Dr. Linder Explains His Approach
to a Tummy Tuck Procedure

We perform tummy tucks or abdominalplasty all the time. It’s one of my favorite
surgeries. The purpose of a tummy tuck is to remove not only fat, but to remove skin as
well. When patients have had usually significant weight loss, fluctuation, or have had
babies, there’s tremendous amounts of excess skin. We need to remove that in
performing a tummy tuck or a panniculectomy. The type of tummy tuck depends upon
the amount of skin laxity as well as whether we need to tighten up the, plicate the
rectus muscles, the muscles along the midline, especially after baby birth because those
are pulled apart. It also depends upon how much skin there is, both below the belly
button and as well as above the umbilicus. A mini tummy tuck is excellent for our
patients that have just skin along the lower abdominal area, but the skin around the
belly button and above is in good shape, then we just do a mini tummy tuck.

Full tummy tuck or extensive tummy tuck or abdominalplasty is where we dissect all the
way up to the subcostal ribs, high, in order to get all the skin down, including the upper
abdominal skin. That’s a full tummy tuck. Finally, the tummy tuck sometimes will require
hernial orifice or hernia repairs. If we diagnose a hernia repair, our general surgeon will
often do a diagnostic test as CT or ultrasound, depending on his wishes, and we can do a
concurrent hernia repair, sometimes requiring mesh graft, with the abdominalplasty, so
there’s a functional and there’s a cosmetic component, and they can be done at the
same time as needed or deemed necessary.

Liposuction of the hips is extremely important. I do this in most of the patients who
have significant amounts of fat on the hip or the iliac crest at the same time as a tummy
tuck in order to reduce the hips so they don’t end up too large or bowing outward.
When you flatten the lower abdomen, you want to also contour the hips at the same
time.

The most common complications of abdominalplasties are seromas. And therefore,
seromas are reduced by our use of drains. We do use Jackson Pratt drains. They’re
placed for one week and then I remove them, once there’s less than 24 ccs per drain per
24-hour period. Our patients also are given pneumatic compression boots in order to
reduce risk of DVT, deep venous thrombosis, and god forbid, a pulmonary embolus. So,
DVT prophylaxis on low risk patients for tummy tuck or abdominalplasty is with
pneumatic compression boots. Furthermore, our patients are maintained on antibiotics
until the drainage tubes are removed and are given pain medication as necessary as
well.

The muscle tightening is extremely important, and that’s a big component of
abdominalplasty, because we need to plicate that midline muscles back to the middle,
called the rectus sheath, in order to give you a further tightening of the abdominal wall,
and that’s called abdominal tightening with lipectomy tummy tuck procedure. The
recovery period for a tummy tuck is anywhere between six and eight weeks. This is a
very invasive operation, it requires that the patients give themselves some time off, that
there’s no abdominal wall exertion or exercise for the first few weeks. We don’t want to
tear any of the sutures, which could increase risk for bleeding hematoma or seroma
formation.