Tummy Tuck & Fleur-Di-Lis Abdominoplasty

University of Washington Trained Plastic Surgeon Dr. Ludwig Allegra Body Contouring Specialist

Learn About Body Contouring:

Just like these people you are about to read about, You can have these same positive changes in your life. As people who specialize in the beauty industry, we know how important beauty is. In life, the little things can make a big difference and Beauty gives people so many advantages. A Tummy Tuck could be that procedure that brings more beauty to you and with that the little edge in life to help you get what you want out of life. The abdomen is a common area of concern for many, whether its after having children or from weight loss your physique can dramatically be improved with a tummy tuck procedure.

It is our Mission to take care of you like our closest friends and family. We will spend all the time we need to come up with a tailored plan just for you. Ultimately, through our Team approach, we want you to feel as confident as possible about your treatment plan. Our office will do everything we can to help you every little step of the way..

More on Abdominoplasty | Tummy Tuck:

A Tummy tuck surgery is also known as an Abdominoplasty. This procedure removes excess fat, skin and tissue to create a smoother contoured abdomen area. The abdominal muscles are also tightened underneath to further reshape and correct weakness they may have occurred from previous factors like pregnancy. Many times, diet and exercise will not bring back the flat, contoured abdomen and stomach that you used to have when you were younger or something you never had. Here are some common causes of that can lead to loose skin and sagging abdomen: Aging, Genetics, Pregnancy, Prior surgery, Significant weight gain followed by weight loss, trauma, congenital conditions etc.

Fleur-Di-Lis Tummy Tuck | Abdominoplasty:

The Fleur-Dis-Lis Abdominoplasty is a variation of a tradiontal tummy tuck where the incision is just about the mons area and curves to the sides. This is an additional incision which is perpendicluar to the traditional incision and meet at the bottom and up top is near the breast bone. This technique is sometimes necessary in those with a large amount of excess tissue to be removed. This will be required to contour the waist into a more hour glass shape.

Reverse Tummy Tuck:

The Reverse tummy tuck involves an incision under the breast in the creases underneath breasts that connect in the midline. This technique is sued to remove the excess tissue thats is higher up on the abdomen. Excess skin this high up cannot be removed with a traditional approach. The is type of oncision is not common and Dr. Allegra will determine whether this is neccessary during your tailored approach consultation.

Click here for actual Tummy Tuck Abdominoplasty Before and After Pictures of someone 2 weeks after her procedure.

A Tummy Tuck | Abdominoplasty is not a substitute for weight loss or an appropriate exercise program. You should always do this for your general health. Again, sometimes you can exercise and lose weight to the maximum degree and still not remove the unwanted skin and tissue that is sometimes left from the conditions above.

More on being a Tummy Tuck Abdominoplasty Candidate:

Am I a Candidate for the Tummy Tuck | Abdominoplasty Procedure? This is a great question. Briefly, these are some of the things that we will consider below:

1. Generally you want to be in fairly good health. You should not have major medical problems that affect your daily life and regular functioning.
2. You should be psychologically fit and have realistic expectations about the procedure.
3. You should not smoke 2-4 weeks before your procedure and after.
4. You should have some sense that you do not like your stomach area.
5. You should have physical evidence that would suggest a tummy tuck | abdominoplasty will help your situation and likely alleviate some of the dislike you have towards your stomach | abdominal area.

From a Health Perspective: The American Society of Anesthesiologists have a classification system below. Typically, we operate on patients that are ASA PS 2 and 1:

1. ASA PS 1 Normal healthy patient No organic, physiologic, or psychiatric disturbance; excludes the very young and very old; healthy with good exercise tolerance
2. ASA PS 2 Patients with mild systemic disease No functional limitations; has a well-controlled disease of one body system; controlled hypertension or diabetes without systemic effects, cigarette smoking without chronic obstructive pulmonary disease (COPD); mild obesity, pregnancy
3. ASA PS 3 Patients with severe systemic disease Some functional limitation; has a controlled disease of more than one body system or one major system; no immediate danger of death; controlled congestive heart failure (CHF), stable angina, old heart attack, poorly controlled hypertension, morbid obesity, chronic renal failure; bronchospastic disease with intermittent symptoms
4. ASA PS 4 Patients with severe systemic disease that is a constant threat to life Has at least one severe disease that is poorly controlled or at end stage; possible risk of death; unstable angina, symptomatic COPD, symptomatic CHF, hepatorenal failure
5. ASA PS 5 Moribund patients who are not expected to survive without the operation Not expected to survive > 24 hours without surgery; imminent risk of death; multiorgan failure, sepsis syndrome with hemodynamic instability, hypothermia, poorly controlled coagulopathy
6. ASA PS 6 A declared brain-dead patient whose organs are being removed for donor purposes

From a health standpoint, you will be assessed by our nurse, doctor, and the certified registered nurse anesthetist or board certified anesthesiologist. Typically, if you are over 50 we will get a medical risk assessment. If you have some major disease issue such as diabetes, hypertension, smoking history, etc we will get a medical risk assessment over the age of 40 or younger. We will always go through a complete medical history and physical on your preop appointment and on the day of your procedure.

