Have you ever stood in front of a mirror holding in your tummy and wishing it was flat? A tummy tuck (abdominoplasty) may be the answer. A tummy tuck is designed to give the abdomen a firm and smooth appearance. The excess skin and fat are removed to improve the abdominal contour. A tummy tuck also will serve to tighten the abdominal muscles and trim the waistline. The best candidates are men and women who have excess fat and loose skin or muscle of their abdominal wall, from pregnancy or weight loss, despite diet and exercise. The incision at the lower part of the abdomen can be hidden in the bikini line or underwear.Schedule Your Consultation
|Pain Level After Surgery
|Duration of Surgery
|Lower abdomen, from hip to hip, and around the belly button
|Return to regular activity
An initial consultation is set-up where we discuss the tummy tuck procedure, and whether you are a good candidate for the surgery. Your medical history is reviewed, and you will be asked to see your medical doctor for a physical check-up and a few labs to make sure you can undergo the surgery safely. You are given the opportunity to be seen by your own doctor to give the green light for surgery. You are asked to stop medications that cause bleeding, such as aspirin, or aspirin-like products (Motrin or Ibuprofen), a week before this procedure. You are asked to stop smoking two weeks before and two weeks after surgery, for the surgery to be performed safely, and for you to have optimal results. You are given the opportunity to talk to patients who have had the same surgery you are considering. We will see you shortly after the surgery (in a day or two usually). You are seen regularly after your surgery. You are always welcome to come back for follow-up, even years after your surgery, free of charge.
Patients who are not happy with the way their tummy looks may benefit from one of several procedures:
Tummy Liposuction: For people with tight skin and good muscle tone but an extra amount of fat. Some people requesting a tummy tuck may be better candidates for liposuction. The advantage is a quicker recovery period, and avoidance of the lower abdominal scar. A special form of abdominal liposuction is the creation of a six-pack abdomen with abdominal etching to showcase the abdominal muscles after the fat around them has been liposuctioned.
Level I Mini Tummy Tuck: For people with good muscle tone, minimal fat, and good skin tone above the belly button, but loose skin below the belly button. Excess skin below the belly button is excised. This procedure takes about two hours and is typically done under general anesthesia. An incision is made hip to hip, excess skin is excised, minimal liposuction is performed and muscles are tightened, if necessary.
Level II Abdominoplasty: For people with loose muscle tone, extra abdominal fat, and loose skin above and below the belly button. Excess skin is excised, abdominal muscles are tightened, and excess fat is liposuctioned from the abdomen and flanks. The procedure takes about two to three hours on average, and it involves making an incision in the lower abdomen, from hip to hip and around the belly button, elevating the skin and fat flap up to the ribcage, and removing the excess skin without injuring the belly button. As the skin and fat flap is elevated, the abdominal muscles are tightened to create firm abdominal muscles. By tightening the muscles, a nice waistline is formed. Next, the skin is closed leaving a scar in the lower abdomen and one around the belly button. The flanks, or sides, are liposuctioned, if needed, further enhancing the patient’s waistline. The end result is a firmer, more aesthetically pleasing abdomen.
Level III Abdominoplasty: For people with loose muscle tone, loose skin above and below the belly button, and a larger amount of fat of the abdomen and flanks. The incision may have to be extended around the flanks or an inverted “T” incision. This procedure can be thought of as an exaggerated tummy tuck- more skin is removed, more fat is removed, and more significant muscle tightening is accomplished. This procedure takes three to four hours. It involves making an incision in the lower abdomen, from hip to hip and around the belly button, elevating the skin and fat flap up to the ribcage, and removing the excess skin without injuring the belly button. As the skin and fat flap is elevated, the abdominal muscles are tightened to create firm abdominal muscles. Next, the skin is closed leaving a scar in the lower abdomen and one around the belly button. The flanks, or sides, are also liposuctioned. The scar is around the belly button and from hip to hip extending to the flanks, and possibly including a vertical abdominal scar as well.
At the Bitar Cosmetic Surgery Institute, we take pride in making sure we provide for our patients the best surgical experience possible, anticipating problems or set-backs, and addressing them before they happen. This is a process that includes the pre-operative preparation, the actual surgery, and the after care.
General complications can occur with any surgery. Cosmetic surgery is usually a safe surgery performed on healthy patients and, as all surgeries go, is with low risk. What we do to even lower the risk of complications is to operate at a first class surgery center with board certified anesthesiologists and nurses. To avoid post-operative complications, we advocate early mobilization –patients seen in our office one or two days after surgery- and active participation in their own post-operative care. When we create a partnership, the results invariably improve.
Bleeding after a tummy tuck is rare. Before surgery, our patients are tested to make sure they don’t have any common bleeding disorders by their own physicians, and by lab tests. The use of tumescent solution before liposuction of the abdominal flanks, if it is performed during a tummy tuck, minimizes bleeding. Also, at the end of the operation, two drains are placed under the skin to manage any early post-operative bleeding. In our practice the rate of significant bleeding is less than 1%. The treatment of a hematoma or a blood clot under the abdominal skin is to open the incision and remove the blood clot. Typically, this is a straightforward procedure.
