You may be a candidate for abdominoplasty surgery if you:

• Have a persistent baby bump or lower abdominal POOCH after pregnancy
• Have separated and weak abdominal muscles which could be a result of pregnancy or due to excess weight gain or loss.
• Have a saggy and loose abdominal skin.
• Have thin inelastic skin with multiple stretch marks
• Are unable to lose weight with exercise and diet from the front and sides of the abdomen.
• Now maintaining stable weight.
• Physically fit to undergo surgery.
• Family is completed.
• Have realistic expectations from the abdominoplasty surgery
• You are mentally prepared for surgery and recovery

It is very necessary to maintain a healthy lifestyle to maintain the results of the procedure.

• It leaves a cut mark below bikini line. However modern medical treatment can make it inconspicuous. It you love tattoo. You can hide it with beautiful tattoo.
• It can remove lowerstretch mark only depending on amount of extra skin. Upper abdominal stretchmarks will come at lower level which can be hide easily. Fractional co2 laser and PRP treatment help to improve stretch marks.
• Visceral fat can not be removed during tummy tuck surgery.
• One has to maintain healthy lifestyle for long tern good result

virtual  consultation with doctor prince

• As every patient structure is different and everyone has a different goalfor the tummy tuck surgery. Personalised consultation helps to define your goal and outcomes of the tummy tuck surgery. At the time of consultation, you are free to ask questions to Dr prince and he will answer your every query related to your Tummy tuck surgery.

  You come to know about: –

  • Is tummy tuck for you or not?
  • Is it safe for you?
  • What is there specifically for you in terms of tummy tuck surgery type, duration of surgery.
  • The realistic goal and achievable outcomes of the abdominoplasty surgery
  • Lipoabdominoplasty surgery risk & recovery
  • Preoperative preparation and post-operative care for the tummy tuck surgery.
  • Total cost of your tummy tuck surgery.
  • What is your comfort level with the liposuction surgery?

  To get best from your tummy tuck surgery consultation

  It is good to make a list of important questions before proceeding for the consultation step. So you won’t miss addressing any of your concerns. The patient care coordinator is always there to help you.

  You should give a brief your cosmetic surgeon about:

  1. Your area of concern
  2. What result you expect as you can take representative photographs
  3. Your obstrect or child birth history
  4. Your weight gain, weight loss history
  5. Your lifestyle including diet habit and physical activity
  6. Any medical conditions & medical treatments
  7. Any supplements such as vitamins, fat burner, herbal treatments or nutritional supplements
  8. Alcohol, smoking, tobacco, and drug uses,
  9. Drug allergies
  10. Previous surgeries, particularly body contouring surgery.
  11. Your surgical goals, you can take your end goal photographs for reference.

  Your tummy tuck surgeon will evaluate the following:

  • Fat distribution in the area of your concern.
  • Skin quality
  • Underlying muscle tone
  • Your general health status and any pre-existing health conditions or risk factors.

  Tummy tuck surgeon will discuss:

  • Your surgery options, which is best tummy tuck type to achieve your goal.
  • May mark on your body to explain the extent of the tummy tuck surgery. like area of liposuction, amount of skin will be removed expected length of scar and its location
  • Tummy tuck surgery result and recovery
  • Will show tummy tuck surgery “before and after” photographs of his operated patients.
  • May take your photographs and show edited photos, help you to visualize achievable liposuction results.
  • Potential risks or complications.
  • Tummy tuck surgery cost for you.
  • Preoperative planning like fitness test and preoperative preparation.

1. Preoperative Preparation:

You should be in your optimum health for a safe and smooth recovery

Once you decide to go ahead with surgery you are advised the following:

1. Complete your body check-up test
2. Any medical condition like diabetes or hypertension should be under control.
3. Quite smoking as advised by surgeon
4. Any nutritional support or on-counter medicineshould be stopped
5. You will be given detail instruction before surgery
6. The abdominoplasty surgeon team is always there to guide you in case of any confusion.

2. On Admission at the Cosmetic Surgery Center

Please inform about:

1. Recent illness like common cold, fever, urinary tract infection or any other seasonal illness
2. Your medical ailments like blood pressure, diabetes, asthma, thyroid or any other illness
3. Any ongoing medication
4. Past history of any major illness, hospitalization, trauma, or surgery
5. Drug or any other allergy
6. Family history of any significant illness like blood pressure, diabetes, cardiac ailment, cancer, G 6 PD deficiency, thyroid, thalassemia, bleeding disorder, or any other illness.

