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Tummy Tuck

Tummy Tuck

Tummy Tuck

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A tummy tuck, or abdominoplasty, is a surgical procedure that reduces excess skin and fat on the abdomen. Aging, significant weight loss, and pregnancies can have a dramatic effect on the appearance of our midsections. Patients that want a firmer, smoother abdomen can achieve sculpted results that are long-lasting, and incisions that are discreetly hidden post-surgery. After all, diet and exercise won’t have an effect on skin that has been stretched past its limit. Furthermore, this is often the only solution for those suffering from diastasis recti, which commonly occurs when the abdominal muscles separate during pregnancy. During a tummy tuck, surgeons can tighten and repair these muscles so that patients have improved core strength, a flatter midsection, and relief from the other uncomfortable symptoms that accompany this condition. If you’re not seeing the abdomen you once had, or want a fresh start with a flatter and firmer belly, you may be a good candidate for a tummy tuck.  

3 month follow up tummy tuck with lipoThis lovely patient had received a tummy tuck with circumferential liposuction and rectus muscle tightening ( or plication ). using local anesthesia IV sedation and removed 3.2 liters using tumescent assisted liposuction The tumescent local anesthesia had several benefits. First, It blocks the pain signals to the brain during surgery keeping the surgery painless, but also allows the brain to receive those signals slowly after surgery. The brain in turn is less likely to sensitize the surgical area yielding a less pain profile compared with the same surgery performed under general anesthesia. The second benefit is that tumescent fluid has an epinephrine an agent shut down local blood vessels and dries the tissues from blood during surgery, causing less blood depositing and minimize the risk of necrosis The third benefit is that fluid infiltration into tissues also diminishes the risk of ischemia to the flap and allows better wound healing. A Good Liposuction of love handles and flanks seen in these photos allows a restoration of the internal bony structure and the natural curves of the hip and the waistlines. Liposuction of the abs keeps the flap thin and decreases the metabolic demands of the tissues, which also improves the quality of wound healing. In Addition, It allows a similar thickness to both edges, giving it a natural transition, avoiding the ridging or step off effect that I often see in patients who received a tummy tuck without adequate liposuction.of the abs, love handles but no flanks.

My name is Dr. Obaid Batal, and my patients receive world-class care and benefit from specialized techniques and many years of experience. To learn more about what sets Body by Batal apart, schedule a personal consultation. Call (310) 230-5911 to reach my offices in Beverly Hills or Tarzana or fill out our online inquiry form to get started.

Before and After Photos

About Tummy Tucks

In 2020, abdominoplasty was the eighth most frequently performed cosmetic surgery procedure in the United States, with a total of 97,988 cases. [1]

Tummy tucks are performed using a horizontal incision that is placed just above the pubic area between the hip bones and another that encircles the navel. However, I find that in most cases this additional incision can be avoided for specific patients. Once I have access to the underlying abdominal tissues, I remove excess fat and skin, correct the muscle laxity and redrape the skin of the midsection for smooth, firm results.

In order to achieve the best body contouring, or who have unwanted fat deposits, a tummy tuck can and also should be combined with liposuction in a procedure referred to as a lipo abdominoplasty [2] to sculpt ideal contours for the abdomen. A lipo abdominoplasty eliminates troublesome areas of fat on the flanks, and the love handles.

How Can I Get Rid of Stubborn Belly Fat?

Fat on the abdomen is notoriously hard to eliminate, and although many patients that opt for a tummy tuck have undergone massive weight loss, there may be some deposits of fat that are resistant to diet and exercise. I frequently perform liposuction during tummy tuck surgeries, and the combination of these procedures offers considerable advantages! The major benefit from that is to equalize the thickness of the upper abdomen and the groin area so the incision will not appear as a step, and the level above and below the incision is even. It also gives a great cosmetic appearance which reveals the contours of the corrected muscle evident by the pictures you see in the photos.

Tummy Tuck Benefits

A tummy tuck can provide physical and emotional benefits. The surgery can be a great option for those who have:

  • Lost a significant amount of weight
  • Given birth
  • Want to improve the overall appearance of their midsection

Abdominoplasty can also increase self-confidence and self-image. People who have had a tummy tuck often report feeling more comfortable in their clothes and being more confident with their body. The most obvious benefit of a tummy tuck is an improved physique, but having restored core strength means additional benefits go beyond a flatter stomach!

By plicating the abdominal muscles, and repairing the effects of diastasis recti, abdominoplasty can also be the solution to a number of medical issues. 

  • It can help with back pain and discomfort [3]
  • It can assist with any bladder or bowel issues associated with lax abdominal muscles [3]
  • It can also help reduce the incidence of hernias, which can be painful and potentially dangerous.

Lastly, a tummy tuck can help with long-term health, specifically with patients who are receiving abdominoplasty to remove significant amounts of loose-hanging skin that gets in the way when they move. With increased mobility, patients can more easily exercise, which will reduce the risk of obesity and related diseases like cancer in women. [4] 

The most advantage I personally see is the improved confidence and a patient that is at peace with their body image, which often leads to the patient starting to focus on the essential core of his or her health. It is exactly what happens in the broken window theory. Once the window is repaired, the people will resume treating the building with care, and that is exactly what happens when the patient restores the abdomen and midsection shape. 

