Tummy Tuck Surgery (Abdominoplasty)

With a tummy tuck, Dr. Zuckerman can remove excess skin and fat from the abdominal region, reshaping the midsection for a more trim, hourglass figure. These aesthetic issues may develop for several reasons:

• Significant weight loss
• Pregnancy
• Genetics
• Aging

Candidates are typically in relatively good overall health, able to obtain medical clearance for general anesthesia, and not excessively overweight. This surgery can also be a good match for those suffering from diastasis recti, separation of the abdominal muscles post-pregnancy. For those who suffer from excess deposits of fat in the abdominal region without excess skin, Dr. Zuckerman may be able to perform liposuction alone to achieve the desired surgical result. However, excess skin or stretch marks can only be addressed via a tummy tuck. Most often, patients who had had a previous pregnancy do require some form of tummy tuck over liposuction alone, but Dr. Zuckerman will discuss which procedure may suit you best at your initial cosmetic consultation. If you have achieved significant weight loss and would like to eliminate excess skin in the abdomen and other areas, Dr. Zuckerman’s post weight loss surgery (body contouring) procedures may be the best fit for you.

Dr. Zuckerman describes tummy tuck surgery with an actual patient from preoperative markings to showcasing her three month result.

Abdominoplasty, or tummy tuck surgery, consists of several operative steps:

• To begin, Dr. Zuckerman makes an incision low on the abdomen, just above the pubic area, stretching from hip to hip.
• He then makes another incision vertically to free the umbilicus, or belly button, from existing tissue.
• He lifts the skin beginning from the incision and moving up the abdomen. He then tightens and repairs abdominal muscle separation if needed.
• Dr. Zuckerman then performs liposuction and contouring to remove excess deposits of fat in the abdomen and flanks.
• Excess skin is then removed, and Dr. Zuckerman redrapes the abdominal tissue for a firm, flat appearance.
• He recreates the external appearance of the umbilicus, or belly button, in the newly draped abdominal tissue, then connects it to the existing umbilical stalk.
• Finally, the initial horizontal incision on the lower abdomen is closed in multiple layers to ensure a thin, flat surgical scar.

The initial horizontal incision will be the only visible postoperative surgical scar and, with Dr. Zuckerman’s techniques, will be placed low enough on the abdomen as to be hidden under most swimwear and undergarments. Due to Dr. Zuckerman’s experience, he is typically able to perform this procedure in approximately three hours. You may undergo surgery at Dr. Zuckerman’s state-of-the-art, fully equipped operating room located inside his office in midtown Manhattan. This operatory facility has been certified by the American Association for Accreditation of Ambulatory Surgery Facilities, Inc. (AAAASF), certifying it as a facility that offers an equally high standard of care as a hospital. The privacy, discretion, and convenience of Dr. Zuckerman’s private in-office operating room facility is an exclusive benefit of Zuckerman Plastic Surgery that many patients appreciate. Should you desire, you may also undergo surgery with Dr. Zuckerman at Manhattan Eye, Ear & Throat Hospital, a major hospital in Manhattan in the Northwell system where all types of breast, body, and face cosmetic surgery procedures are performed. Dr. Zuckerman is on staff in the department of plastic surgery for Northwell system hospitals in Manhattan among others.

Achieving the Best Tummy Tuck Surgery Outcomes

As mentioned above, abdominoplasty is a popular procedure nationwide. However, Dr. Zuckerman is among the most experienced in this procedure in the region and has long studied techniques for improving it. He employs techniques to ensure that your new abdominal contour will be as flat as possible, that your waistline will be slim and of hourglass shape, and that minimize the risk of complications. Dr. Zuckerman’s technique to create a natural-looking belly button avoids any external scar, which otherwise is a common vestige of the procedure. Learn more about Dr. Zuckerman’s surgical techniques, developed over the years as a specialist in this procedure to achieve the best outcomes for each patient.

Mini Tummy Tuck versus Full

Some patients with limited excess skin and muscle separation, can undergo a “Mini Tummy Tuck” by Dr. Zuckerman. The mini tummy tuck can be an attractive option due to the more minimal required abdominal incision. However, most patients do better with a full abdominoplasty, because there is limited correction possible via the mini operation. On the graphic, Dr. Zuckerman compares the two procedures visually, and he can help you decide which cosmetic surgery procedure is right for you at your consultation. Note that a similar tradeoff exists between a tummy tuck and liposuction. Liposuction is a great option with minimal incisions, but it cannot be used to remove excess skin. Dr. Zuckerman is happy to answer any questions that you may have about these procedures at your initial consultation.

Diastasis Recti Repair During Tummy Tuck Surgery

In adult women, diastasis recti is largely due to previous pregnancy and involves the connective tissue between the rectus abdominis muscles being stretched beyond its elasticity creating a gap. It results in a separation along the midline of the abdomen and typically causes a bulge in the upper or lower abdomen. The relevant connective tissue, the fascia, will not return to its initial state without surgical repair. This condition is, for the most part, a minor annoyance and an aesthetic issue, but it can also be associated with pelvic floor issues, back pain, and herniation of the intestines. While certain abdominal exercises may improve the appearance of the separation by increasing the overall size of the rectus abdominis muscles, this essentially disguises the condition but does not correct it as the fascia remains stretched. The condition can only be repaired surgically. During a tummy tuck, Dr. Zuckerman places permanent stitches in the connective tissue, which then create a thin layer of scar tissue “gluing” the fascia back together at its original length.

