At the Maryland Plastic Surgery Center, Dr. Adam Summers offers Annapolis and Baltimore tummy tuck patients the opportunity to achieve a flatter, smoother abdomen, and trimmer waistline. Dr. Summers is exclusively sought out by many tummy tuck patients from Annapolis, Baltimore, and the region because he has become known for achieving wonderful results with minimal downtime. In fact, most of his patients find that they are able to walk immediately without assistance and that their pain is controlled with ibuprofen alone after 2 days. He combines his surgical expertise and extensive medical training to perform this procedure for Maryland abdominoplasty patients from across the state. Below, Dr. Summers describes the tummy tuck procedure.
Sometimes simply dieting and exercising are not enough to take care of waistline problems. In such cases, Dr. Summers has helped many Baltimore tummy tuck patients remove excess skin and fatty deposits from their abdomen and reposition their abdomen muscles for a tighter formation. If you are considering a tummy tuck (or abdominoplasty) procedure, Baltimore and Annapolis abdominoplasty patients have found that Dr. Summers’ techniques consistently help patients achieve their goal of a flatter and tighter stomach. The abdominoplasty procedure can also repair a condition known as a “diastasis recti”, where there is a separation between the vertical abdominal muscles (this typically occurs following pregnancy).
Many factors affect the contour of your abdomen. Childbirth can stretch abdominal muscles to an extent that is uncorrectable with exercise. Excess fat deposits may produce undesirable bulges or fullness, and loose skin following childbirth or weight loss may result in an unattractive abdomen.
In women, pregnancy causes significant stretching of the tissues of the abdomen. After delivery, you may be able to exercise to recover the tone in the muscles themselves, but the fascial tissues (the layer of tissue which interconnects the muscles), do not respond to this effort. Stretching or looseness of the lower abdominal tissues creates bulging, which you cannot correct with exercise.
As fat is lost beneath the skin of your abdomen, especially after significant weight loss, the tissues may become much looser and may actually hang downward. Skin also does not respond to any type of exercise; however, excess loose skin can be removed during tummy tuck in Maryland.
Even in individuals who are not overweight, localized deposits of fat can occur in areas of the abdomen, producing an undesirable contour. If fat deposits are the only contour problem, they may be correctable with liposuction alone. However, if stretched musculature or loose skin is present, an abdominoplasty is necessary to achieve the best result.
An abdominoplasty can achieve the following: it reshapes the underlying framework of the abdomen to firm the abdominal wall, removes excess fat deposits that may be present, eliminates excess loose skin to produce a flatter, more youthful abdomen, and removes some (and occasionally all) “stretch marks”.
During your consultation at the Maryland Plastic Surgery Center, Dr. Summers will ask you about the areas of your abdomen that concern you. He will specifically explain which components of an abdominoplasty will be necessary to achieve the best contour, and describe the type of changes you may hopefully achieve.
How much your abdomen can be reshaped depends on several factors. The quality of your tissues is very important, and is a factor over which we have little control.
If you are significantly overweight, you’ll get a much better correction if you achieve a more ideal body weight before your abdominoplasty. There is a limit to the amount of fat and skin that can be safely removed during the procedure.
To reshape the underlying musculofascial framework and remove excess skin, incisions are necessary. Incisions are placed low on the abdomen, and their length depends on the amount of correction you require. In most cases, it is necessary to reposition or reshape your umbilicus (belly button). Dr. Summers will discuss the specifics of the incisions during your consultation in Baltimore.
Any incision will produce a scar. The quality of these scars depends on several factors — most importantly your own specific healing characteristics. You should think of scars as a worthwhile trade-off for significant improvement in the shape of your abdomen.
An abdominoplasty cannot change the underlying skeleton and is limited by how much the muscles can be tailored. Limitations are present. Risks associated with abdominoplasty are generally very small. We want to provide you the best information so that you’ll be well informed in making your decision. At his elegantly appointed tummy tuck Maryland office, Dr. Summers will discuss any specific limitations during your consultation.
