Abdominoplasty (Tummy Tuck) Surgery
Abdominoplasty, also called a tummy tuck, is a type of plastic surgery that helps make your stomach look flatter and tighter. An abdominoplasty allows Dr. Poppler to remove extra skin and tighten the core muscles. An abdominoplasty is often paired with liposuction (or liposculpting) to remove excess fat around the waist and flanks and to highlight your core muscles and six pack. Many people choose this surgery after weight loss, pregnancy, or when exercise and diet cannot remove extra skin and fat.
Where Are the Scars?
During a tummy tuck, Dr. Poppler makes a cut (called an incision) low on the stomach, usually just above the pubic area and below the hip bones (Pelvis). Dr. Poppler uses his experience to predict how the scar will move as your skin heals and stretches so that it is hidden under skimpy underwear or swimsuits. Often, there is also a small scar around the belly button if it is moved during surgery. Dr. Poppler uses a technique that helps hide this scar inside the belly button and makes it less visible to others.
What is Rectus Diastasis?
A Rectus Diastasis is a deformity of the abdominal wall (stomach muscles) caused by pregnancy, or occasionally being very overweight, where the six pack muscles (rectus abdominus muscles) are separated away from the midline and one another. This can cause the abdomen to bulge and women to look pregnant, even when they are not. It can also cause weakness of the core muscles, muscle imbalance, and chronic low back or abdominal pain. Women with this disorder are often told they cannot do core abdominal exercises, or they may make this condition worse. Correcting the separation of the six pack muscles restores them to their natural position, correcting these complaints.
Rectus diastasis is like a hernia of the abdominal wall, but in some ways worse because it decreases the strength of your abdominal core muscles. A hernia is when there is a hole in the abdominal wall (often, but not always caused by previous surgery) that allows your abdominal contents (usually fat and sometimes a loop of bowel) to protrude out of your abdominal wall. A hernia can be dangerous if a loop of bowel escapes, gets stuck, and twists. For this reason, hernia repair is usually covered by insurance. Unlike a hernia, in rectus diastasis the fascia (strong support tissues that wrap our muscles and hold our organs in place; when you eat a steak, the gristle is fascia) between our rectus muscles has stretched, thinned, and become much weaker. However, there is no hole in it. Sometimes patients with rectus diastasis also have a hernia. In these cases, insurance may cover some of the cost of correcting a rectus diastasis.
Although rectus diastasis can be very debilitating, it is considered cosmetic, not a “medical condition” by insurance companies and therefore its repair is not covered by insurance. You will find an occasional story online of a patient who successfully had their surgery covered by insurance. We have seen many patients try to get this covered and have never seen one succeed unless their surgeon commits fraud in their documentation. This is an ongoing form of systemic sexism that feels (and is) very unjust. Unfortunately, it is unlikely to change soon. If you want to advocate for change, you likely need to speak with your state and federal senators and congress people and ask them to make a law mandating coverage to repair rectus diastasis. If you have the time and energy to do this, please let us know as we would be happy to support you.
Can men get rectus diastasis?
Yes. Although rectus diastasis is most often caused by pregnancy, patients who have a large round belly with most of the fat inside the abdomen can get rectus diastasis. Any condition that causes the contents of the abdomen to expand (usually fat, but sometimes a tumor or other growth) can cause rectus diastasis. Having a large amount of fat inside the abdomen (known as visceral fat) is a known risk factor for heart attack, stroke, and peripheral vascular disease. For this reason, it is very important to lose weight if this is the reason for your rectus diastasis. Losing weight is also essential before abdominoplasty and rectus diastasis repair when visceral fat is the cause, or present with rectus diastasis. If you do not lose weight, it is impossible to bring the rectus muscles back together.
Differences in Technique for Men vs. Women
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Women: Dr. Poppler will focus on tightening muscles stretched by pregnancy (rectus diastasis), removing loose or stretch marked skin, and giving your waist an nice feminine shape. The goal is to restore a smooth, hourglass shaped waistline and natural belly button shape.
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Men: Men usually want a straighter, firmer look without as much waist shaping. Men usually do not have rectus diastasis that needs corrected. Men also typically have hair on their abdomen. Dr. Poppler will focus more on removing extra fat and skin, while preserving a straight, masculine waist, and minimizing distortion of abdominal hair to preserve a natural, manly look.
What is a Mini-Abdominoplasty (or Mini-Tummy Tuck)?
A mini-abdominoplasty is an operation that addresses extra skin and fat in the lower abdomen. Mini-abdominoplasty uses a shorter scar at the waist and does not involve a scar around the umbilicus. This is not typically appropriate for patients with a lot of extra skin or with separation of their rectus abdominus (six pack) muscles (diastasis recti.) At your consultation, Dr. Poppler will examine you and if appropriate discuss the possibility of mini-abdominoplasty with you.
Why People Choose Abdominoplasty
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Flatter stomach
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Removal of loose, hanging skin
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Stronger abdominal muscles
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Improved body confidence
Possible Complications
Like all surgeries, abdominoplasty has risks. The risks are small but are higher in people with certain medical conditions such as smoking, poor nutrition, auto-immune diseases, or diseases that require the use of blood thinning medications. Dr. Poppler will carefully review your risk factors with you at your consultation and help you modify these where possible to make your surgery as safe as possible. At Treasure Valley Plastic Surgery, your safety is our number one priority, and all surgical prices include an insurance plan to help pay for care related to any complications.
Possible complications listed from most to least common include:
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Changes in skin feeling (numbness)
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Fluid build-up (seroma)
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Scars that may be thick or uneven
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Poor wound healing
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Infection
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Bleeding
What happens if I have a hernia?
Dr. Poppler will carefully examine you during your consultation for possible hernia (hole or weak point in the abdominal wall that your abdominal contents may protrude through). If you have a hernia, Dr. Poppler may order a scan such as an ultrasound or CT scat (cat scan) to better evaluate this. If you have a large or complicated hernia, Dr. Poppler may refer you to a general surgeon that specializes in hernia repair. If you have a small hernia, Dr. Poppler will repair it for you as part of your abdominoplasty surgery.
Should I lose weight before surgery?
If you are significantly overweight, you may not be a good candidate for abdominoplasty (tummy tuck) and Dr. Poppler may recommend you lose weight prior to surgery so that he can give you a better result and decrease your risks with surgery. Best results are achieved when you are at the weight you intend to stay at. Losing weight before surgery is not helpful if you think you will gain it right back. Similarly, doing surgery before losing weight produces a sub-optimal result because your skin will loosen again as you lose weight. For this reason, it is best to lose weight before abdominoplasty surgery if you intend to lose weight or if you are significantly overweight, but otherwise you should have surgery when you are at a stable weight you are happy with.
How long is recovery after a tummy tuck?
Recovery from abdominoplasty surgery usually takes about 6 weeks. Most patients return to light activities within 1 week, and work in 2-3 weeks. Return to most exercise is possible about 3 weeks after surgery. Depending on if you have your muscles tightened, you will have some lifting and twisting restrictions for 3 months. Swelling is typically mostly gone in 4 weeks but will come and go for about 3 months.
Is a tummy tuck safe?
A tummy tuck is generally safe when performed on appropriate patients by a board-certified plastic surgeon. Like all surgeries, there are risks such as infection, bleeding, fluid build-up, or scarring. Choosing an experienced surgeon like Dr. Poppler, following his advice to modify any risk factors before surgery, and following aftercare instructions lowers these risks and improves results.
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