• Day of surgery: Tummy tuck surgery is performed, with accompanying liposculpture of the flanks and contouring of the waistline. Dr. Zuckerman employs a revolutionary long-acting local anesthetic, which helps patients minimize discomfort for up to three days after surgery. Two small drains are left in place to eliminate the possibility of postoperative fluid collection.
  Walking is encouraged. Hips are kept gently flexed for the first week. Gentle compression garment is worn. Showering is allowed with drains in place.
• Postoperative Days 3-5: Swelling reaches is maximum level, but pain remains well controlled. Activity level gradually increases. Pain medication is weaned off.
• 1 week: Drains are removed painlessly. Hips no longer required to be flexed. Swelling begins to subside. Majority of patients return to work. Most patients off all pain medication.
• 2 weeks: Normal daily routine is resumed, including gentle aerobic exercise. Compression garment still worn under clothing to reduce swelling.
• 6 weeks: All exercise allowed to be resumed, including strenuous lifting and abdominal exercise. Swelling continues to reduce, approaching zero during this time.
• 3 months: Final contour is achieved
• 1 year: Final appearance of scars is reached, optimized by scar massage, silicone-based scar gel, and protection from the sun.

On the day of surgery, Dr. Zuckerman applies a long-acting local anesthetic called EXPAREL® for all abdominoplasty patients. Whereas most traditional pain medicines last up to a maximum of twelve hours, EXPAREL® gradually releases medication to a particular region for up to three days. This approach is a significant departure from previous techniques and minimizes postoperative pain and discomfort. However, Dr. Zuckerman will also prescribe traditional pain medication for the management of any other potential postoperative discomfort in the days after surgery. Some bruising and swelling should be expected as well. Most patients are able to return to work or daily activities in one to two weeks. However, patients should avoid heavy lifting or other intensive exercise, which may place stress on the incisions, for up to six weeks after abdominoplasty. Dr. Zuckerman will likely place two surgical drains in your incision to collect fluid and minimize the risk of possible complications. These are easily managed and removed relatively painlessly in the office by Dr. Zuckerman after one to two weeks.

After surgery, you will have a scar low on the abdomen that is well-hidden under most undergarments and swimwear. Dr. Zuckerman also offers a comprehensive scar care regimen for up to one year after surgery to optimize the aesthetic appearance of your ultimate scar.

Tummy tuck surgery is overwhelmingly safe when performed by a board-certified plastic surgeon. Dr. Zuckerman is highly experienced with tummy tuck procedures and will take the utmost care to minimize any risks. However, all significant surgery carries possible risks of complication including:

• Wound breakdown
• Infection of the incision sites
• Hypertrophic, raised, scarring
• Bleeding or hematoma formation

Below are the answers to some questions Dr. Zuckerman most frequently receives from prospective patients. If you don’t see your question below, feel free to contact Dr. Zuckerman’s office, and a member of his staff will be glad to reach out to you.

Can I undergo a mini-tummy tuck instead of a full tummy tuck?

In your cosmetic surgery consultation with Dr. Zuckerman, he can discuss with you whether you may benefit from a mini-tummy tuck. However, 8 times out of 10 in Dr. Zuckerman’s practice, a patient will need the full tummy tuck.

Can I undergo a liposuction only instead of a full tummy tuck?

If you have skin laxity (excess skin) or muscle separation, then liposuction only will not give you a good result. Liposuction cannot eliminate excess skin; it only removes fat.

Can I undergo tummy tuck surgery if I would like to lose weight in the future?

If you wish to lose only a moderate amount of weight, you could be a candidate for tummy tuck surgery now. However, patients wishing to lose large amounts of weight should do so before undergoing the surgery.

Can I undergo tummy tuck surgery if I wish to become pregnant in the future?

I generally recommend that a woman wait until she is finished having children before undergoing tummy tuck surgery.

Can I undergo tummy tuck and liposuction at the same time?

Yes, my tummy tucks almost all involve liposuction of the abdomen, and flanks as part of the procedure. You may optionally add liposuction of the lower back as well. The goal is to remove excess fat via liposuction and excess skin via the tummy tuck procedure to reshape your abdominal contour.

Must I have surgical postoperative drains put in during surgery?

Yes, I place drains in the abdomen for all abdominoplasty patients. They typically remain in place for one to two weeks and are not painful to remove. They help prevent collections of fluid called seromas and are quite important. You can shower with them in place, and they require minimal maintenance.

Can I undergo tummy tuck surgery at the same time as a C-section?

While this may seem like a good idea, it actually is generally agreed by plastic surgeons not to be. During pregnancy, many of the anatomical structures of the abdomen are stretched out. This means that tummy tuck surgery performed at the end of pregnancy could lead to suboptimal results, because the surgeon would have difficulty stretching abdominal skin and tissue tight enough. In addition, tummy tucks performed at this time are associated with a high complication rate including infections. I generally advise patients to wait six months after childbirth before underoing a tummy tuck.

Are you ready for your tummy tuck surgery (abdominoplasty) consultation with Dr. Zuckerman? He will perform a thorough evaluation of your desired outcome and needs based on your anatomy and medical history. Dr. Zuckerman will also address any questions or concerns you may have about the surgery and discuss with you the details of his approach: incision location(s), procedure length and techniques, likely operative outcome, etc. Contact his office by clicking the button below or by calling (212) 231-9897. Dr. Zuckerman also offers consultations via Skype and a process for out-of-town patients to visit New York City to have surgery with him.