You may notice with the passage of time you formed a tummy.
This can be due to many factors: excess or loose skin, excess fat, or stretching of the abdominal fascia and muscles. Significant weight loss and pregnancy can stretch the abdominal muscles and skin beyond the point they can return to normal. A healthy diet and regular workouts may not correct the problem.
An abdominoplasty (tummy tuck) works in two ways. First, under the skin the abdominal muscles are tightened, like an internal ‘corset.’ The muscles loosen during pregnancy, causing a separation of the rectus muscles. This separation is called a “diastasis.” Sometimes this happens with a hernia near the belly button. A hernia is an actual hole in the fascia, and is less common. You cannot fix a diastasis by sit ups, as the muscles do not cross the midline. You will notice this looseness when you “suck it in” and still cannot get your belly as flat as before children. The muscle tightening helps narrow your waist and firm your abdominal wall.
Second, an abdominoplasty removes excess skin and fat, frequently removing all the skin between the belly button and the pubis. The scar looks like a C-section scar with a scar around the belly button. The length of the scar depends on the amount of skin and fat removed. Removing skin will remove stretch marks and wrinkling of the lower abdomen, and flatten and tighten the contour of the entire abdomen.
The abdominoplasty procedure is done under general anesthesia at the Premier Plastic Surgery facility in Palo Alto. Typically this is an outpatient surgery as pain control is managed with the use of new “pain pumps” which allow the controlled flow of anesthesia for the sore areas. This eliminates the need for patients to stay overnight in facilities. The pain pump is put in at surgery and drips numbing medication internally for the first three days after surgery. We find it reduces postoperative pain significantly.
The tummy tuck procedure is frequently combined with liposuction or other cosmetic surgery procedures such as breast augmentation, breast reduction, or breast lift and is known as the “Mommy Makeover”. Depending upon the length and size of surgery, an overnight stay may be required. People who are still losing significant weight or who are planning another pregnancy should wait.