Candidates for Abdominoplasty

Tummy Tuck in Los Angeles | Body by Batal

If you are someone who has a previous pregnancy and or recently lost a significant amount of weight and has loose, hanging abdominal skin you may be a good candidate for a tummy tuck. Candidates for abdominoplasty are in good general health, at a stable weight, and non-smokers. Female candidates should also have finished having children, as future pregnancies can affect the results of this surgery. There are a few exceptions to that. If a patient hasn’t had any children yet but wants to, or may want more children, loose skin or a “pooch” may affect her ability or confidence to engage in a romantic relationship, and create the family she desires. I would also perform a tummy tuck for the pure merit of restoring her shape since she may not become pregnant for several years, or is undecided as to whether she wants to have more children. In that case, the tummy tuck is usually done without correcting the rectus diastasis, oblique muscle diastasis, or the muscle laxity.

Candidates for a tummy tuck should be comfortable knowing that although the scar may be easily concealed under the bikini line, it does require an incision that will leave a mark. Furthermore, candidates should be able to commit to a recovery period, which may require help from family members or close friends. If you feel you might be the ideal candidate for this procedure, schedule a consultation!

Personal Consultation

During our personal consultation, we will meet in a private consultation rooms, where together, we’ll discuss:

  • Your medical history, and whether you’ve had any prior surgeries
  • The medications you take
  • Your desired outcomes for surgery

After listening to your goals and getting a better understanding of your unique needs, you can expect my honest recommendation for the best course of action, whether that be liposuction, a tummy tuck, a combination of the two, or another procedure entirely. Your personalized treatment will be designed with safety as a priority, while also giving you the natural-looking results you desire. We will go over the procedure in detail, so that you have a good understanding of the surgery, know what exactly happens during the operation, and what to expect during your recovery.

Preparing for Surgery

Though abdominoplasties are routinely performed, they are still major surgeries and they require careful preparation. Be sure to follow all the instructions that my staff and I give you over the weeks leading up to the date of your surgery.

  • First, if you smoke, we ask that you stop several months before and after the operation. Smoking causes a decrease in blood flow and increases tissue damage which can be detrimental to the healing process. We often perform a nicotine level test before surgery for specific cases and may be doing it routinely for all patients regardless of their recorded history.
  • Medications like aspirins, and anti-inflammatory drugs are usually allowed to be continued, although a portion of surgeons will opt to stop those medications several days before the surgery due to the theoretical increase in the risk of bleeding. I personally believe that the risk is negligible and that I choose to deal with those medications on a case-by-case basis. Herbal supplements should be avoided before surgery.
  • Also, we ask that you maintain a stable weight before and after the operation. This stable weight should be roughly the same over the last 12 months. In fact, I encourage patients to lose weight before surgery to maximize the flattening effect of the surgery and decrease the pressure underneath the muscle repair by melting the visceral fat. If more weight is gained after the operation, then the results of the procedure may be diminished.
  • Finally, we ask that you make arrangements for a ride home after your procedure, and have a responsible and trusted adult stay with you for at least 24 hours after your surgery.

What to Expect on the Day of Your Tummy Tuck

The day of your surgery has arrived. I will meet with you and go over the procedure and answer any last-minute questions you have before anesthesia is administered. A board-certified anesthesiologist or licensed nurse will administer local anesthesia combined with IV or oral sedation in order to keep you comfortable. General anesthesia is still available for patients that prefer or require it. Using local anesthesia with sedation rather than general anesthesia has a number of significant benefits, including fewer risks. The local anesthesia keeps patients numb long after the procedure has ended, meaning they stay comfortable during the most challenging part of their recovery. There is collective evidence of decreasing postoperative pain using local anesthesia with sedation which blocks the brain from sensitizing the areas of surgery. The brain is usually responsible for creating pain after receiving the signals from the body parts receiving surgery. If the treated part, in this case, the abdomen and the flanks, is anesthetized, they will produce low input signals. The brain will interpret those signals more benign and the patient will feel less pain.

I frequently perform a high volume of tumescent fluid-assisted liposuction during a tummy tuck. Because the tumescent fluid used during liposuction and other surgical procedures contains epinephrine, which constricts blood vessels, along with lidocaine and saline. Saturating the tissues with these fluids will decrease the risks of bleeding and also minimize the risk of necrosis adding an extra layer of safety to the procedure. 

Furthermore, it:

  • Minimizes bleeding, bruising, and swelling
  • Reduces the risk of ischemia
  • Allows patients to avoid the after-effects of general anesthesia such as nausea and constipation
  • Maintains tissue health during the operation

Once the anesthesia has taken effect, I will begin your surgery according to the treatment plan we discussed during your consultation. It usually starts with liposuction of the love handles and flanks, then the abdomen. Fat transfer to the hip could also be performed after harvesting the fat, which will be kept in sterile conditions until injection.

