Here in Brazil, we call the Tommy-Tuck surgery as Abdominoplasty. This cosmetic procedure treats loose or sagging abdominal skin, leading to a protruding abdomen that typically occurs after significant weight loss. The ideal candidates for abdominoplasty are individuals in good health who have one or more of the above conditions and who have tried to address these issues with diet and exercise with little or no results.
Women who have had multiple pregnancies often seek abdominoplasty as a means of ridding themselves of loose abdominal skin. While in many cases diet and exercise are sufficient in reducing abdominal fat and loose skin after pregnancy, in some women these conditions may persist.
Another common reason for abdominoplasty is to remove excess skin from a person who has lost a large amount of weight or is obese. A large area of overhanging skin is called a pannus. Older patients are at an increased risk of developing a pannus because skin loses elasticity as one ages. Problems with hygiene or wound formation can result in a patient who has multiple hanging folds of abdominal skin and fat. If a large area of excess tissue is removed, the procedure is called a panniculectomy.
The patient is usually placed under general anesthesia for the duration of surgery. The advantages to general anesthesia are that the patient remains unconscious during the procedure, which may take from two to five hours to complete; no pain will be experienced nor will the patient have any memory of the procedure; and the patient's muscles remain completely relaxed, lending to safer surgery.
The skin will be lifted off the abdominal muscles from the incision up to the ribs, with a separate incision being made to free the umbilicus (belly button). The vertical abdominal muscles may be tightened by stitching them closer together. The skin is then stretched back over the abdomen and excess skin and fat are cut away. Another incision will be made across the stretched skin through which the umbilicus will be located and stitched into position. A temporary drain may be placed to remove excess fluid from beneath the incision (for 1 week). All incisions are then stitched closed and covered with dressings.
In some cases, additional procedures may be performed during or directly following abdominoplasty. Liposuction, also called suction lipectomy or lipoplasty, is a technique that removes fat that cannot be removed by diet or exercise. During the procedure, which is generally performed in an outpatient surgical facility, the patient is anesthetized and a hollow tube called a cannula is inserted under the skin into a fat deposit. By physical manipulation, the fat deposit is loosened and sucked out of the body. Liposuction may be used during abdominoplasty to remove fat deposits from the torso, hips, or other areas. This may create a more desired body contour.
Some patients may choose to undergo breast augmentation, reduction, or lift during abdominoplasty. Breast augmentation involves the insertion of a silicone-filled implant into the breast, most often behind the breast tissue or chest muscle wall. A breast reduction may be performed on patients who have large breasts that cause an array of symptoms such as back and neck pain. Breast reduction removes excess breast skin and fat and moves the nipple and area around the nipple (called the areola) to a higher position. A breast lift, also called a mastopexy, is performed on women who have low, sagging breasts, often due to pregnancy, nursing, or aging. The surgical procedure is similar to a breast reduction, but only excess skin is removed; breast implants may also be inserted.