The most important step in avoiding infections/wounds, in my opinion, is to perform the surgery at a first-rate surgical facility with board certified anesthesiologists and nurses. Patients are given the appropriate intravenous antibiotics coverage throughout the surgery. During the surgery, the skin surface of the patient is cleaned properly. After the procedure, our patients are prescribed antibiotics to minimize infection. As a result of these extra precautions, our rate of infection after a tummy tuck is extremely rare. Conservative removal of skin is important for the results to be good, but also so that the skin is not under too much tension after tummy tuck. Wound healing problems may occur at the superficial incision level where the tension is highest, in the lower mid-abdomen, and a small open wound may occur which will usually heal nicely with dressing changes and antibiotic ointment.
By elevating the skin in the abdomen to perform a tummy tuck, the nerves that provide sensation to the abdomen are cut, and sensation over most of the abdomen, especially the lower portion, is lost for months. After a year, sensation usually returns, but not completely. This fact is significant for patients to understand so that they will not put heating pads or cold compresses on their abdomen after surgery because with nerve sensation absence, a burn may occur.
Smoking is an absolute contraindication in tummy tuck. The carbon monoxide and nicotine in cigarette smoke causes severe reduction in blood supply to the skin and tissue during healing. This results in delayed wound healing, wound separation, death of the skin, and a higher risk of infection. Cotinine testing is performed in patients with a smoking history to ensure that they are safe when having this procedure.
Our office will provide a comprehensive post-operative plan to ensure the best possible outcome. The plan will include what to expect postoperatively, such as estimated recovery time, pain management, garments or dressings, and anticipated activity level. For your safety, we require that an adult stay with you at least the first 24 hours after surgery and drives you to your next day follow-up visit. With most procedures, you will be instructed to limit activity for the first week or two, which could include restrictions on driving, prolonged travel and flying. In addition, we ask you refrain from exercise until cleared by the physician, usually around four weeks post-op. You are asked to refrain from smoking for a minimum of two weeks. To optimize healing, we recommend that you eat a high protein diet. You should anticipate a variable degree of bruising and swelling, as with any surgical procedure; light make-up may be used to cover bruises starting a week after surgery. We also offer scar creams at an additional cost to optimize results.
To promote healing and minimize complications, you will be seen in a series of post-op appointments, including the day after surgery. These appointments will continue throughout the first year after the procedure to make sure you are healing as planned. For your added convenience, you also have direct access to Dr. Bitar’s cell phone number if you need to reach him after hours. The final post-op visit, one year after surgery, is one of our favorites since the results are fully apparent and we love seeing our patients happy. You are always welcome to come back and see us, even years after your surgery.Schedule Your Consultation
At the Bitar Cosmetic Surgery Institute, we take pride in providing our patients with the best surgical experience possible, emphasizing patient safety while trying to optimize surgical results. This is a process that includes comprehensive pre-operative preparation and patient education, the development of a personalized operative plan, and a thoughtful post operative care regimen emphasizing patient comfort and promoting recovery.
There are a number of strategies which the Institute has adapted to further ensure patient safety. We are selective and only offer surgery to patients whose general health and lifestyle choices permit healing and facilitate recovery. To minimize risk, we require a preoperative assessment that includes a thoughtful history and physical exam, as well as targeted laboratory tests.
We operate at accredited hospitals and surgicenters that have demonstrated a commitment to the highest standards of care, employing board certified anesthesiologists and nurses. We adhere to well established surgical principles designed to ensure patient safety and have developed policies and protocols to minimize the risk of infection. Dr. Bitar is committed to continuing education, honing his skills and introducing new techniques always with the aim of improving safety and surgical results.
We emphasize patient safety in our peri-operative care plan, advocating early mobilization, optimizing nutrition, and providing detailed care instructions. After surgery, patients are seen in our office frequently and early, starting the day after their procedure, and a staff member is available around the clock for any questions or concerns. Our entire team is committed to our patients’ well being and every measure is designed to minimize potential complications, promote comfortable and rapid recovery, and optimize surgical results.
Our commitment to excellence and exceptional patient care is in every step of your doctor-patient experience. Dr. George Bitar is a distinguished board certified plastic surgeon who stays on the cutting edge of advancements in cosmetic surgery and technology to offer the best possible results. With a blend of artistry and meticulous surgical technique, he is able to achieve beautiful and natural results for our patients. We provide a high level of patient safety and our experienced and caring staff will be with you every step of the way. Our institute offers a wide variety of surgical and non-surgical options, from skin care, injectables and lasers to in-office or hospital options, to provide a versatile approach to fit individual patient needs. Your aesthetic goals are our priority and each procedure is customized to ensure you receive the best possible outcome.
For more information, call our office at 703-206-0506.
Content on this website is for information only and should not be used to diagnose or treat your plastic surgery or cosmetic surgery problems. Please contact your plastic surgeon with all questions and concerns.
If you would like further information regarding this procedure, please feel free to contact our office to schedule an appointment by calling (703) 206-0506 or filling out an online request form.