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Tummy Tuck

A tummy tuck is a cosmetic surgical procedure that can help reduce the appearance of a protruding abdomen, and thus enhancing its appearance.

A surgical tummy tuck involves the removal of excess, sagging skin and fat that is resistant to regular diet and exercise. After childbirth and extreme weight loss, the effects of loose abdominal muscles and skin are largely reversible through surgery. This is achieved by surgically removing excess skin and fat from the abdominal area and having the muscles of the abdominal wall tightened.


Mini-Tummy Tuck vs. Full Tummy Tuck

Cosmetic surgery can help to enhance your figure through a variety of body contouring procedures, such as “abdominoplasty.” This surgical procedure can be performed in two ways: a full tummy tuck (complete tummy tuck) or a mini-tummy tuck (partial tummy tuck). This, of course, depends on your condition. Even if you are committed to a good diet and regular exercise, the excess fat that can accumulate in the abdominal area may just sit there and drive you crazy. The type of patients who most commonly undergo tummy tuck surgery are women left with a protruding belly after having multiple pregnancies. During a full tummy tuck:

  • Skin is separated from the abdominal wall all the way up to the ribs.
  • The surgeon draws underlying muscle and tissue together and stitches them, thereby narrowing the waistline and strengthening the abdominal wall.
  • Abdominal skin is drawn down and excess is removed. With complete abdominoplasty, a new opening is cut for the navel. Both incisions are stitched closed.
  • After surgery, the patient has a flatter, trimmer abdomen. Scars are permanent, but will fade with time.
Mommy Makeover tummy tuck and breast augmentation

Tummy Tuck Incision Diagram

If the storage of excess fat is predominantly in your lower abdomen, a mini-tummy tuck may work out best with improving the appearance of loose, stretched-out skin. This technique is often done on an outpatient basis allowing for a quicker recovery period than with a full tummy tuck. Because a small, horizontal incision is made just above the pubic region, the discreetly-placed scar can be covered with clothing. To lose your pouch in the lower abdomen, the excess skin is cut and removed while the remainder is stitched back together for a firmer look and feel.

As compared to a fully tummy tuck, this minimal technique allows the navel to remain intact. A mini-tummy tuck can take about one to two hours, while complete abdominoplasty may take about two to five hours.

Besides the longer, hip-to-hip scar a tummy tuck produces, as well as the repositioning of the belly button, it involves muscles tightening for beautiful results. Because this procedure is more intricate involving a much wider incision and more skin removal than a mini procedure, you will need to restrain yourself from work and activities during a longer period

For both the mini and full techniques, you may receive general anesthesia or local anesthesia with a sedative. Dr. Hochstein commonly performs liposuction in conjunction with your tummy tuck technique in order to remove extra fat; this will help to contribute to a smoother abdominal profile. For more information about your options with abdominoplasty, please call our office to make an appointment for an initial consultation.


Who Is A Good Candidate For A Tummy Tuck?

  • Is close to their ideal body weight (within 30%)
  • Is in good health and relatively good shape, but still has a large fat deposit or loose abdominal skin that is diet- and exercise-resistant
  • Weight has been stable for 6 months or more
  • Has good skin tone and elasticity
  • Has realistic expectations
  • Is emotionally stable
  • Understands the risks of abdominoplasty surgery

A Miami tummy tuck is also helpful to women who have experienced pregnancy and found their abdominal area is having a hard time returning to its normal shape through diet and exercise. Men and women that have lost a great deal of weight, but still possess excess skin and fat in their abdominal area can also benefit from a tummy tuck procedure.

Initial Consultation

At your initial consultation, Dr. Hochstein will evaluate your health, determine the extent of fat deposits in your abdomen, and assess your skin tone. Be specific about what you would like done, i.e. bring your favorite bikini bottoms. If your surgeon fully understands your expectations, he’ll be able to determine whether your goals are realistic.

You are at increased risk for complications if you have diabetes, poor circulation, heart, lung or liver disease, smoke, have a family history of blood clots, take certain medications, etc. You’ll want to discuss your medical history thoroughly with your Miami tummy tuck physician before you choose to undergo surgery. Here at Dr. Hochstein’s office we only use Board Certified Doctors for all of our Anesthesia needs. You can look up all information on are Anesthesiologist under Patient Education.

How To Prepare For Your Upcoming Surgery With Dr. Hochstein

During consultation, you will get specific instructions on how to prepare for a tummy tuck (Abdominoplasty) surgery, including guidelines on eating and drinking, and taking or avoiding certain vitamins, and medications on consultation day.

