By: Dr Elie F. GHARIOS

Even people who aren't fat sometimes have a lot of extra skin, especially after pregnancy or weight loss. The skin can be tightened up with a procedure called an abdominoplasty, popularly known as a "tummy tuck."

What happens during the procedure?

The procedure is usually performed under general anaesthesia and 3 to 4 days stay in the hospital.

In many patients the excess skin is all below the belly button. By making a short crosswise incision just above the pubic area and extending out toward the hip bones, it is easy to take out the excess and tighten up what is left. This technique is a minor tummy tuck and it take only an hour or two of operating room time.

When the extra skin is above the belly button as well as below it, all the abdominal skin must be pulled down and tightened. To avoid dislodging the belly button, it is left in its original position on the muscles and brought out later through a new hole in the skin. If the abdominal muscles are loose or separated, they can be repaired at the same time. This is called a standard tummy tuck or abdominoplasty and usually takes two to five hours, depending on the extend of work required.

What to expect post-procedure

The tummy tuck is an excellent operation with a low complication rate.

Drains are removed on the 3rd or 4th day and sutures 10 to 14 days after the operation.

The main potential problems are the scar around the belly button, which is usually minor but can be conspicuous, and the scar across the lower abdomen, which tends to widen but is usually concealed by a reasonable bathing suit.

How soon does normal life resume

For the first few days, your abdomen will probably be swollen and you are likely to feel some discomfort which can be controlled by medication.

Recovery to feeling like your normal self varies from patient to patient. If you start out in top physical condition with strong abdominal muscles, recovery from abdominoplasty will be much faster. Some people return to work after one to two weeks. Others take three to four weeks to rest and recuperate.

Exercise will help you heal better. Even people who have never exercised before should begin an exercise program to reduce swelling, lower the chance of blood clots, and tone muscles. Vigorous exercise, however, should be avoided until you can do it comfortably.

Your scars will evolve over the next six months to a year. Most of the changes will happen during the first few months. Tissue folds will tend to flatten. The scars will start out reddish in color and lighten over time. You will be given long term scar care instructions in our office to optimize their softening and improvement. Your active participation in this scar care will improve your chances to minimize these scars.

Your new look

Abdominoplasty, whether partial (mini tummy tuck) or complete, produces excellent results for patients with weakened abdominal muscles or excess skin. In most cases, the results are long lasting, if you follow a balanced diet and exercise regularly. If you are realistic in your expectations and prepared for the consequences of a permanent scar and a lengthy recovery period, abdominoplasty may be just the answer for you.