. vanVliet helps determine whether you are a good candidate after a thorough discussion and examination.

Your initial consult with Dr. vanVliet is critical to ascertain what bothers you most about the appearance and contour of your abdomen. Dr. vanVliet will work closely with you to help tailor a treatment plan to your wishes while taking into account your overall health and tissue constraints.

She will conduct a thorough examination during which she will clearly outline the extent and location of scars that would be required to effect significant improvement for your abdominal contour. The more global and extensive the abdominal skin laxity, the longer the corrective incisions will need to be.

Once a surgical plan has been made, an operative date can be scheduled. Dr. vanVliet will again see you for a preoperative visit to review your operative course with you. She believes that an informed, prepared patient is a more relaxed and happier patient.

The extent of surgical work can vary from mini-tummy tucks to correct skin excess that is limited to below the navel to a full tummy tuck where the entire abdomen is treated. In the case of massive weight loss patients, with extensive skin laxity in front and back, the tummy tuck may be extended circumferentially to comprise a lower body lift.

Your surgery will be conducted using a general anesthetic, and your operative time in general will vary between 3 and 5 hours, depending on the extent of work to be done. The extent and location of your scars will also have been fully reviewed with you before your surgery and will correlate directly with the extent of the work being done.

Most commonly, a long incision extends from hip bone to hip bone just above the pubic region. A second incision is made around the navel and excess skin is removed from around it. The abdominal wall muscles are tightened as required to further help contour the abdomen.

In some cases, Dr. vanVliet also includes selective liposuction to target fat in the midsection, flanks, and surrounding areas and leave you with a smoother contour. It’s also common to get a tummy tuck as part of a Mommy Makeover. This customized procedure addresses the breasts, in addition to the body’s contours, to restore a woman’s figure after pregnancy. Dr. vanVliet plans these details with you well in advance of your procedure depending on your goals.

Your surgery will be conducted at Southlake Regional Health Centre. Please ensure that you follow Dr. vanVliet’s preoperative instructions regarding when to arrive for surgery and when to stop eating and drinking. Also, aspirin, anti-inflammatories, and other blood thinners can significantly increase your chances of operative bleeding, so you need to avoid taking these medications at least one week prior to your scheduled operative date. A relative or friend should accompany you to the hospital.

Dr. vanVliet will meet you in the operative suite and do preoperative markings and photos before you go off to sleep. You will then have your general anesthetic administered by a board-certified anesthetist. After 3 to 5 hours, you will wake up in the recovery room where you will be closely monitored until you are fully awake.

You will have a dressing covered by an abdominal binder. In most cases, there will be drains that are necessary to reduce postoperative swelling and pain. Intermittent pneumatic compression stockings, placed on your calves preoperatively to reduce the risk of problematic blood clots, will remain on your calves until you are discharged home. In most cases, you will require an overnight stay in the hospital.

Dr. vanVliet will assess you prior to your discharge home the morning after your surgery. She will write you a prescription for antibiotics and pain medication. The nursing staff will give you simple drain care instructions. You will need to be under the care of a friend or family member for another 24 hours after your discharge home.

For the first 7 to 10 days, you will be moving slowly and you will not be capable of much outside of self-care; multi-tasking and caring for others will be a few weeks off. In your first postoperative month, it is important to not cross your legs or to spend extended time sitting or lying down in order to reduce the potential formation of blood clots in the legs. In your first week, you will be walking slightly bent over, but you do have full permission to walk as upright as you like, and in fact we encourage you to be in putter mode around the house.

You will be doing daily drain measurements as instructed, but you will be in sponge bath mode during this first week, leaving your binder in place. On your first post-op office visit, we will remove your dressings and likely your drains for you, after which you can shower. Your binder will need to be worn most of the time for the first month to help provide support to the tight incisional closure and to reduce postoperative swelling.

Initially, you will notice your incisions are puckered, raised, and red and that you are swollen. Over time, the swelling resolves and the incisions become softer and paler. Your supportive compressive binder is integral and supportive of this process.

Most people are able to return to work in 2 to 3 weeks and back to gentle exercise at 1 month, gradually working up to normal exertion by 6 to 8 weeks.

Abdominoplasty surgery is a major procedure but a relatively safe one when conducted by a board-certified plastic surgeon who is trained in body contouring surgery. Healthy, nonsmoking patients with a good BMI tend to do very well, with minimal operative risks.

However, as with any surgical procedure, including specifically this one, there is always the possibility of complications related to your surgery or to your anesthetic. Bleeding and infection rates are low, but they may occasionally necessitate the need for further surgery, blood transfusion, or hospitalization. The potential for blood clots is also low and can be significantly reduced by the use of specialized compression stockings that massage your calves, both during and after your surgery, until your discharge home. Occasionally, there is delayed scar healing or thick scarring, but in the majority of cases, the subsequent scars are of excellent quality.

Dr. vanVliet will have detailed discussions with you before your surgery so that you are well informed regarding your operative risks and complications, as well as the benefits that you can anticipate. It is critical that you closely follow your pre- and postoperative instructions in order to optimize your surgical outcome.

Dr. vanVliet will be able to advise you on the cost of your tummy tuck based on your initial consultation with her at our Newmarket practice. The cost of tummy tuck surgery in Ontario is related to the complexity and extent of the work to be done, but also includes associated anesthesia and hospital fees. Fees are due in full 3 weeks prior to your scheduled surgery date and can be paid by certified cheque or money order or with credit/debit cards. If you would like to learn more, please refer to our fees & financing section or contact us by phone or email to schedule your consultation with Dr. vanVliet.

Weight fluctuations and substantial weight loss can leave patients with extensive skin laxity and folds that are both uncomfortable and unsightly. I have seen many teary-eyed patients in my office who, although happy with their weight loss, are unhappy with their subsequent appearance. Bariatric procedures can often successfully give patient’s bodies a new lease on life while also resolving health issues and making patients feel better. These patients have worked hard at their weight loss. They come to me when they want to look as good as they now feel. They want the outside to match the inside, and who can blame them?

Often, there are many areas to address; my initial consultation is usually focussed on prioritizing which corrective procedures to consider, and in what combination. Considerable planning is involved; the more extensive the skin laxity and folds, the more extensive the corrective surgical procedures become. The clock ticks during surgery (this is important) and the operative risks and complications increase as the procedures become more lengthy. My role is to address the patient’s aesthetic goals in the safest and most effective manner possible. This often means staging procedures into manageable components.

With respect to loose tummies, if the residual fullness or skin laxity is mild after weight loss or pregnancy, very often our non-surgical modalities are very effective. CoolSculpting® for example is a safe and comfortable way to reduce small areas of residual fullness if one’s skin quality is good. Some patients are better candidates for skin tightening if there is minimal fullness, laxity or folds. In those cases, our radio-frequency Pellefirm® is a great non-surgical option. If the skin laxity and folds are more extensive, anything from a mini tummy tuck; to a full tummy tuck; to a circumferential Body Lift can be considered. In more severe cases, the full tummy tuck may morph into a ‘Fleur de-Lis’ design or Lower Body Lift to exact a more powerful correction.
The initial consultation is an important first step and it is during your initial consultation that we can together decide which treatment would be best for you.