Abdominoplasty (a.k.a. Tummy Tuck). Is it for you?
By Anne Connor
Every day when my son comes home from school, I ask him the same question.
"So, what did you learn today?"
Some days he'll moan "division" before plopping down in a chair. Other days he'll relay something particularly interesting about science. But recently, he barged in the house, threw his backpack over the chair, and buoyantly offered "Guess what I learned today!" I couldn't wait to hear.
He stood tall, then announced, "I learned that Britney Spears is 60 percent plastic!"
The Logic of Youth
I soon learned that a friend - having absconded his teen sister's magazine - read that Spears had had plastic surgery over 60 percent of her body, which, by his way of thinking, made her 60 percent plastic.
I'd forgotten about this conversation until last spring, when I started having recurring kidney infections. I'd prolapsed with my last two pregnancies and knew that eventually I'd have to return my bladder to its original location. Gravity being what it is, I'd have to have a hysterectomy at the same time, so I'd put the surgery off and gone on my merry, if somewhat incontinent way.
These infections, however, changed all that. It was time to go in for some repairs.
Problem Solving Over Coffee
"I know what I'd do," said my ever-practical sister as I relayed my tale of woe. "I'd have them give you a tummy tuck while you're under. Heck, you'll already be on the table."
I looked down at the extra skin and energy stores around my belly. I could grab mine in two hands.
"Yeah, right," I replied laughingly, but secretly filed the idea away in the back of my mind until my next doctor appointment.
The following week, I listened as my gynecologist described my litany of upcoming procedures: bladder repair, bowel repair, a hysterectomy and bladder sling. At the end, when he asked, "Any questions?," I cleared my throat and asked - almost jokingly - if there was any chance he could throw an abdominoplasty into the mix.
To my amazement, he sat back down. "It's been done," he said nonplussed. "After all, you're already on the table." (Had he been talking with my sister?) He gave me the number of the plastic surgery department, suggested a consultation, and told me to call his nurse when I'd decided what to do.
Armed and Dangerous
With the names and numbers of three surgeons, I called. I was directed to Dr. Minas Chrysopoulo, with whom I scheduled a consultation.
When we met, I was forthright about my surgeries and went - oddly - to great lengths to explain that I was only doing this because I'd already be on the table. He chuckled but seemed to understand. He looked realistically at my trouble spots, and made a few notes, and we talked extensively about what an abdominoplasty, or tummy tuck, entails.
In addition to the extra skin, Dr. Chrysopoulo explained, the muscles that run across my stomach had split during childbirth. If I wanted to proceed with surgery, he would stitch those back together, remove the extra skin from my lower abdomen, and if necessary, use liposuction to "contour" my waistline. (So polite!)
Going With My Gut (so to speak)
There were two things I liked about Dr. Chrysopoulo from the start.
First, he was cautious. If I was on the table too long for my gynecologic surgeries, he said he wouldn't do his bit. (The biggest risks in any surgery are reactions to anesthesia and blood clots, and I'd be at risk for both).
Second, he went to great lengths to ensure I had a realistic idea of what plastic surgery would - and wouldn't - do for me.
"So many people watch reality TV and walk away with unrealistic expectations," he explained. I laughed and told him I don't watch TV and had never seen a reality TV show in my life. What I was hoping for was a stronger, sleeker me, not a new one.
We shook hands and, feeling at ease, I decided to proceed.
On the Big Day
Right up until the day of surgery, I wasn't sure whether I'd wake up with my new "contour" or not.
Dr. Chrysopoulo, however, arrived at the hospital optimistic. Once my vitals were taken, I donned a hospital gown and stood while he took out a permanent marker and drew on my stomach.
I was quartered and halved with dotted and solid lines. Even my husband, who took all this in with a bemused look, agreed that I looked like a side of beef.
When they wheeled me to my gynecologist, I told Dr. C that if he was able to operate, I wanted to be able to bounce quarters off my belly when he was done. He gave a hearty laugh and I was wheeled off to the O.R.
When I came-to in the afternoon, I tried to gain focus on my husband and the nurse. Following assurances that my "female procedures" had gone well (it was important to me to keep my ovaries), I saw Dr. Chrysopoulo at the back of the room.