The Cosmetic Surgeon Will:

• Listen to your concerns and explain to you again about the surgery
• Discuss your goal of abdominoplasty surgery
• Your physical fitness is also evaluated (you will also be examined by anesthesiologist for physical fitness)
• Will mark the operative area with your active participation. This is useful as guidelines in the procedure.
• Preoperative medications will be started.
• The preoperative formalities are done.

Marking

On the day of surgery, again lipoabdominoplasty plan is discussed again. Meticulous marking is done for liposuction area, skin incision, muscle tightening. The low placement of the suture line is done.

In the Operation Theater

Anesthesia

Usually done under general anesthesia

Liposuction

Liposuction is a part of modern tummy tuck surgery. The surgery begins with tumescent infiltration and Vaser Liposuction of somatic fat/or localized fat deposits is done. In case of torsoplasty, first, back liposuction is done.

Incision

Skin is pulled up and low incision under bikini line is taken. The length depends on the amount of extra skin to be removed for tightened abdomen. The skin flap is elevated from the underlying muscle and umbilicus is left attached to the muscle. As much aspossible, the skin is excised to give good abdominal shape.

Muscle Tightening

The separated rectus muscle is plicated in a mid-line from below the chest bone to the pubic bone. If needed lateral plication of the oblique muscle is done to further tighten muscles to give the hourglass shape of the tummy.

Transposition of Umbilicus

The umbilicus is fixed to the underlying muscle at the aesthetically appropriate location. A hole is created in a skin flap at the same location. The umbilicus is fixed to the skin flap in such a manner that the suture line goes deep in an invisible position.

Deep sitted umbilicus looks natural Umbilicalus shape can be discussed and plan Like vertical shape oval shape or round shape.

If the umbilicus is highly positioned and skin above the umbilicus is not much extra, floating the umbilicus technique can be used to avoid circum polar scarring.

Mons pubis lift: Vulva and external genitalia hang due to the laxity of skin post-pregnancy and post-weight loss. Mons is pulled up and fixed at a higher level.

Skin Closure:

Skin suturing is done in layers with buried suture. Care is taken that the suture line remains below the bikini line. One should be able to wear a swimsuit easily.

Finishing Liposuction

Minor asymmetry is corrected and sculpting of the abdomen is done. Extra fluid is aspirated.

With drain or Drain less Abdominoplasty

Before closure, the drain is used and fixed depending on the surgical extent to drain out the fluid and broken fat. When the drain is not used, it is called drain less abdominoplasty. The tissue of the abdominal wall is sutured with quilting suture so tissue stitch to each other faster. However, drainless technique takes longer time and so anesthesia time.

Tummy tuck Immediate Recovery

• You will be shifted to the recovery room.
• Once you’ve awakened fully from the anesthesia you will be shifted in room.
•  You can go home next day.
• You will be provided with pressure garments and post-surgical care instructions.
• Doctor prince and the surgical staff will be there to assist you.

Abdominoplasty Surgery Result depends on

• Extent of the surgery.
• Individual healing process.
• Technique and technology used,
• purpose, and the end goal of the surgery and
• Operating surgeon’s hand to a very extent.

One must follow cosmetic surgeon advice to get best result. You can see Tummy tuck surgery result as follows

• Immediately: There is a huge difference in your contour. Imagine how delighted your new look will be?
• 1^st week: Some swelling will be there, closed drainage will have more swelling. whereas open drainage will have less swelling,
• 1^st MONTH:Major result is visible over a month as the majority of the swelling has been reduced now.
• 6^th -8^th MONTHS: A complete result of tummy tuck surgery in men or woman will be visible
• 8^th-12^th MONTHS: Collagen synthesis and skin tightening take place.
• The lipoabdominoplasty surgery result is faster with open drainage technique compared to closed drainage technique.
• In most of the patient, fat cell can increase in size but can’t multiply. Fat rarely comes back in the abdominal wall area.
• There is no substitute for a healthy lifestyle in order to maintain the best and permanent results.