After I’ve made the preliminary incision just above the pubic area, the abdominal skin will be separated from the underlying layers of tissues using a process known as undermining. Patients that receive liposuction during their tummy tuck require less undermining during this stage, which allows for a quicker procedure and a faster recovery. Once I have access to the underlying tissues, I can address the abdominal muscles, placing sutures to repair the muscles. My special techniques not only bring the muscle together horizontally but also shorten the elongated muscle adding an extra flattening effect. The incisions are designed to be very low to be covered by the bikini line. The incision around the navel allows it to remain in place as the flap is lifted. After other necessary adjustments are made, the abdominal skin is redraped, excess skin is removed, and the incision is sutured shut. A new opening is made for the navel so that it remains in its original location. It is essential for the surgeon to know what could cause a wide scar and avoid it. The most common cause is the tension of the wound. Therefore, the tension should be gradually taken off the main wound by adding sequential tension sutures in the upper and mid abdomen. The deep layers of the wound, called Scarpa’s fascia should absorb the tension and should also be fixed to the deep abdominal wall fascia. When the surgeon does that, the skin closure will only have minimal to no tension, allowing a nice thin scar. Obviously, meticulous techniques in skin closure will play a part in the cosmetic appearance of the wound.  

Drainless Abdominoplasty

I perform drainless abdominoplasties when applicable. This specialized technique results in less fluid buildup, so that patients aren’t required to care for drains as they heal. While this may not be the best option for every patient, it offers significant advantages and a much more comfortable recovery.

Once the surgery is complete, my surgical team will dress the abdomen in a surgical wrap. You should wear your wrap, or any compression garments, until you are instructed otherwise.

We will observe you as the anesthesia wears off and when you are ready, you can go home with a friend or family member at the wheel. Let the healing begin! 

Recovery

After the procedure, you must avoid any strenuous activity for the next six weeks. Recovery speed varies from person to person based on age, body type, and previous medical history, so it is essential not to rush your recovery. Nevertheless, patients are able to begin taking short walks immediately after returning home. This promotes good blood circulation that will speed along the healing process. 

The residual effects of the local anesthesia along with a prescription for pain medication will ensure that you remain comfortable during the few days of your recovery. A compression garment will be given to wear for six weeks to keep the treatment area protected and reduce swelling.

After Your Abdominoplasty

Our warm welcoming staff will be here to support you throughout your recovery. You’ll return to our offices for regular follow-up appointments so that I can monitor your progress. Once you’ve completed your recovery, you’ll be able to look forward to a smooth, flat stomach, free of excess skin. Over the next few months, it is still important not to aggravate the incision area. You’ll be given instructions on how to care for your incision so that scarring is kept to a minimum. Remember that it is imperative to maintain a stable weight and a healthy diet, because a change in weight can impact the results of a tummy tuck.

What is the Cost of a Tummy Tuck in Los Angeles?

The cost of your abdominoplasty will depend on the details of your procedure, which we will discuss during the consultation. After the consultation, you can expect a detailed overview of the cost of your personalized procedure and first-class care. The range of cost will depend on the number of treated areas with liposuction like the abdomen, love handles and flanks. It also depends on your weight and height, and any previous scarred areas caused by previous surgery. However, the average cost is between $10,000 -$16,000. In rare circumstances where liposuction is not needed and there are no existing scarred tissues, the cost could be as low as $8,000. Mini tummy tuck is also offered which includes removing the skin from the lower abdomen only, and so no incision around the umbilicus is needed. This ranges from $3,000 – $6,000. It should be taken into account that only a few patients are good candidates for a mini tummy tuck.

Don’t let your abdomen keep you from enjoying everything life has to offer. Call (310) 230-5911 or contact us online today!

References

  1. American Society of Plastic Surgeons. PLASTIC SURGERY STATISTICS REPORT 2020.; 2020. https://www.plasticsurgery.org/documents/News/Statistics/2020/plastic-surgery-statistics-full-report-2020.pdf

  2. Flores González EA, Pérez Chávez F, Ramírez Guerrero OR, Gracida Mancilla NI, Vázquez Apodaca RA. A New Surgical Approach to Body Contouring. Plastic and Reconstructive Surgery – Global Open. 2021;9(5):e3540. doi:10.1097/gox.0000000000003540

  3. Taylor, D. Alastair F.R.A.C.S.(Plast.); Merten, Steven L. F.R.A.C.S.(Plast.); Sandercoe, Gavin D. F.R.A.C.S.(Plast.); Gahankari, Dilip F.R.C.S.(Ed.), F.R.A.C.S.(Plast.); Ingram, Scott B. F.R.A.C.S.(Plast.); Moncrieff, Nicholas J. F.R.A.C.S.(Plast.); Ho, Kevin F.R.A.C.S.(Plast.); Sellars, Graham D. F.R.A.C.S.(Plast.); Magnusson, Mark R. F.R.A.C.S.(Plast.). Abdominoplasty Improves Low Back Pain and Urinary Incontinence. Plastic and Reconstructive Surgery 141(3):p 637-645, March 2018. | DOI: 10.1097/PRS.0000000000004100

  4. Terry PD, Miller AB, Rohan TE. Obesity and colorectal cancer risk in women. Gut. 2002;51(2):191-194. doi:10.1136/gut.51.2.191

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