Extended
Tummy Tuck

Embarking on the journey to achieve a more sculpted and aesthetically pleasing body contour often involves considering surgical options like an extended tummy tuck. This comprehensive guide explores the intricacies of extended tummy tuck procedures. We are offering valuable insights into what patients can expect, the qualifications to look for in a plastic surgeon, and important considerations before and after surgery.

Limitations

Understanding the limitations and realistic expectations is crucial when considering an extended tummy tuck. Factors like BMI, genetics, and preexisting medical conditions can influence the outcome, and we provide insights into managing expectations.

Choosing the right plastic surgeon is paramount, and we outline the essential credentials and qualifications patients should seek in their surgeon. Dr. Nick Masri, a double board-certified plastic surgeon and Fellow of the American College of Surgeons, exemplifies the level of expertise and commitment to excellence to look for in a surgeon.

We also address the cost of an extended tummy tuck, acknowledging that it can vary based on individual circumstances. Patients should be prepared for this financial commitment, as cosmetic procedures are typically not covered by insurance.

While alternatives to an extended tummy tuck exist, we stress the limited effectiveness of non-surgical treatments for addressing significant skin laxity and lipodystrophy.

As you embark on your journey toward a more confident and contoured self, this comprehensive guide aims to equip you with the knowledge and insights needed to make informed decisions about extended tummy tuck procedures. With careful planning, open communication with your surgeon, and realistic expectations, you can achieve life-changing results and a rejuvenated body contour.

What is the medical term for an extended tummy tuck, and is it commonly known by any other names?

The medical term for an extended tummy tuck is “Extended Abdominoplasty.” It’s often known by this name in the medical field. This procedure goes beyond what’s typically associated with a “mini tummy tuck” or a “standard tummy tuck.”

Who is an ideal candidate for an extended tummy tuck procedure?

Ideal candidates for an extended tummy tuck procedure are typically individuals who fall into several categories. These include:

• Plus-sized individuals: Those with excess skin and fat deposits in the abdominal and flank areas.
• Weight loss patients: Individuals who have lost significant weight through diet and exercise or other methods.
• Post-pregnancy: Women who have experienced pregnancy-related changes and wish to address issues like stretched skin.
• Aging concerns: People with aging skin that has led to skin laxity and irregularities around the waistline.
• General health: Healthy individuals without uncontrolled health issues are generally suitable candidates.

However, not everyone is an ideal candidate. Those with uncontrolled health conditions, such as diabetes or hypertension, are not suitable candidates. Similarly, smokers and individuals on steroids should reconsider the procedure. Additionally, those with a BMI greater than 50 may not be optimal candidates, depending on the distribution of their adipose tissue in their body.

What are the primary motivations that lead people to consider this surgery?

The primary motivations for considering this surgery often revolve around self-improvement and enhanced self-image. Many individuals express a desire to return to a previous version of themselves. Beyond physical changes, the psychological benefits are profound. Increased self-confidence and self-esteem can lead to improved relationships. Additionally, some individuals experience enhanced hygiene and increased ease in daily activities, adding to the functional benefits of the procedure.

How does an extended tummy tuck differ from a standard tummy tuck (abdominoplasty)?

Difference between tummy tuck and extended tummy tuck:

• Extent of Tissue Removal: In an extended tummy tuck, excess skin and fat are removed not only from the abdomen but also from the hips and proximal flanks. This comprehensive approach targets a larger area.
• Muscle Tightening: Both procedures involve abdominal muscle tightening, but in an extended tummy tuck, sutures are used to create an internal corset, resulting in a more pronounced hourglass shape. This is especially beneficial for patients who are plus-sized, have experienced weight loss, or have skin laxity due to pregnancy.
• Standard Tummy Tuck: A standard tummy tuck focuses on removing excess skin and subcutaneous fat but typically has a less extensive scope compared to the extended version. It also involves muscle tightening and may include repositioning the umbilicus (navel).
• Mini Tummy Tuck: Mini tummy tucks are even less extensive, primarily addressing skin excision just above the pubic area. This procedure is suitable for mothers with lower BMIs who have undergone C-sections and have mild skin laxity and scarring. Umbilicus repositioning and muscle tightening are rarely performed in mini tummy tucks.

