Live each day as if your life had just begun. - Johann Wolfgang von Goethe
It's not your fault that you haven’t had any success firming and toning your midsection. You've tried time and again to get rid of stubborn fat and loose skin. Despite diligently following a nutritious diet and exercise plan, you’re still longing for the flat, toned tummy you used to have — when you were younger or before you had children.
Who’s to blame? Not you!
I would like you to know that these issues with your appearance probably can't be fixed by following a healthy lifestyle alone. Often, outside factors, such as the aging process, hereditary traits, major weight loss and/or pregnancy are to blame.
As you get older, your body gradually stops producing collagen and elastin. These are two proteins that are essential for healthy skin. Without a good supply of collagen and elastin, your abdominal skin weakens and becomes less elastic. This makes your skin unable to "bounce back" to a smaller size or shape after pregnancy or when you've lost a lot of weight. On top of that, pregnancy can also cause your abdominal muscles to separate or become severely weakened. This condition is technically known as diastasis recti, and makes your stomach bulge as if you were still pregnant. So, don't blame yourself for being unable to tone up your stomach because these are issues beyond your control!
You can win the battle against the bulge
Although all of this may sound bleak, don’t feel like it’s a losing battle. Abdominoplasty, or a tummy tuck, is a cosmetic surgery procedure designed to correct these exact concerns. With a tummy tuck, you’ll have the following done:
- stubborn fat in your mid-section removed
- sagging abdominal skin tightened up
- separated stomach muscles, if necessary, repaired
That means you can get the toned tummy you used to have! Plus, your healthy lifestyle after surgery will ensure that your results are maintained for a long time.
Unique point: you don’t have to have a normal BMI
Many surgeons tell their patients that they should be at a normal BMI (Body Mass Index) before considering surgery. To calculate your BMI, only your height and weight are measured. I do not support this. I believe BMI is an inaccurate method of measuring someone's ideal weight because it doesn't take into account other factors, such as your bone structure or how muscular you are. I have had patients who were denied surgery because they were considered "overweight" and even "obese", when in fact they were healthy and at their ideal weight. I performed surgery safely on them and they were able to achieve the improvement they wanted.
For this reason, I do not use BMI as a way to pre-select patients. I always meet with each patient first and examine their physical health and medical history before determining whether they are a suitable candidate.
What will happen during your surgery
Tummy tuck is an outpatient procedure. This means that you won’t need an overnight stay unless it's necessary. Most of the time, the surgery takes about three hours to perform, although it depends on the complexity of your situation. It can be shorter or longer. For example, your surgery may take longer if I need to perform liposuction first to remove surplus fat. This technique is also known as lipoabdominoplasty. Other factors that contribute to the length of your surgery include the amount of excess skin/fat that needs to be removed and whether your abdominal muscles need to be repaired and to what extent.
Prior to the start of your surgery, a board certified anesthesiologist administers general anesthesia. For this reason, you won't feel anything and are completely comfortable throughout the entire duration of your surgery.
A horizontal incision across the pubic area is created, extending from one hipbone to the other. However, the incision won’t be too long because I make sure to position it in a region that can be easily covered by your underwear or bikini. That way, you won’t have to worry about other people seeing your scar when you wear certain clothes.
I separate the tissues from the underlying muscles and repair your abdominal muscles. To do this, I strategically place internal stitches in your stomach muscles, which run vertically from the pubic bone to the ribs. These stitches hold your restored abdominal muscles in a tightened position, so they don’t bulge. If you don't have diastasis recti, then this won't be necessary for me to do.
I rejoin the muscles and tissues (often with the use of additional internal stitches). Loose excess skin is removed before the remaining skin is pulled taut. The location of your navel is aligned with your new, svelte abdominal contour. It's important that the amount of skin tightening is accurately measured for each patient. For example, if you have a larger frame and too much skin and fat are removed in your mid-section, your stomach may look fine on its own but the overall result will look strange because it won’t complement the rest of your body. Basically, it'll look like you have someone else’s stomach on your body! For this reason, I always look at your mid-section in relation to the rest of your body.
Closing the incision
Finally, I close the incision with sutures before dressing the treated area with bandages. A compression garment may also be put on for added support. Please continue to wear your compression garment until I advise otherwise, since it is necessary for your healing process.
It can be so discouraging to work hard at toning your stomach, but not see any improvement from all of your effort. It's not your fault! – Dr. Leila Kasrai
Unique point for faster recovery: you don’t need drains!
Many surgeons place drainage tubes in the treated area to alleviate any fluid accumulation underneath the skin after surgery. But these can be:
- extremely uncomfortable: imagine trying to rest with tubes hanging out of your body!
- difficult to handle: the tubes need to be kept in place so you have to be extra mindful of their presence.
- troublesome to keep clean: the tubes need to be drained daily to keep them working properly.
- a factor that contributes to infection: the drains are placed through open incisions into your body, and these open wounds are highly susceptible to infection. Drains prolong recovery because of these open incisions.
- possibly painful, particularly if they fall out
You’ll be relieved to know that I do not usually use drainage tubes. Instead, I use a series of internal sutures to hold the remaining tissues in place before closing the incision. Doing so reduces much of the empty space where fluid tends to accumulate after surgery. With very little or no empty space, the risk of fluid accumulation is decreased. That’s why generally you won’t need any pesky, uncomfortable drainage tubes. You may know this as a drainless tummy tuck or no-drain tummy tuck. You’ll be able to focus on your recovery better in more comfort, and see your results faster.