Incisions for abdominoplasty are placed low on your abdomen to allow them to be concealed. The length of the incision depends on the degree of looseness in your skin and how much will need to be removed. Dr. Summers will discuss your unique situation with you.
The skin and fat are first lifted off the underlying musculature of the abdomen. If the fascia (the tissue that interconnects the muscles) is stretched, he will tighten it by placing multiple rows of sutures. In essence, the underlying framework of the abdomen is reshaped. The skin and fat are then pulled downward, and the excess is removed. Due to the amount of skin that generally must be removed, it is usually necessary to make an incision around the umbilicus (belly button).
Tummy tuck Maryland patients who have a “pouch” or loose skin below the bellybutton, but with otherwise good abdominal contour and skin quality, may be good candidates for a mini tummy-tuck. In this procedure, a smaller incision is made above the pubic line and excess skin is removed, and the lower abdomen is tightened. There are no incisions around the belly-button and upper abdominal tightening is not performed. A mini tummy-tuck may be safely combined with more aggressive liposuction of the abdomen, if needed.
All of your incisions will be carefully closed with sutures placed beneath the skin, so there is no chance of having “railroad track” marks — this encourages the formation of very fine-line scars. To minimize fluid collection and swelling, and to improve your comfort in the treated areas, you will wear an elastic garment (which we provide) for three weeks (or more) after surgery. Typically, the procedure takes 3 hours to perform.
It is a widespread practice for a plastic surgeon to perform multiple procedures during one operation. This allows the surgeon to better “sculpt” your final appearance. In addition, having several procedures done simultaneously saves you the expense of paying the operating room and anesthesia costs more than once. However, having too many surgical procedures at one time can lead to complications. The decision to have multiple procedures done depends on which procedures are being done, the extent of surgery, the operating time, and your age/health. The surgeon decides whether it is appropriate to include more than one procedure in your operation.
During your initial consultation we will discuss your desired changes and expectations, review your medical history, and current health, and make an assessment on whether a tummy-tuck is the right procedure for you. This is a suitable time to ask specific questions about the abdominoplasty procedure so that you are fully prepared, mentally, and emotionally, for surgery. Dr. Summers will review in detail how the abdominoplasty procedure will be performed for you, and he will discuss all the risks of the procedure with you. Dr. Summers will also discuss if any ancillary procedures, such as liposuction, are appropriate. At the end of your initial consultation, Dr. Summers will provide you with a quotation that outlines all the fees associated with your selected procedure(s). If you wish to proceed with the tummy-tuck, you will be scheduled for a second consultation.
The second consultation is designed to give you an opportunity to ask any additional questions and to make sure that you fully understand all the pre-operative requirements, post-operative restrictions and potential risks and complications of the abdominoplasty procedure. The informed consent documents will be reviewed in detail, photographs will be obtained, laboratory work and a medical clearance (if necessary) will be requested, prescriptions will be written, a surgical date will be selected, and a deposit will be collected. We will also give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, avoidance of smoking, and the use or avoidance of certain vitamins and medications.
Generally, post-operative instructions call for rest and limited movement in order to speed up the healing process and recovery time. The length of recovery varies with each procedure and is different for each tummy tuck Maryland patient. Bruises usually disappear within a few days, and most swelling is gone in a matter of weeks. If you follow our post-operative instructions carefully, you will be able to enjoy your normal activities within no time. Your scars will fade over time but are permanent. We take care to conceal any scars so that they are barely visible, if at all. The image-enhancing effects of plastic surgery become more evident over time with certain procedures taking up to a year for your body to fully adjust and settle into its new look. When you come in for your consultation we can discuss your expected recovery period and any post-operative instructions in detail.
An abdominoplasty, whether partial (“mini-tummy tuck”) or complete (“full tummy-tuck”), produces excellent results for patients with weakened abdominal muscles or excess skin. In most cases, the results are “permanent” if you follow a balanced diet and exercise regularly.