What are the main surgical techniques involved in an extended tummy tuck?

The main surgical techniques involved in an extended tummy tuck are as follows:

• Markings and Incision:

  The procedure begins with precise markings on the lower abdomen, pubis, hips, and anterior flanks. An incision is made along these markings on the lower abdomen. This incision allows access to the targeted areas.

• Tissue Dissection:

  Surgical dissection proceeds through the subcutaneous tissue, subcutaneous fat, and down to the fascia of the anterior abdominal wall. The dissection continues anteriorly and superiorly until reaching the umbilicus then it continues on to the ribs and underneath the breast bone. Throughout this process, blood vessels are cauterized and tied to minimize bleeding.

• Flap Elevation: 

  The skin is elevated from the abdominal wall, extending laterally to the hips and anterior flanks and progressing upward to the ribcage and beneath the breastbone. This creates a flap that provides access for the procedure.Disection continues past the umbilicus to ribs and underneath the breast bone.

• Muscle Tightening:

  The rectus muscles of the abdominal wall are tightened using multiple layers of sutures. This tightening creates an internal corset-like effect, shaping the waistline and potentially revealing a “six-pack” appearance.

• Anesthetic Injection:

  The abdominal wall is injected with anesthetic to reduce postoperative discomfort.

• Flap Extension:

  The skin flap created earlier is extended over the lower abdominal incision. Excess skin is tailored and removed to align with the lower incision.

• Umbilicus Reconstruction:

  The patient’s natural belly button (umbilicus) is tailored and attached to the abdominal wall, ensuring a recessed and natural appearance.

• Drain Placement:

  Drains are inserted and brought out through the lateral aspects of the lower abdominal incision to manage postoperative fluid buildup.

• Wound Closure:

  The surgical wounds are closed in layers using absorbable sutures.

• Umbilicus Positioning:

  The umbilicus is positioned through the skin flap in its natural location and secured with sutures.

• Dressing Application:

  Finally, dressings are applied to the surgical sites to facilitate healing and protect the incisions.

These steps collectively result in an extended tummy tuck procedure, addressing excess skin and fat while contouring and tightening the abdominal area.

What is the expected duration of an extended tummy tuck surgery?

The results of an extended tummy tuck surgery can last for several years. However, the longevity of these results can be influenced by factors such as age, weight fluctuations, pregnancy, and potential health issues that may arise over time.

Is it performed under general anesthesia or local anesthesia with sedation?

Extended tummy tuck procedures are performed exclusively under general anesthesia in a hospital setting by licensed board-certified staff.

What are the potential risks and complications associated with an extended tummy tuck?

Extended tummy tuck surgery, like any surgical procedure, carries inherent risks and potential complications. While it’s important to discuss these with your surgeon in detail, here are some main considerations:

• Bleeding: Bleeding is a known risk, and in rare cases, a transfusion or a return to the operating room may be necessary to control it.
• Wound Issues: Complications such as wound infection, wound dehiscence (wound opening), skin necrosis, and delayed wound healing may occur.
• Fluid Collections: Seromas (fluid collections under the skin) or hematomas (collections of blood under the skin) may develop and require surgical intervention.
• Scarring: Hypertrophic (thickened) or keloid (raised and thickened) scarring is possible and may necessitate future treatments.
• Thrombosis and Embolism: Deep venous thrombosis (blood clots in deep veins) and pulmonary embolism (clots in the lungs) are serious, potentially life-threatening complications. Understanding the signs and symptoms and discussing prevention strategies with your surgeon is crucial.

It’s essential to have a thorough conversation with your surgeon about these risks, as well as the specific measures that will be taken to minimize them during your extended tummy tuck surgery.

