The surgeon will make an incision around your belly button and lower back, removing any excess fat from the tissue underneath it. They will then remove any remaining fat from around your abdomen and tighten sagging muscles with stitches or staples before closing up the wounds and applying bandages. This surgery can reduce excess belly fat as well as excess skin on your lower stomach, hips and thighs; however, it does not work for people who have large amounts of fat deposits in these areas because those deposits cannot be removed without removing parts of muscle tissue as well
Extended tummy tuck with muscle repair: An extended tummy tuck is a minimally invasive procedure that removes excess fat and skin from the abdomen. It is performed when there is not enough skin to comfortably perform a standard tummy tuck or when there are multiple areas of loose skin that need to be removed. The procedure may also be recommended if you have had previous abdominal surgery or if your abdomen has been stretched by pregnancy, which can cause the muscles to separate and bulge out through the weak spots in your skin.
Read on to learn more on Extended Tummy Tuck With Muscle Repair, Extended Tummy Tuck With Liposuction and How Much Does An Extended Tummy Tuck Cost
Extended Tummy Tuck With Muscle Repair
Not all tummy tucks are alike. Some involve more extensive surgery than others, and for this reason, what to expect during recovery can vary from person to person. The aim of the tummy tuck is to slim and tighten the waist for a more shapely and youthful appearance, but the surgical route to get you there (and into some cute new clothes) can vary quite a bit.
Depending on the amount of excess skin and fat to be removed, incisions can be shorter or more extensive, including the repositioning of the belly button. But one of the biggest factors to impact recovery from a tummy tuck, also called an abdominoplasty, is whether or not a muscle repair is included.
Why the muscle sometimes needs a repair
If you have seen the abs on even one superhero you will know the muscle we are talking about. It is called the rectus abdominis and it runs vertically from your sternum to your pubic bone. It has a left and right side separated down the middle by a band of tissue called the linea alba.
The linea alba can become over stretched, usually during pregnancy but also due to extreme weight gain or a lifting injury. When this happens the two sides of the muscle move further apart, resulting in an outward bulging of the belly that doesn’t go away, even when weight (baby or otherwise) is gone. This condition is called diastasis recti.
Besides being a cosmetic issue for some people, this condition can affect posture and trunk strength. It can cause pain in the abdomen, hips, and back, as well as bowel and bladder issues, all of which can have a huge impact on quality of life.
Why the muscle sometimes doesn’t need a repair
Not all tummy tucks include a muscle repair because not all bellies that can benefit from a tummy tuck have a diastasis recti. Even when the linea alba is stretched out, it can sometimes return to its normal size on its own. Furthermore, if a woman has had a cesarean section, a repair will likely have already been completed at that time.
How the muscle is repaired
Diastasis recti can be corrected by a general surgeon, but plastic surgeons routinely do this as part of their tummy tuck procedure. The surgery involves folding over the stretched tissue of the linea alba and suturing the two sides of the rectus abdominis muscle together. Though you can’t see it from the outside of the body, this involves suturing up and down the whole length of the abdomen.
Why a muscle repair impacts tummy tuck recovery
The difference in recovery between a tummy tuck with muscle repair versus one without has to do with the fact that muscles contract. Unlike the skin and fatty tissue that cover the abdomen, the muscles underneath (and the rectus abdominis is a big one) are prime movers and stabilizers of the whole trunk. This means that they contract nearly any time you move your body. Even simple movements like lifting your arms when sitting upright or rolling over in bed can engage these muscles — and then there’s coughing and sneezing.
When the muscle is repaired it needs time to rest so that it can heal up. Over exerting yourself too early can compromise your results and will certainly be painful.
How a muscle repair impacts recovery
When a muscle repair is included with your tummy tuck, you will be required to be more careful and your recovery will take a bit longer — from three to four weeks longer.