"Hey doc," I asked in a painkiller-induced voice that I didn't recognize as my own. "Any luck?" He nodded, but looked pretty serious. I must have looked like hell.
He checked out my stitches, gave some instructions to my husband, and said he'd be back shortly to check on things. I sat up to talk to him, but the pain meds knocked me down, and the minute he walked out the door I threw up. I was off to a wonderful start.
Later, That Same Year
Now that I'm healed, I look back on my recovery and wonder how I dealt with all those procedures at once. At the same time, I'm absolutely glad that I did. While my recovery took longer (I was out of work for six weeks), I was able to get everything taken care of, and all were a success.
My abdominoplasty, which has far exceeded my expectations, took my focus off the fact that I was closing the door on my child-bearing years. Oddly, or so it seemed, I walked away stronger, slimmer, and, as several people have mentioned, carrying myself in an entirely different way.
Most important, I feel stronger. The back pain I've struggled with for the last decade has decreased considerably, and the woman I work out with says I look stronger and more balanced. Now, when she yells "Engage your core!" (Why do the always do that??), I actually can. It never occurred to me that prior to surgery, I simply didn't have the tools to get the job done.
Never Say Never
It's funny that before, I never would have considered plastic surgery. My husband and I are pretty natural. We bike, we hike, and for the most part, live a pretty healthy lifestyle. But I have to admit that this procedure has changed my perspective.
No, I'm not going to race out and "fix" another body part, but these days, I wouldn't rule out repairing something that's broken, even if the procedure was considered cosmetic.
So, is Britney Really Plastic?
Due to the extensiveness of abdominoplasty, several follow-up appointments are required. One day I had scheduling problems and was forced to take my 10-year-old son with me. I'd been honest with him about my procedures since he, as the big brother, would have to play a role in my recovery. He liked Dr. Chrysopoulo immediately. When the check-up was almost over, I asked if he had any questions. He hesitated, then asked curiously, "Is Britney Spears really 60 percent plastic?"
Dr. Chrysopoulo answered slowly, as if being faced with a trick question. "Actually," he said, "she's about 80 percent water." And then he got it. He laughed out loud and my son look delighted, proud that somebody finally understood what he'd been talking about all those long months.
Q&A with Dr. Minas Chrysopoulo
ANEW: Who's the most likely candidate for an abdominoplasty?
MC: Anyone who has excess tissue in the abdominal region that hasn't responded to dieting and regular exercise. [Women who choose abdominoplasty] have typically had at least one pregnancy, have lost significant amounts of weight, or both. They've been left with stretched, permanently damaged skin that doesn't shrink down. We frequently use liposuction in conjunction with abdominoplasty to provide extra definition and for "fine-tuning."
ANEW: Who is not a candidate?
MC: Women who are planning to have more children, patients who are very overweight and smokers. Smoking significantly increases the risk of wound healing complications. Also, some patients who have had previous abdominal surgery may not be candidates.
ANEW: What difference have reality TV shows, where men and women are "transformed," made to your industry?
MC: They've both helped and hurt our industry. On one hand, people are now being exposed to the marvelous things plastic and reconstructive surgery can achieve. However, many people also develop unrealistic expectations, particularly with shows the The Swan and I want a Famous Face.
ANEW: Can you briefly describe the process?
MC: Abdominoplasty is performed under general anesthesia as an outpatient. The excess skin is removed and the underlying muscles are tightened. Liposuction is used for further contouring, and drains are placed to decrease the risk of fluid collection. After the incisions are closed, the patient is placed in dressings and an abdominal binder.
Patients typically go home the same day. Though rare, patients undergoing abdominoplasty can suffer serious complications such as deep vein thrombosis (blood clots in the legs) and pulmonary embolism. These risks are decreased by having the patient ambulate and move around as soon as possible after surgery. Patients are much more likely to do this if they're at home.
ANEW: What can the average patient expect in terms of recovery?
MC: The drains are removed as soon as possible. It may be a few days after surgery before the patient can stand fully upright without discomfort. Sutures are removed 10 days after the operation. The abdominal binder is worn for a full three weeks after surgery. After that, patients can wean themselves out of it based on their comfort level. Activity is increased as tolerated with the exception of lifting anything heavy. All restrictions are typically lifted once the patient is six weeks out.
To learn more about abdominoplasty, please click here.