Factors that can lead to recurrence:

Fluctuations in weight can markedly affect your results. Although, the Tummy Tuck procedure is essentially a permanent correction those same conditions above can cause a recurrence for you if you are not conscious about avoiding factors that are you able to control. Hence, if you are planning on losing a significant amount of weight you should inform
Our Plastic Surgeon Dr. Allegra about this during your consultation. Depending on how much you will lose, Our Plastic surgeon Dr. Allegra may or may not decide to proceed with your Tummy Tuck | Abdominoplasty.

What if I have a hernia?

Ventral hernias (bulging through the abdominal wall) canoccur primarily (without previous surgery) usually near the umbilicus (belly button) or secondarily (after a previous surgery). If you do have a hernia it will likely need to be repaired. This repair may or may not require placement of a mesh at the time of your tummy tuck. During your consultation our Plastic Surgeon Dr. Allegra will examine your abdomen to see whether a hernia may be present.

Tummy Tuck Abdominoplasty with Hernia Repair Discussed:

Hernia can occur from previous abdominal surgery with open or laparoscopic. They can also occur naturally without any previous surgery. This usually occurs near the belly button (umbilicus) in the midline region. Hernias located on the sides of the abdomen or up higher in the abdomen are uncommon unless previous surgery has been done. In any case, if there is a hernia in the setting of tummy tuck it is usually repaired. This can be performed at the time of the tummy tuck procedure. Repair may consist of simple primary repair with sutures or if larger hernia defects are noted a mesh may be required to prevent recurrence of the hernia. During your consultation plastic surgeon Dr. Allegra will examine your abdomen for hernias and may order tests if necessary to further evaluate the situation.

Tummy Tuck and Drains

Commonly drains are used after a tummy tuck procedures. They may stay in 1-2 weeks depending on how much fluid is coming out of the drains. A tummy tuck can also be performed without drains. The drains are placed to handle the dead space underneath the skin that is created from the procedure. If the dead space is large fluid will accumulate in this space and be removed by the drains. When no drains are used this dead space is either minimal for example a “smaller tummy tuck” or quilting sutures may have been used to try to eliminate this dead space. Dr. Allegra can go through drain care and dead space in more detail during your consultation.

Tummy Tuck Recovery

Recovery from a tummy tuck is variable. In general you would like to have some time off for recovery. You will likely be in a semi flexed position after the surgery to prevent tension occurring on the incision. This tension can lead to a wide scar or possible wound separation. You may be in an abdominal binder or garment. You may have drains in place to drain any excess fluid that can occur during recovery. Dr. Allegra generally sees his patient the next day and tailors the recovery period based on how you are doing on follow up.

Is a tummy tuck right for me or do I just need liposuction? Do I need a body lift?

How much does a Tummy Tuck (Abdominoplasty) cost?

The total cost of surgery usually includes 3 main components;

1. Surgeon's fee
2. facility/Hospital fee and
3. Anesthesia fees.

Fees may be given to you as separate or all included. Price for procedures can vary based on many factors.

Local Complications of Tummy Tuck

Wound Dehiscence
This is where the incision line can separate. There is no infection per say but the edges of the wound are spread apart. This can be a superficial or deep separation. If it’s superficial; meaning just the skin or under the skin is involved, local wound care will likely solve the issue with time. However, separation can occur at deeper levels in the tissue this may require revision or more aggressive wound care techniques.

Wound Infection
Infection can happen with any surgery. Signs of infection include redness, pain, swelling, drainage or fever. Treatment can vary from oral antibiotics to IV antibiotics to surgical drainage or debridement.

Seroma and Abscess
These are sterile fluid collections or pockets that can form under the skin and subcutaneous tissue. This is not an infection or abscess. Signs include a swelling in the area that may be localized or span a larger area, ballotable (fluctuation when you press on the swelling like a fluid wave), and usually no pain. If the seroma becomes infected it is called an abscess (usually have pain associated). Small seromas may be treated with time and can resolve on their own. Larger ones may need drainage. Seromas if recurrent may need serial drainage or sclerosing agents to alleviate.

Nerve Pain
Nerve pain can occur secondary to plication of abdominal wall, direct injury or entrapment. Most of the time this pain is temporary and resolves on its own. Nerves associated with tummy tuck include the ilioinguinal nerve, the iliohypogastric nerve and the lateral femoral cutaneous nerve (meralgia parasthetica).  If nerve pain is severe or chronic diagnosis and treatment include local blocks to surgical intervention.

Venous Thromboembolism
The formation of blood clots in the legs with the possibility of travelling to the lungs (pulmonary embolism). This complication can be diagnosed with CT angiography of the lungs and or duplex venous ultrasound. Some symptoms include, leg swelling, leg pain, chest pain, anxiety, lightheadedness, shortness of breath. Treatment consists of anticoagulation.

Complications:

• Bleeding
• Infection
• Seroma
• Deep Vein Thrombosis (DVT)
• Wound breakdown
• Skin loss

Risks of the procedure are outlined above and will be discussed with you in detail at the time of your consultation. Our Plastic Surgeon Dr. Allegra encourages you to have questions ready and is always available to answer questions regarding your safety in terms of procedure and anesthetic risks.