Abdominoplasty Washington DC
Abdominoplasty (Tummy Tuck) is a procedure that removes excess skin and fat from the lower abdomen. The procedure may also tighten abdominal muscles that may have become lax or separated after pregnancy or through the aging process. The end result is an abdomen that is smoother and flatter. The procedure is not effective at removing stretch marks and should not be used as a substitute for responsible diet and exercise. Ideal candidates are healthy patients with relatively stable weight. In the consultation, Dr. Pittman will discuss your goals, your medical history and your previous surgeries. He will determine the safest and most-effective course of treatment. At times abdominoplasty is combined with liposuction to contour the hips.
Abdominoplasty is usually an outpatient procedure that lasts 2-3 hours. There are instances in which patients spend one night in the hospital following the procedure. An incision is made horizontally across the lower abdomen at the level of the pubic bone. A separate incision is made above the belly-button. The skin in between the two incisions is removed and discarded. The abdominal muscles may be surgically tightened at this time to flatten and strengthen the abdominal muscles. The upper abdominal flap is then brought down to contour the abdomen. A new belly-button is created.
What to do After Surgery
Immediately after surgery, Dr. Pittman will apply a dressing that will remain in place for 48 hours. Some tenderness and post-operative discomfort is expected and can be controlled with pain medications and muscle relaxers. Surgical drains may be placed at the time of surgery. The drain outputs need to be recorded and emptied twice daily. Most patients are able to return to normal light activity within a 2 weeks. Swelling continues to go down over the next 4-6 weeks. Patients are discouraged from heavy exercise for 6 weeks following the procedure
Frequently Asked Questions
How long is my recovery?
Some patients spend one night in the hospital following this procedure. You will have mild to moderate swelling and bruising of your abdomen. The swelling might persist for several weeks. You will be given an abdominal binder to wear when you leave the hospital. Many patients also choose to purchase a form fitting surgical garment. This helps to reduce swelling and protect your incision. You should be able to resume normal activities in a few days. You may take small walks as long as you are not dizzy. Strenuous exercise, heavy lifting and abdominal exercises are restricted for 6 weeks.More information about surgical garments can be found on the Marena Group Website.
How long will I be in pain?
You will have discomfort for a few days. Tightness and soreness in the abdomen might persist for a couple of weeks. You will be given a prescription for pain medication to use immediately post-op, and can change to Ibuprofen or other over the counter pain relief after a few days.
How often will I need to come to the office for follow-up visits?
Your first post-op visit will typically be within three to five days after surgery. We will check your incisions, observe for signs of infection and monitor your recovery. We will then see you on a weekly basis until your drains are ready to be removed. Sometimes, after the drain is removed, you can develop a collection of fluid in your abdomen called a seroma. This is not serious, but can be uncomfortable and put stress on your incision. If this occurs, we will remove the fluid with a small needle in the office. This might have to be done once or twice weekly until the body absorbs the fluid. This is not a painful procedure.
When can I go back to work?
You should be able to return to work in about two weeks. If your job requires physical labor, you should consider taking 4-6 weeks of leave or return to work with lifting restrictions.
When can I drive?
You can drive as soon as you are off of the narcotic pain medication and feel alert enough and physically able to do so.
What medications will I be on after surgery?
You will be given prescriptions for pain medication; usually Percocet or Norco. You may take one or the other to control your pain. A prescription for Zofran is also given; you can have this filled if you need to. This can be used to control post-operative nausea and vomiting that some patients experience after anesthesia. Antibiotics and a muscle relaxant may also be prescribed.
Can I go home the same day?
Patients who have this procedure go home the same day or spend one night in the hospital. You may be able to go home the evening of surgery if you are doing well. Someone will need to drive you home and stay with you the first night.
When can I have sex?
You may have sex when you feel comfortable enough. However, we suggest waiting a week to give your incision time to heal. Too much stress on your incision can cause it to reopen.
Will I have scars?
You will have one long incision across your abdomen, usually extending upward from hip to hip. You will also have an incision around your belly button. You will have an adhesive glue covering your incisions. Your incisions can get wet 48 hours after surgery. Do not apply any ointment or scar products to your incision until discussed with our office.
Will I have drains?
Two drains are usually necessary to help collect fluid that accumulates in your abdomen following surgery. These are left in place when you leave the hospital. You will need to empty and measure the output of the drains at least twice daily. The nurse will show you how to empty the drains before you leave the hospital. The amount of time the drains stay in place varies with each patient. Usually they stay in place for 2-3 weeks. They are usually concealed when secured under loose garments.
When can I shower?
You can shower or take a sponge bath 48 hours after surgery. You should not submerge your incision under water for 6 weeks after surgery.
When will I see the results?
Bruising should disappear within 1-2 weeks. Swelling can persist longer, noticeably up to 6-10 weeks. You will notice a difference immediately, seeing changes throughout your recovery, but it could take up to three months to see the final result.
How do I prevent constipation?
Narcotic pain medication can cause constipation. We recommend taking Miralax. This medication is available over the counter at the pharmacy. You should begin taking this medication when you get home, and continue as long as you are on the narcotic pain medication. Increasing your fiber intake, eating fruits and vegetables and drinking plenty of fluids also helps. If constipation becomes a serious problem, we suggest either a Dulcolax suppository or drinking Citrate of Magnesium.
What if I cannot urinate?
Following anesthesia, some patients have difficulty urinating. If you go home and are unable to urinate within six hours, you might need to be catheterized. Please call the Plastic Surgery Resident, at 202-405-1141, or go to the Emergency Department; either Georgetown or one that is closer to your home. Patients are usually able to urinate after the medication leaves your system.
How can I reach someone, after office hours if I have a problem?
If you have a problem and the office is closed, you may contact the Plastic Surgery resident on call by calling the page operator at 202-405-1141, and asking to speak to the plastic surgery resident on call.
Do my sutures need to be removed?
Dr. Pittman usually uses dissolvable sutures. They are not noticeable and are absorbed by the body. You will have one suture holding each drain in place that will be removed with the drain.
What if I get pregnant after my abdominoplasty?
Abdominoplasty will not interfere with your ability to become pregnant. However, pregnancy will interfere with your surgical result. Skin and tissue are removed from your abdomen, but your remaining abdominal skin will stretch to accommodate your pregnant belly.