How long is the typical recovery period following the surgery?

The typical recovery period for an extended tummy tuck surgery spans from 3 to 6 months. It’s important to note that scars may continue to mature for up to a year. In most cases, patients can return to their daily activities, including showering, driving, and work (depending on their job type), within 1 to 2 weeks post-surgery. However, the exact timeline can vary based on the specific procedure and individual circumstances.

Are there any specific pre-operative preparations that patients should be aware of?

Yes, there are several essential pre-operative preparations that patients should be aware of before undergoing an extended tummy tuck:

• Medical Clearance: All patients must obtain preoperative medical clearance from their primary care physician. This involves a thorough assessment of your current medical condition to ensure you are medically fit for surgery.
• Lab Tests: A series of lab tests will be required as part of the pre-operative evaluation. These tests help assess your overall health and can identify any potential issues that need to be addressed before surgery.
• Imaging: A chest X-ray and an electrocardiogram (ECG or EKG) may be necessary to evaluate your heart and lung function. These tests provide important information for the surgical and anesthesia teams.
• Medical Clearance Letter: Your primary care physician will provide a medical clearance letter. This letter summarizes your medical condition and confirms your suitability for the planned procedure. Both your surgeon and the anesthesia provider will review this letter.
• These pre-operative preparations are critical to ensure your safety and well-being during the extended tummy tuck surgery.

What kind of post-operative care is necessary for optimal results?

Post-operative care plays a crucial role in achieving optimal results. Here are some key aspects of post-operative care:

• Nutrition and Hydration: Maintaining a balanced diet and staying well-hydrated are essential for a smooth recovery and optimal healing.
• Wound Care: Proper cleansing and care of surgical wounds are important to prevent infection and promote healing.
• Compression Garments: Wearing well-fitting compression garments as advised by your surgeon can aid in reducing swelling and promoting proper contouring.
• Open Communication: It’s important to maintain open communication with your surgeon. Don’t hesitate to ask questions or express any concerns you may have during the recovery process.
• Drain Maintenance: If drains were placed during surgery, following your surgeon’s instructions for drain maintenance is crucial for a successful recovery.

By following these post-operative care guidelines and working closely with your surgeon, you can optimize your results and ensure a smooth and safe recovery.

Can you describe the scarring that may result from an extended tummy tuck, and how can it be managed?

Scarring after an extended tummy tuck can vary among individuals and is influenced by several factors. Tension during surgery is a significant factor affecting scar aesthetics, and while it’s challenging to predict, it is an essential component of the procedure. Postoperatively, patient movements such as walking or getting in and out of bed or a car can inadvertently increase tension on specific areas, impacting scar appearance.

Genetics also play a role, as factors like collagen and elastin production are determined by one’s family history. Unfortunately, genetic predisposition can be challenging to overcome.

Maintaining a healthy diet and staying well-hydrated are crucial for optimal wound healing and scar formation. Smoking and the use of steroids can be detrimental to wound healing and increase the risk of complications such as infection or poor scar formation, including hypertrophic or keloid scarring.

To improve scarring, I recommend the following:

• Healthy Diet: Ensure you are consuming a balanced diet rich in nutrients to support the healing process.
• Hydration: Stay adequately hydrated, as it is essential for optimal wound healing.
• Scar Massage: Gently massaging the scar tissue can help promote better scar appearance and reduce tightness.
• Silicone-Based Scar Products: There are silicone-based scar treatment products available that can be applied to the scar to improve its appearance.

The timing and use of adhesive scar tapes and creams should always be discussed with your surgeon, as individual circumstances can vary. Working closely with your surgeon and following their recommendations can help manage and improve the appearance of scars following an extended tummy tuck.

What kind of results can patients expect in terms of body contouring and aesthetics?