If you are a smoker, plan to quit at least 1 to 2 weeks before your surgery and not to resume for at least two weeks after your surgery. It is important to avoid overexposure to the sun or tanning beds before surgery, especially to your abdomen. Do not go on a stringent diet before surgery, as this can inhibit your ability to heal. If you develop a cold or infection of any kind, let Dr. Hochstein know as soon as possible because your surgery may need to be postponed.

Arrange for someone to drive you home, and take care of you for a day or two after your surgery. (You may need to have someone drive you back and forth for your first few follow-up visits).

If you’re realistic in your expectations and prepared for the consequences of a permanent scar and a lengthy recovery period, abdominoplasty may be just the answer for you.


The Tummy Tuck Procedure

When Dr. Hochstein performs a tummy tuck procedure, he will remove excess fat and skin from the lower abdomen and tighten the abdominal muscles. This may be performed with or without liposuction (“lipoplasty”). Tumescent, ultrasonic assisted (UAL), power assisted (PAL), or VASER ® Hi Def (VAL) liposuction can be utilized to smooth out the contours of the abdomen, while removing stubborn fat deposits. Liposuction and tummy tuck surgery are commonly performed together for post-pregnancy patients.

The first issue to be addressed is skin stretching. The skin from the supra pubic area to the level of the umbilicus is usually removed and the upper skin is stretched down to the lower portion, which also results in a lifting/tightening of the external genitalia. Sometimes stretch marks develop as a result of this. Depending upon their position most can be removed or at least brought to a much lower location. When healed, the scar should be thin and located in a low enough position so that a bikini will completely cover it. I have seen abdominoplasty scars, which seem to go very high as the incision goes outward. This is the worst possible situation, however, when it comes to hiding the scar and makes it impossible to lower or otherwise hide.

The next problem, which is addressed, is the fat layer. The lower abdominal fat is excised along with the overlying skin in one piece. There is additional shaping performed in the hips and back using liposculpting. I prefer to use the power-assisted techniques to remove these fat deposits to create a narrow waist. Recently, ultrasonic or smart lipo gained some popularity but I have seen some very irregular and poor results using these techniques.

The last issue is the muscle stretching or separation. This is what creates the out-pouching of the stomach and probably the most important part of the operation. The muscles are tightened using multiple permanent stitches to retighten the abdominal musculature. This is also the portion of the surgery, which creates the most pain. The advent of the pain pump, which I have been using for the last year, has completely changed this. No longer is the patient in severe pain after the surgery. The entire recovery period has been shortened by these great machines.

Bend at the Waist (45 degree angle) Pain Pump for Tummy Tuck Recovery
Bend at the Waist (45 degree angle)
After a Tummy Tuck all patients must stand at a
45 degree angle for at least the first 10 days to
avoid tension on the incision.
Pain Pump
Used to minimize pain after a Tummy Tuck.

Mommy Makeover

Many individuals who undergo these procedures also choose to complement their body reshaping results with breast surgery. To correct sagging and to regain lost volume after childbirth, breast lift surgery (“mastopexy”) and/or breast augmentation surgery (“augmentation mammaplasty”) are commonly combined. By undergoing these body contouring procedures, a woman is able to gain back the body she had before the effects of pregnancy.

A tummy tuck is just one of the procedures available at Dr. Hochstein’s practice, located in Aventura, Florida. A Tummy Tuck that is performed with or without a breast lift (Mastopexy or Bennelli) has become one of the most popular surgeries performed by myself and for very good reasons. When properly done, there is no surgery, which can alter the post-pregnancy body more other than perhaps breast augmentation / breast lift. Every anatomical change cannot only be corrected but even brought back to a better-than-before pregnancy state. A True Mommy Makeover!

There are several changes that occur to the female body during the pregnancy. The most visible change is the stretching of the skin with the possibility of developing stretch marks. There is also a fat redistribution with the fat being centered in the hips and abdomen area. There is also a significant muscle separation creating an out pouching of the abdomen. All of these are addressed by the modern Miami abdominoplasty (Tummy Tuck).


Reducing the Risks in Tummy Tuck Surgery

There are risks involved with this surgery. Some of these risks include infection and blood clots, which can be treated easily and are rare.

The greatest risk is the development of blood clots in the legs. These can travel to the lungs, and can be fatal. I try to limit this risk by using compression devices on the legs during and after the surgery to keep the circulation going as well as encouraging patients to take frequent walks around the house. I also recommend the use of a recliner to keep the legs elevated and facilitate the movement of getting up and down. The pain pump has also helped in this respect because the patients are able to ambulate much more and much quicker. I have performed 2,000 tummy tucks myself and have never experienced this particular complication, but it is important to inform the patient of its risk. There can also be poor scarring or infections as a result of the surgery. Oftentimes, this is due to over-tightening of the skin or poor blood supply to the healing areas. In general, my patients are extremely happy with their outcome. Scars usually heal well. Occasionally, poor scarring is the result of the genetic predisposition or an underlying disease process such as diabetes or smoking. All of these and other risks should be discussed with your surgeon prior to the operation.