Note: Patients with stria (stretch marks) above the umbilicus (belly button) may notice that the skin below the bellybutton loosens up several months after surgery. This is because the skin is damaged (the stretch marks indicate that the collagen fibers in the skin have been torn) and has lost their elasticity. In this case, a secondary abdominoplasty may be performed to further tighten the abdomen, if necessary.
The major complications associated with abdominoplasty procedures include (but are not limited to) the following: bleeding, scarring, pain, asymmetry, dimpling of the skin, contour irregularity, fluid collections requiring drainage, loss of abdominal skin, open abdominal wounds, numbness of the abdomen, pain of the abdomen, obvious scars, widening of scars, loss of the belly-button (umbilicus), off-center positioning of the umbilicus, residual “pouching” of the abdomen, loosening (laxity or sagging) of the lower abdominal skin, firm lumps under the skin, fat necrosis (undesired loss of fat), and the potential for re-operation if any of the above should occur.
Other major post-operative complications such as infection and blood clots are rare, but can occur. Infection can be treated with drainage and antibiotics, but will prolong your healing significantly. You can minimize the risk of blood clots by moving around as soon after the surgery as possible. Poor healing, which results in conspicuous scars, may necessitate a second operation.
Smokers must stop smoking at least one month prior to surgery to avoid an increased risk of these complications.
It may take you weeks or months to feel like your old self again. If you start out in top physical condition with strong abdominal muscles, recovery from abdominoplasty will be much faster. Some people return to work after one week, while others take three or four weeks to rest and recuperate.
Because Dr. Summers performs the abdominoplasty procedure in a way which minimizes post-operative discomfort, the typical patient having an abdominoplasty (tummy-tuck) at the Maryland Plastic Surgery Center can walk immediately afterwards. Most patients only need to take narcotics for 48 hours, after which time ibuprofen is adequate. This rapid recovery is significantly different than the type of recovery patients typically experiences at other plastic surgery centers.
It is impossible to predict how your scar will appear following surgery. Some patients have a scar that is virtually invisible while others have a very noticeable scar. Dr. Summers will do everything possible to help you obtain the best possible scar.
Your scars may appear to worsen during the first three to six months as they heal, but this is normal. Expect it to take nine months to a year before your scars flatten out and lighten in color. While they’ll never disappear completely, abdominal scars will not show under most clothing, even under bathing suits.
Prior to surgery, engaging in a regular exercise routine will help you heal better. 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 avoided until you can do it comfortably.
Although we encourage walking after surgery, we do not want you to return to your exercise routine for approximately one month after sugery. If you start on an exercise routine too soon, you will develop fluid collections in your abdomen which will require drainage with a needle and/or additional surgery.
For the first few days, your abdomen will probably be swollen around the pubic area, and you will feel some discomfort – this is controlled by medication prescribed to you prior to the procedure. You will return to the office for your first dressing change one or two days following the procedure, so plan to have someone available to drive you to your appointment. You should wear your abdominal binder and/or compression girdle for three weeks following surgery.
Your drain tube will need to be emptied several times a day – you will record the amount of fluid in the collection reservoir each time you empty the drain. If you have had liposuction at the same time as your abdominoplasty, there will be a lot of drainage in the first two days – this is normal and is the liposuction fluid coming out of your tissues.
Although you may not be able to stand straight at first, you should start walking immediately after surgery – most patients are able to walk upright within one week of surgery.
Because we want you to keep the incision dry, you will not be able to get in the bathtub. One week after surgery, you will return to the office for your second post-operative visit. At that time, surface stitches, if used, will be removed. Surgical tape will be applied over the incision to help protect it during the early healing phase. The drain tube may be removed, after which time you will be able to shower.
When showering, keep your back to the shower stream to minimize wetting of the surgical tape – it is important that these tapes stay on securely. Bathtubs, jacuzzies, swimming pools and hot tubs are off-limits for another 3 weeks. You will return each of the next two weeks for changing your surgical tape. After three full weeks, we will typically remove the surgical tape completely and allow you to start using scar fading cream (e.g. “Mederma”) or Vitamin E oil. These creams/oils should be massaged into the scar to help soften and fade the scar. Additional scar treatments and/or therapies will be recommended based on your individual needs.