Symptoms
After a muscle repair patients often experience feeling more full quickly when eating and the sensation of not being able to take as deep a breath as they used to. This is due to a decrease in the amount of room inside the abdominal cavity caused by tightening the muscles. The stomach has less room to expand and the diaphragm meets more resistance as it moves down to allow you to take a breath. Both of these issues, if they occur, typically resolve within four to six weeks.
Abdominal Binder
Shortly after surgery you will be given an abdominal binder to help support the repaired muscle and to reduce overall swelling. You will be given instructions on how to put it on and will be told to wear it regularly. You will probably need help putting it on and taking it off in the first few days.
Lifting restrictions
After surgery, your doctor will restrict you to lifting no more than about 10-15 pounds. You will be prohibited from lifting anything heavier for a full six to eight weeks after surgery. You will also not be allowed to do any core strengthening exercises, such as sit-ups, to avoid stressing and potentially tearing the repair.
Posture
It is typical of all patients after a tummy tuck to have slightly hunched over posture. This is normal and it is important not to force an upright position and put undue strain while your incision heals. This becomes even more important after a muscle repair. You may even be given a walker to get around the first week after surgery.
You still have to get out of bed
Even with a muscle repair, your surgeon will require that you begin moving about within a day of your surgery. This includes getting up to go to the bathroom and with some restrictions, taking a shower. This is important for your overall health and healing and the prevention of blood clots. Many patients opt to sleep in a recliner to make these movements easier. Have someone at home to help you, especially during the first couple of weeks.
Though the muscle repair does add some challenges to your recovery, the long term benefits can far outweigh them. A study published last fall (2019), showed postpartum women who underwent a rectus abdominis repair had significant improvements in trunk function, urinary incontinence, and overall quality of life.
Extended Tummy Tuck With Liposuction
Have you ever put new carpet in your house only to realize that, next to the new carpet, the paint looks faded and the light fixtures appear dated?
Well, a tummy tuck (abdominoplasty) can sometimes have the same effect – suddenly that muffin top is more obvious when your belly is nice and flat. This is a situation where liposuction can work well with your tummy tuck.
What is Liposuction?
Liposuction is a process where the surgeon makes tiny incisions in the skin and inserts a cannula, or small tube, through the incision into underlying fat deposits. By moving the cannula up and down in the fat tissue, the surgeon is able to break up the fat, and then suction it out through the cannula.
Liposuction can be performed on many areas of the body from the thighs to underneath the chin. It may also be used in conjunction with a tummy tuck to give an improved overall appearance. A tummy tuck with liposuction can make the newly tightened stomach look more natural and proportional to the rest of the torso.
Doesn’t the Tummy Tuck Remove the Fat? Why Do I Need Liposuction, Too?
Though its primary function is to tighten the belly, some fat will likely be removed during a tummy tuck. But, if you have a full tummy tuck, in which the incision extends from hip bone to hip bone, you may still find you have fat on your sides or “flanks” and even along the lower back—those pesky muffin tops.
In some instances an extended or full tummy tuck, in which the incision extends around the sides or all the way around, may be most appropriate to deal with excess fat and loose skin in these areas.
But for many, liposuction of the flanks and lower back may provide the desired results without the more extensive surgery.
What About Liposuction On the Front of the Abdomen?
If you are concerned that a tummy tuck will tighten your abdomen but leave too much fat behind on the front (anterior) of your abdomen, your surgeon may recommend two separate procedures. He can advise you on whether liposuction alone, abdominoplasty alone, or a combination of the two will help you achieve the results you are looking for.
Be aware that liposuction in the area of the tummy tuck – the anterior of the abdomen – may need to happen in a separate procedure from the tummy tuck itself. This is called “staging” the procedure and your specific anatomy will determine whether you should have liposuction then tummy tuck, tummy tuck then liposuction, or both procedures together.
Liposuction and Tummy Tucks are Not Weight Loss Procedures
Remember that both liposuction and a tummy tuck – together or individually – are meant to “fine tune” your appearance. They aren’t weight loss procedures.
