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Questions about Tummy Tuck in Joliet and Naperville

Who is a good candidate for an abdominoplasty?

The purpose of the abdominoplasty procedure is to remove excess skin and subcutaneous fat from the abdominal area. Good patients for the procedure often complain of a lower abdominal "pooch," stretch marks of the abdomen (especially below the belly button), or have lost significant amounts of weight with poor retraction of their skin.

Some patients who desire liposuction are often better served with an abdominoplasty and vice versa. A number of patients with redundant skin throughout their mid-section may be better candidates for a circumferential abdominoplasty. The ideal procedure for you will be determined during your consultation with Dr. Rios.

Is a tummy tuck an inpatient or outpatient procedure?

The vast majority of tummy tuck procedures are performed on an outpatient basis. These are performed at an accredited outpatient surgery center for your convenience. The procedure can be performed in a hospital if you feel more comfortable in that setting.

Where are the incisions?

The incision for an abdominoplasty begins just above (sometimes within) the pubic hair. It then slowly curves up towards the hips in both directions. The length of the incision will depend on how much skin needs to be removed. When large amounts of skin are removed, the incision can extend from hip to hip. We can keep these incisions low enough to be concealed when wearing low cut clothing.

If a circumferential abdominoplasty is to be performed, the incision will go around the entire waist area. The goal is to conceal the resultant scars in areas covered by undergarments/bikinis.

What happens to my belly button?

The belly button is normally cut out from its pre-operative location. This is necessary because of the large amount of skin that is removed from below the belly button. If this is not done, the belly button will wind up in the pubic hair. Once the skin of the abdomen is redraped, a new hole in the skin flap is made to accommodate the belly button where it is sutured back into position.

Patients who are found to be good candidates for "mini" abdominoplasty have their belly button left attached to the surrounding skin. It is moved by cutting the attachment of the belly button at its base, then sliding it down with the abdominal skin.

Is anything done to my abdominal muscles?

Normally the rectus ("6 pack") abdominis muscles run up and down in the midline from the rib cage to the pubic area. For a variety of reasons (e.g. pregnancy, weight loss) the tissue between the muscles may stretch, leaving a gap between the muscles. This can sometimes be seen as a bulge with strenuous effort. The musculature will be examined during your abdominoplasty. If there is a gap between them, a permanent suture will be used to bring them together again.

Will I have "abs" after my tummy tuck?

Not unless they were there pre-operatively. The main determinant of the visibility of the abdominal muscles is the thickness of the skin and fat covering them. These layers can be safely be thinned a small amount at the time of surgery, but not enough to result in "abs." Liposuction of the skin/fat layer can be used minimally at the time of tummy tuck due to safety considerations. Liposuction in a delayed fashion (3 months later) can be performed more aggressively in order to defat the abdominal wall further.

Will the procedure get rid of my stretch marks?

Normally the procedure removes all the skin from the belly button to the pubic area. If all of your stretch marks are limited to this area, then they will most likely be removed during the procedure. If you have stretch marks above the belly button, they may not be removed during the procedure.

Can I have liposuction performed at the same time?

One of the most critical aspects of the abdominoplasty procedure is ensuring the healthy blood supply of the remaining skin. It is believed that aggressive liposuction of the abdominoplasty flap my result in wound healing difficulties due to possible disruption in this blood supply. Because safety is our number one concern, liposuction of the abdominoplasty flap will not be performed at the same time. A limited amount of liposuction may be performed at the same setting for excess fatty deposits in the hip areas.

Extensive liposuction (e.g. hips, thighs, back) at the time of the abdominoplasty will also be avoided. Dr. Rios believes that this may raise the risk of the procedure to you to unacceptable levels. Extensive liposuction can be performed (including the abdominoplasty flap) at a second stage 3-6 months later.

Some patients have a combination of excess skin and subcutaneous fat. These patients are advised to go staged abdominoplasty-liposuction for the best results.

Will I need drains after the surgery?

Maybe, maybe not. Tummy tuck procedures make a space where there was none before surgery. If left alone, fluid would collect in the area and give a full soft feeling, not what you are seeking when you have a tummy tuck. Many plastic surgeons place drains in the area to remove the fluid that would normally accumulate, allowing the skin layer to heal back to the muscle layer. Despite the use of drains fluid collections (seromas) are still among the most commonly reported complications in tummy tucks.

One of Dr. Rios' mentors in training, Dr. Todd Pollock, was among the first to report the use of progressive tensions sutures to prevent fluid collections on tummy tucks. This technique of sewing the skin layer back to the muscle layer helps close down the space where the fluid would want to collect. Dr. Rios has been using this technique for over three years and has had only one seroma. Progressive tension sutures will be placed during your surgery, and if Dr. Rios feels it appropriate he will leave the drains out.

Surveys of our patients has revealed that they dislike drains and we do our best to avoid their use.

Do I wear any special garments after surgery?

You will wake up from surgery wearing a flexible binder around the abdomen. It is loosely placed. This helps keep your dressings in place.

What about pain control after the procedure?

Dr. Rios uses several strategies to help control your post-operative pain.

  1. During the surgery he injects local anesthetic in the area of procedure.
  2. Patients can choose to have a pain pump placed at the time of the tummy tuck. This will continue to instill small amounts of local anesthetic over the next several days.
  3. He prescribes several oral medications which help relieve the pain and help you get some needed rest.

Will the scar always be visible?

Yes. Any time the skin is injured, whether with a surgical knife or a scraped knee, the body heals by scarring. Our best option is to place incisions and the resultant scars in areas where they can be easily concealed or difficult to find. The abdominoplasty incision is placed so it can be hidden with undergarments or bikinis. The scar of the abdominoplasty is permanent. We do our best to give you the highest quality scar possible, but much of the outcome is up to your body's healing characteristics.

What about a "mini" abdominoplasty?

Different plastic surgeons have different ideas of what constitutes a "mini" abdominoplasty. I define "mini" abdominoplasty as a procedure designed to minimize the amount of dissection required and is for patients with laxity only in the area beneath the belly button. The amount of upper abdominal skin/fat excess and the position of the belly button are key factors in determining the suitability of this procedure for you. In my experience, these procedures are appropriate for a limited number of patients.

How long will the results last?

Gravity and aging are forces which cannot be modified post-operatively. These will continue to exert their effect on your skin and soft tissue. Further weight loss (or fluctuation) which stretches the skin envelope may result in redundant skin. Patients who maintain a steady healthy diet, exercise, and weight routinely enjoy their results for many years.

How long before I can get back to work?

Some of that depends on the kind of work you do. Patients normally walk slightly bent at the waist for 3-4 days, and gradually assume an upright position by day 5-10. You may also have small drains which exit in the pubic area for about a few days. Patients who perform work that involves no strenuous activity can normally return to these activities an as little as 10-14 days. I recommend patients avoid more physically duties such as heavy lifting or straining for 4-6 weeks.

When can I exercise?

Exercises such as brisk walking can begin 2-3 weeks post-operatively. Heavy lifting, intense aerobic activity, or high impact exercises can be resumed at 4-6 weeks.

Take the Next Step

Now that you have looked through our FAQ's and are considering abdominoplasty, we invite you to schedule a consultation to discuss any lingering concerns or questions and to let Dr. Rios decided if a tummy tuck is the appropriate procedure for you. For men and women in Joliet and Naperville interested in tummy tuck surgery, offices are located not far from Chicago, but far enough to be away from the stresses of the big city. For more information, send us an email or click to schedule your free consultation.

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