1. TAKE MEDICINE AS ADVISED
2. DIET
   Take as much liquid as possible once you are comfortable. We maintain our patients on a liquid diet on the day of surgery, which is subsequently advanced the following day to a soft regular diet. As such there is no restriction on diet, but to achieve better result and sound recovery, we recommend high protein, low fat and low carbohydrate diet. Please watch your weight. Try to stay 1-3 pounds lighter than your pre-surgical weight.
3. POSITION
   Keep the head of the bed elevated at an angle of 45 degrees to help maximise postoperative comfort. You can change your position and turn side by side. Keep your legs moving in bed.
4. PHYSICAL ACTIVITY
   You are advised to walk as much as possible on the day of evening once you are conscious. One can do office like job within 1week .One can do heavy gym and jerky activity after 1-2 month. You can do cardio like activity in 2-3weeks.
5. RECOVERY
   One will have numbness around the Liposuction area on the day of surgery. Pain is easily managed by pain killers; one will feel like something is done. One will feel stretching and pain while changing position. You will have soreness on pressing the operative site. When liposuction done, one may develop swelling and bruise mark at private part, will go in 2 to 3 weeks.
6. LOCAL CARE
   Usually we follow the open drainage technique. Injected tumescent fluid, residual fat, broken tissue will come out from the tiny punctures and it will be blood stained. So tissue reaction, swelling bruising and pain will be less, and recovery will be faster. Amount and duration of the fluid discharge depends on the area of surgery and extent of fat removal. Normally it stops in a day or two. In case of mega liposuction it may last longer. In the dressing will be done. And you will be taught how to take care of dressing before discharge. Mild bruising may occur for 3 weeks after tummy tuck. If there is excessive bleeding or swelling or pain unrelieved by medication, please call the doctor immediately
7. PRESSURE GARMENTS
   • 3 weeks -24 hours-can remove for bath and put back with seam on the outside.
   • 3 weeks-10 to 12 hours
   • Avoid bending, Avoid wrinkle, wet cloth
   • Tighten the cloth if it becomes loose
     One may develop swelling distal to pressure garment on limb due to pressure, on removing pressure garment for short time swelling will reduce. Wash in normal tap water. Don’t squeeze-avoid drier and sunlight- don’t iron -don’t hang.
8. BATHING
   Take bath after discharge of fluid is stopped after permission of doctor. (No bath in Bath tub). Make area dry and cover the wound with bandage. You may wash and dry the garment at the same time that you are showering.
9. RESULT
   One can see huge the difference in shape immediate after surgery, although it is a partial result. Initial 7 to 10 days there will increase in swelling so result will be less visible. Over one month you will see most of the result as swelling reduces. Improvement in shape and skin tightening goes on for 6 to 8 month.
10. FOLLOW UP VISIT
    After the discharge, you have to do postoperative visit at 3 days, 7 days,15 days and then after 1 month.
11. LONG TERM INSTRUCTIONS
    It is advisable to visit the clinic at 3 and 6months after the operation. Inform doctor, if swelling, redness pain, hardness etc..

Likewise any surgical procedure, tummy tuck surgery in men and women also has some risks and complications.

 Tummy tuck Surgery specific complications:

• Bleeding: it is very rare as, blunt cannula is used for liposuction
• Infection: Surgical site infection is rare but possible. A severe skin infection may be life-threatening.
• Fluid accumulation: Accumulation of fluid is called a seroma. Small seroma gets absorbed by itself. This fluid may need to be drained with a needle. Open drainage technique reduces seroma
•  Wound healing problem; when skin is suture too tight or fat layer is thick, or patient is a smoker, wound healing problem can take place., which delays recovery may need revision surgery.
• Contour irregularities: Skin may look irregular, bumpy, or wavy due to uneven fat removal, poor healing, or thinly stretched skin. These changes may be permanent. Even difficult to reduce with revision
• Spot/ pigmentations: Skin may appear spotted, but rarely does it become permanent.
• Numbness: One may have temporary or permanent numbness in the operative area.
• Hyperesthesia: due to temporary nerve irritation is also possible.
• Fat embolism: Again very rare, can happen with mega liposuction. Broken fat may travel through the blood and gather in the lungs or to the brain. A fat embolism is a medical emergency.
• Kidney and heart problems: As a large quantity of fluid is injected and suctioned out as it can cause potentially life-threatening kidney, heart, or lungs problem.
• Lidocaine toxicity: Lidocaine is an anesthetic drug in infiltration fluid. Although it is safe, in a rare circumstance, lidocaine toxicity can occur, causing serious heart and central nervous system problems.
• Internal puncture: It is extremely rare. A cannula can go too deep, may puncture an internal organ. This may require emergency surgical repair.

Anaesthesia related complications:

Small reaction to major reaction or fluid imbalance can happen. And it is rarest rare death can happen.