The primary goals of this procedure are to achieve a more sculpted and aesthetically pleasing body contour. Here’s what patients can typically expect:

• Excess Skin and Fat Removal: The surgery targets the removal of excess skin and the attached extraperitoneal fat from specific areas, including the lower abdomen, lateral hips, anterior flanks, and mons pubis.
• Abdominal Muscle Tightening: The procedure includes tightening the abdominal wall muscles, creating a narrower and more defined waistline. This helps achieve a slimmer and flatter appearance.
• Umbilicus and Mons Pubis Tailoring: The surgeon also focuses on tailoring the appearance of the umbilicus (belly button) and mons pubis to complement the newly contoured waistline.

Overall, patients can expect a significant improvement in their body contour, with a slimmer, more toned appearance, and an hourglass-like shape. The specific results may vary based on individual factors and the extent of the procedure.

Are there any limitations or realistic expectations that patients should have about the procedure?

Yes, there are some limitations and realistic expectations that patients should consider:

• BMI and Intraperitoneal Fat: Patients with higher BMIs may have limitations in achieving an extremely flat abdomen. The presence of intraperitoneal fat, which cannot be reduced surgically, can influence the outcome.
• Preexisting Body Type: The patient’s preexisting body type and morphology play a role in determining the postoperative results. The extent to which the procedure can reshape the body may vary based on individual factors.
• Medical Conditions: Certain medical conditions, such as uncontrolled diabetes, can affect wound healing and potentially impact the final results.

It’s important to understand that every individual is unique, and results can vary. The surgical team works with patients to help them achieve their individual aesthetic goals while considering their specific circumstances. One size does not fit all, and a personalized approach is essential in managing expectations and optimizing results.

How much does an extended tummy tuck typically cost, and does insurance cover it?

The cost of an extended tummy tuck can vary widely based on individual factors and the specific requirements of the surgery. It typically ranges from $10,000 to $20,000. This cost includes various components such as hospital charges, anesthesia fees, overnight stay (if required), and professional fees.

It’s important to note that cosmetic procedures like an extended tummy tuck are usually not covered by health insurance because they are elective surgeries. Patients should be prepared to cover the costs themselves or explore financing options if available. It’s advisable to discuss pricing and payment options with your surgeon during the consultation process.

Tummy Tuck Cost Article

Are there any alternatives to an extended tummy tuck for achieving similar results?

When it comes to addressing excessive skin laxity and lipodystrophy, there are limited alternatives. Liposuction, while effective for fat reduction, does not effectively address issues of skin laxity. Surgical excision, as performed in an extended tummy tuck, is the preferred and often the most effective option for improving body contour when significant skin excess and loss of elasticity are present. While non-surgical treatments and procedures may offer some improvements in skin tightening, they are generally less effective for addressing these specific concerns.

What credentials should patients look for in a plastic surgeon when considering this procedure?

When considering a plastic surgeon for this procedure, patients should look for the following credentials and qualifications:

• Board Certification: Ensure that the surgeon is board-certified in plastic surgery. This certification indicates that the surgeon has completed the necessary training and passed rigorous examinations in the field of plastic surgery.
• Training and Experience: Verify the surgeon’s training and experience in performing extended tummy tuck procedures. Look for a surgeon with a substantial track record of successful surgeries.
• Membership in Professional Associations: Membership in professional organizations such as the American Society of Plastic Surgeons (ASPS) and the American Society for Aesthetic Plastic Surgery (ASAPS) is a positive indicator of a surgeon’s commitment to the highest standards of practice.
• Fellowship Status: Some surgeons may have achieved fellowship status with prestigious organizations, like being a Fellow of the American College of Surgeons (FACS), which can further demonstrate their expertise and commitment to excellence.
• Patient Reviews and Testimonials: Research patient reviews and testimonials to get a sense of the surgeon’s reputation and the experiences of previous patients.
• Consultation: Schedule a consultation with the surgeon to discuss your goals, ask questions, and assess their communication style, as a good patient-surgeon relationship is crucial.