A “mini” abdominoplasty at the Maryland Plastic Surgery Center usually takes about two hours. With a mini-tummy tuck, the incision is much shorter and there is no incision around the umbilicus, although it may be pulled down a bit as the skin is tightened. Typically, with a mini-tummy tuck, the skin is separated only between the incision line and the navel. After the skin is stretched and the excess skin is removed, the skin is stitched back into place. Sometimes a drain tube is inserted – this is typically determined at the time of surgery.
A “complete” or “full” abdominoplasty at the Maryland Plastic Surgery Center usually takes about three hours, depending on the extent of work required. Most commonly, the incision extends from hip to hip, just above the pubic area. A second incision around the umbilicus is made to free the navel from surrounding tissue. Next, the skin is separated from the abdominal wall all the way up to your ribs. The underlying abdominal muscles are tightened by pulling them close together and stitching them into their new position. This provides a firmer abdominal wall and narrows the waistline. The excess skin is then stretched and removed. A new hole is cut for your navel, which is then stitched in place. Finally, the incisions will be stitched, dressings will be applied, and a temporary tube will be inserted to drain excess fluid from the surgical site.
Most abdominoplasties are performed at the Maryland Plastic Surgery Center – this is our out-patient certified surgical center and patients are sent home shortly after surgery. However, in rare cases patient factors or desires may necessitate that the procedure be performed in the hospital – in this case, patients occasionally choose to recover in the hospital for one or two nights.
If you smoke, plan to quit at least one month before your surgery and not to resume for at least one month after your surgery.
Avoid overexposure to the sun before surgery as this can worsen the appearance of scars.
If you have been trying to lose weight, avoid starting on a strict diet prior to the procedure, as this can inhibit your ability to heal.
Note: If you develop a cold or infection of any kind the week prior to surgery, your surgery will be postponed.
To avoid constipation, we recommend that you cleanse your bowels with a laxative two days prior to surgery. This can be with prune juice or an over-the-counter laxative. Following this routine, drink a lot of fluid the next day to keep well hydrated.
Avoid eating large or “heavy” meals for several days prior to surgery. You should also have an over-the-counter stool softener available to take immediately after surgery.
Please arrange for someone to drive you to the surgery and to drive you home after your surgery. Also, you will need someone to help you out for the first week following the procedure. Do not expect to be able to drive yourself for up to two weeks following surgery.
Following abdominoplasty procedures, most Maryland tummy tuck patients have moderate discomfort the first 48-72 hours, decreasing rapidly thereafter. The degree of discomfort depends largely on the extent of surgery required to reshape your abdomen and your personal pain tolerance. We will prescribe medication to keep you as comfortable as possible. Your abdomen will feel tighter as the result of the procedure. The feeling of tightness will decrease over 1-3 weeks as swelling abates and the tissues become accustomed to their new position.
It’s important to be up and about the day following your procedure. How much activity we recommend depends upon the specific procedure required to reshape your abdomen.
We encourage you to be active, but to adhere to the limitations we prescribe. To assure the best result and to prevent damaging the reshaped areas, we will tailor your activity accordingly.
It may take up to a year for the body to completely adapt to the new abdominal configuration. With proper diet and exercise the striking results of the surgery will be long lasting.
Baltimore, Maryland tummy tuck patients may also benefit from liposuction, a procedure that can help remove fatty deposits that are unresponsive to dieting and exercise. Baltimore liposuction patients enjoy a slimmer figure and a more sculpted physique. To learn about how Dr. Summers has helped Annapolis and Baltimore, Maryland liposuction patients achieve a tighter figure, please visit our liposuction page. Other body contouring procedures Dr. Summers might perform in conjunction with tummy tuck include body lift and breast augmentation in Maryland. Please explore the respective pages to learn more about these treatments.