Liposuction works best on trouble spots – those fat deposits that won’t seem to budge no matter how many crunches you do. Similarly, a tummy tuck will help tighten up a loose abdomen, particularly loose skin that persists after weight loss or pregnancy.
Nature working the way she does, many people have a combination of excess fat and skin. Liposuction and tummy tuck combined can often provide the best results.
Will a Tummy Tuck Combined with Liposuction Work for You?
Dr. Slack offers a free consultation to patients in the Collin County area who would like to discuss their cosmetic surgery options. Take a look at his before and after galleries for tummy tuck and liposuction. Some women may also consider a Mommy Makeover, in which breast surgery is done at the same time as the other procedures. Once you are ready to discuss whether a tummy tuck with liposuction can help you achieve your goals, please get in touch. Dr. Slack will be pleased to chat with you.
How Much Does An Extended Tummy Tuck Cost
The cost of an extended tummy will vary depending on the surgeon, the volume of fat, and the size of the area. The price range for a tummy tuck generally falls between $4,000 and $18,000.
In 2019, the average cost of a tummy tuck (not extended) was $6,092 according to the American Society of Plastic Surgeons. Because there is more involved in an extended tummy tuck, the cost will likely be more. In addition, this cost is only for the procedure and does not take into account anesthesia, operating room facilities, or other related expenses.
Because tummy tucks are usually done for aesthetic reasons only, the procedure will not be covered by insurance. In some cases, a tummy tuck may relieve back pain and incontinence. You will also likely have to take several days off from work for recovery.
How does an extended tummy tuck work?
Extended tummy tucks work by removing excess skin and fat from the abdomen and repairing any muscles that have become loosened or torn. Through an incision above the pubic hairline that wraps around to the lower back, skin and fat are removed from the stomach and flank area. The skin is laid flat, and the belly button is reattached, giving the skin a smoother, flatter appearance.
In a 2012 studyTrusted Source of 25 individuals who underwent extended tummy tuck surgery, all 25 were “extremely satisfied” with the results.
Procedure for extended tummy tuck
- During an extended tummy tuck, the surgeon will typically make an incision between your hip bones, low in the pubic area. If you’re having a tummy tuck after a C-section, they may reopen the same scar.
- Any muscles that have been separated, such as from pregnancy, will be sewn together so they appear taut. Full tummy tucks can fix diastasis recti, which is a splitting of the abdominal muscles.
- The belly button will be cut away, and liposuction may be performed if there is extra fat.
- Excess skin is removed from the tummy and flank area, and the skin will be pulled taut.
- Finally, the belly button is sutured in its original place, unless you and your surgeon decide to change its shape.
Targeted areas for extended tummy tuck
Extended tummy tucks target the upper and lower stomach, waist, flanks, and sometimes the uppermost lateral portion of the thigh.
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Are there any risks or side effects?
As with all surgery, there are some risks and side effects associated with extended tummy tucks. One study found that 8.5 percentTrusted Source of people who underwent tummy tuck surgery were re-administered into the hospital because of some kind of complication. These complications and side effects may include:
- numbness after surgery, which is typically temporary
- excess fluid or blood pooling in the belly
- swelling and redness
- internal organ puncture — while rare, could be caused by cannula (a tube that removes excess fluids from the body) penetrating too deeply and potentially puncturing an organ
What to expect after an extended tummy tuck
Your surgeon or nurse should brief you on what to expect after surgery including:
- what activities to avoid and how long
- if and when you can consume alcohol and certain medications or supplements
- how long to wear your compression garment
- how to manage your drainage tubes, if your surgeon uses them
- when to schedule a follow-up appointment
You will be able to see some results immediately, though your abdominal area will be swollen and bandaged. For the first few weeks, you will likely be advised to rest at an angle and avoid strenuous activity or lifting heavy things.