Tummy Tuck: When crunches don't work

Tummy Tuck: When crunches don't work

by Dr. Diane Gibby • M.D., P.A., F.A.C.S

Most people yearn for a flat, trim stomach. Crunches and sit-ups are great for the abdominal muscles, but they often aren't enough to tighten loose muscle and skin. Women in particular have a hard time strengthening these muscles after multiple pregnancies have stretched their abdomen to the limit. Weight loss can also cause loose skin in the abdominal area which may be resistant to toning by exercise. For many of my patients, the solution has been a surgical procedure known as "abdominoplasty" or tummy tuck which removes excess skin and fat from the abdomen and tightens muscles of the abdominal wall, reducing the appearance of a protruding abdomen. The best candidates for this procedure are women who are in relatively good shape, but who have large fat deposits or loose abdominal skin that has not responded to diet and exercise. If your loose skin is limited to the area below the umbilicus (belly-button), you may benefit from a less complex procedure called a "partial abdominoplasty," or "mini tuck". This procedure usually requires a smaller incision and less time in surgery and recovery. If the loose skin extends above the umbilicus, a full abdominoplasty is usually a better option. This surgery is more complex and often requires a longer incision and repositioning of the naval. Although scars are the inevitable results of any surgery, every effort is mades to keep scarring to a minimum. Placing the incision inside the bikini line, for example, helps conceal the scar. Both procedures are usually accompanied by liposuction to remove fat deposits to achieve more dramatic results. These procedures are often performed on an outpatient basis, at the Women’s Center for Cosmetic and Plastic Surgery, although some patients may prefer an overnight hospital stay. The type of anesthesia used depends on you and your doctor. I prefer general anesthesia, although local anesthesia combined with sedation is also an option. Surgery can take anywhere from one hour for the "mini tuck" to four hours for a complete "tummy tuck". Recovery time after these procedures varies from person to person and depends largely on your general health. For the first few days following surgery, your abdomen will be swollen and tender. Even though you will experience some discomfort, you should start walking as soon as possible to speed the recovery process. The surface stitches will be removed in five to seven days. Patients having abdominoplasty often experience a feeling of tightness and diminished sensation in the abdomen; both generally subside in the months after surgery. Some patients return to work in two weeks following surgery, while others take up to four weeks to recover. I am a believer in exercise to help healing; even people who have never exercised before should begin an exercise program to reduce swelling, lower the chance of blood clots, and tone muscles. Vigorous exercise, however, should be put on hold until four weeks following surgery. A supporting girdle may be recommended for optimal healing and contouring. As with any cosmetic surgery, consult with your plastic surgeon first before considering abdominoplasty. Discuss your goals and expectations. Keep in mind that the desired result is improvement, not perfection. I have found that abdominoplasty can provide excellent results for patients with weakened abdominal muscles or excess skin. In most cases, the results are long-lasting if a balanced diet and exercise regimen are followed.

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