Getting Yourself Back To Normal

It will take you a few weeks or months to feel like yourself again. If you are in good physical condition with strong abdominal muscles, recovery from abdominoplasty will be a lot faster. Some people can return to work after two weeks, while others take three or four weeks to rest and recuperate. Most patients can drive their vehicles within 5 to 7 days, but plan on having someone drive you to the office for your first few follow-ups after surgery.

Exercise of some sort is very important, even if just walking around your house. It will not only help you heal better but it can reduce swelling, lower the chance of blood clots, and tone your muscles. Vigorous exercise, however, should be avoided for 4 to 6 weeks and you are cleared by Dr. Hochstein.

Scars may actually appear to worsen during the first 3 to 6 months as they heal, but this is normal. Expect it to take 9 months to a year before your scars flatten out and lighten in color. While they’ll never disappear completely, abdominal scars will not show under most clothing, even under bathing suits.


Tummy Tuck Drain Instructions

Tummy Tuck Drain Emptying Full Tummy Tuck Drain
1) This is how a full drain looks. 2) Once the drain is full, empty completely.
Squeeze Tummy Tuck Drain Collapse Tummy Tuck Drain
3) Squeeze drain until it is empty. 4) Make sure drain is completely collapsed.
Insert Plug Back Into Tummy Tuck Drain Tummy Tuck Drain
5) Insert plug back into drain. 6) This is what drain should look like.
Collapsed Tummy Tuck Drain with Suction Tummy Tuck Drain - Not Collapsed, No Suction
7) Correct Drain (Collapsed with Suction). 8) Incorrect Drain (Not Collapsed, No Suction).

Abdominoplasty Post Operative Instructions

  • Breathing Exercise – 4-6 times per hour as instructed or as instructed with (spirometer).
  • Ambulating – Must walk every 2-3 hours for 5 minutes to help reduce swelling and lower the risk of
    blood clots.

Walking Instructions

When walking you must be bent at the waist at a 45 degree angle to avoid tension on the abdominal skin and muscles. You will need to consult with the doctor before standing up straight because all patients heal at a different rate. Your back may become sore in this position so we recommend warm compresses and Icy hot gels. You will not be able to stand up straight for at least 10 days or otherwise instructed by the doctor. MAY USE A WALKER

  • Tummy Tuck Drains – For the first 4-5 days you will need to empty drains when they are at the half way point to keep them in suction mode. After this start using your DRAIN LOG and empty once every 24hours. If full before 24hours empty drains and start timing over. To avoid infection always WASH YOUR HANDS before handing your drains and cleaning incision area. Abdominal drains are removed when less than 25 ml
    for 24 hours.
  • Pain pump – The pain pump will be in place for 5 days to help minimize the pain.

Showering

No showering until after your POST-OP apt. the doctor will be removing your dressings at this time. (However you may take a sponge bath from waist down and to clean under your arms). After Dressing are removed you may resume showering using an antibacterial soap but make sure to keep the pain pump dry. Always pat dry incision area, DONT RUB.

  • Lifting – No lifting greater than 10-15lbs for the first 2 weeks after surgery or otherwise instructed by the doctor. On your 2 week follow-up appointment, ask the doctor about your individual weight limitations. (However if you must lift, use your legs).
  • Garment – Wear your garment continuously for 4-6 weeks after surgery. (However you may remove it to shower & wash) We recommend you buy an extra binder so you can change them in between washings.
  • Exercise – Avoid straining of abdominal muscles. Strenuous exercise and activities are restricted for up to 6 weeks after surgery.

*Do not remove the Adhesive Strips (steri-strips) these will fall off within 3-6 weeks after surgery. Once strips are removed apply Bio-Corneum twice daily. (Always Wash your hands)

*Protect the scar from direct sun exposure for 2 years.


Contact Us for a Consultation

A combination of procedures along with a tummy tuck may also be performed on patients after weight loss to remove loose, excess skin and fat. To see examples of Dr. Hochstein’s patient results, feel free to view tummy tuck before and after photos.

Men and women who are interested in a tummy tuck in Miami with Dr. Hochstein can schedule a free consultation to find out if they are the right candidate. At this time, prospective patients can also have all of their tummy tuck questions answered.

To contact Miami tummy tuck surgeon Dr. Hochstein, please call (305) 931-3338 or email us to schedule a complimentary consultation.

Tummy Tuck Before and After - Front View - Dr. Hochstein

Before and After Tummy Tuck - Side View - Dr. Hochstein

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