Tummy Tuck, - performed by Dallas Cosmetic Surgeon Dr. Fred Hackney

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A tummy tuck is the surgical procedure designed to firm and smooths the abdomen. The tummy tuck procedure removes excess fat and loose skin from the abdomen and tightens the abdominal wall. The result is a flatter, tighter abdominal profile.

You might be a good candidate for a tummy tuck if you have loose, sagging abdominal skin that is out of proportion to the rest of your body, abdominal muscles that have been weakened by pregnancy, aging, or excess fat concentrated beneath abdominal skin.

The tummy tuck is performed by placing the incision just above the pubic area and extends to each side. How long the incision is depends on the amount of skin to be removed.

In a mini tummy tuck, only the loose skin below the navel is removed. Since less skin is removed the scar is shorter than a full tummy tuck and is only a little longer than the typical hysterectomy scar. In addition to removing the loose skin, the muscles below the navel are tightened, thereby flattening the lower abdomen.

In patients with loose skin above and below the navel, a full tummy tuck is necessary. Because there is more skin removed, the scar is longer and extends further to each side. Underlying muscles extending from the upper abdomen to the pubic area are tightened by pulling them together and stitching them in place, which flattens the upper and lower abdomen. A full tummy tuck also requires an incision to be made around the navel. Although the navel position is unchanged, there will be a small scar around it.

Dr.  Hackney performs the “no drain” tummy tuck.  In a traditional abdominoplasty, the skin is detached from the underlying abdomen muscles.  The skin is stretched down to the lower abdomen, where the excess skin is removed and the incision is stitched closed.   The skin is not reattached to the muscles, leaving a large area under the skin that seeps fluid.  Drains, which are plastic tubes, are placed under the skin to drain off the fluid that collects under the skin.  The drains come out through the skin in the pubic area, which can become irritated and painful.  These drains attach to small plastic bulbs that collect the fluid.  The patient has to empty the bulbs on a regular schedule until the fluid almost stops draining out.  This usually takes one to two weeks, and then the drains can be removed.

The “no drain” tummy tuck is called this because dissolving stitches are used to reattach the skin to the muscles, decreasing the need for the drains.  The stitches are under the skin and not visible.  Imagine quilting sutures holding the undersurface of the skin the muscles together.

This technique, also called quilting sutures or progressive tension sutures, was originally published in a plastic surgery journal in 1998 as a method to decrease the possibility of fluid collecting under the skin.  This is called a seroma.   Since then other surgeons have gained experience with this technique and have improved it.  While not having the drains is an obvious benefit from a convenience standpoint and it is easier to get up and walk around, there are other important benefits.  The possible benefits are decreased chance of a bleeding under the skin, decreased problems with the skin healing, and better scars.  Not all patients are suitable for this technique.  Dr. Hackney will examine you and determine the quilting sutures would be right for you.

Dr. Hackney will evaluate you during your consultation and discuss which type of tummy tuck would best suit you.

Depending on the extent of your surgery you may choose to spend the night of surgery in the hospital or surgery center in Dallas. Most patients prefer to be asleep during the procedure. The first week following a tummy tuck, you will not be able stand up straight because your skin will be tight. This will gradually loosen up and you will be standing and walking normally in one to two weeks after surgery. You will be wearing a compression garment for a few weeks after your tummy tuck. You will be able to return to non-strenuous work in two to three weeks and return to your regular exercise program four to six weeks after your surgery.

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