Leaving the surgical facility
Once the effects of the anesthesia have worn off, you are discharged into the care of the person you’ve authorized to help you. This person or another responsible adult should stay with you the initial night following your surgery. They'll be able to help you since you'll probably find it difficult to perform even the simplest of tasks alone.
Recovering from your surgery
- 2 weeks off and limitations on activity
- Feelings of discomfort and numbness
- Undissolvable stitches removed in about 2 weeks
- Instructions on scar care
You will need to arrange to take about two weeks off from work or your everyday activities. During this time, you should rest while your body heals. Avoid heavy lifting and other strenuous activities. On the other hand, you should take several short walks around the house each day to help prevent blood clots from developing in the legs. You may need help from someone to get around in the first day or two after tummy tuck surgery.
A note to moms: I tell my patients that they should treat their recovery like it's the best vacation of their life. Being a mother myself, I know you might feel a little guilty for taking so much time off for yourself. You've dedicated your life (not to mention your body!) to your children, and you deserve to do something that will make yourself happy, too. So, kick back, and relax! Besides, this is a great time to spend some precious time with your children, as well, because you can't go rushing off to work, cook or do whatever else you have to do to manage your household.
The treated area may be numb, tender or sore. You can take oral pain medication as directed to relieve any postoperative pain or discomfort. Any stitches in the treated area will be removed about two weeks after surgery at one of your follow-up appointments. You can gradually resume your normal routine, including your exercise regimen, as advised.
Although surgical complications are uncommon, you can do your part to minimize any inherent surgical risks by following all of my pre- and post-operative care instructions closely. I’ve designed these instructions with the ultimate goal of achieving a speedy recovery for you. Your care instructions include avoiding smoking for several weeks prior to and following surgery. Smoking inhibits proper healing, increasing the risk of complications such as infection. It can also lead to a longer, drawn out recovery .
Your incision scar will appear pink or red at first. As time passes and with proper care, the scar will fade to the colour of your skin, making it dramatically less noticeable. I understand that scarring is a huge concern. I will provide specific instructions on how to care for your scar so that its visibility is minimized in the long run.
You’ll love your results
You’ll notice a flatter abdominal profile immediately after surgery. However, your aesthetic results will continue to improve over the course of about six months, as your body heals and swelling subsides. Once you’ve healed, you may be pleased to see that you have a flat stomach and even possibly a "six-pack”.
Frequently asked questions about abdominoplasty
What is abdominoplasty?
Abdominoplasty, familiarly known as a tummy tuck, is a cosmetic surgical procedure that firms up the mid-section, making it leaner and more "cinched in". It flattens the stomach and gives you a more defined waist. Muscular definition of your abdominal area may also be improved.
Do I need a mini or full tummy tuck?
This is a question that can only be answered by seeing me in your initial consultation. I'll assess your mid-section, quality of skin and shape to determine which technique will adequately achieve your goals. Generally speaking, however, a full tummy tuck tends to be more popular than a mini.
I don't have much loose skin or fat, but I still have a bulging stomach. Can I still get a tummy tuck?
Loose skin and excess fat aren't the only reasons why your stomach may bulge. Diastasis recti, a term that refers to a vertical separation of the right and left abdominal muscles, may also cause bulging. A tummy tuck can be performed to correct this, even if you don't have loose skin or excess fat.
Why can't I just get liposuction?
Liposuction is designed only to remove excess fat. It does not adequately tighten up the skin, despite claims by some liposuction devices and surgeons. To tighten up the skin, excision is necessary and that's what a tummy tuck is for.
What happens if I gain weight after surgery?
Your results may be negatively affected. Please follow a healthy lifestyle to maintain your results.
What happens if I get pregnant after surgery?
Like weight gain, your results may be negatively affected with future pregnancies. I always recommend that women should consider a tummy tuck only after they've stopped planning to have children.
Can I get rid of stretchmarks with a tummy tuck?
Usually, stretchmarks located below your belly button may be removed, but usually not in their entirety. Stretchmarks located well above the belly button or on your waist may not be removed.
Where will my scars be?
I will tell you where you can expect to have scars before your surgery. Usually, they're placed very low, so they remain hidden by underwear or a bikini.
Is it painful?
A tummy tuck can cause more discomfort than other procedures, and this is particularly true if muscle correction is performed. Pain medication will be prescribed to help you ease discomfort in the first few days.
How much weight will I lose?
If you're considering a tummy tuck as a way to lose weight, then you are not a suitable candidate. A tummy tuck is best performed on patients who are at a healthy stable weight.
Am I a candidate if I have a high BMI?
I don't use BMI as a way to determine who is a candidate for the surgery because I believe it is an inaccurate method of measuring weight. I always examine a patient's unique body type and concerns instead.
Will I need drains after my surgery?
Usually, I don't place drains for my patients because I apply unique suturing techniques that make them unnecessary.
Tummy tuck can be a more invasive procedure. To make an informed decision, you should be aware of the possible risks:
- Seroma and hematoma
- Noticeable scars
- Temporary changes in sensation
- Excessive bleeding and bruising
Please follow the care instructions I've designed for you. These will help you to prepare for your surgery and recover afterward, allowing you a safer and more effective experience.