Tummy Tuck

Las imágenes de la cara y el cuerpo que no sean del personal y los pacientes de la Dra, Rodríguez son modelos estándar

Loose skin and stubborn fat can accumulate at the abdomen. This is especially common after pregnancy and weight loss, but it can also happen to women and men due to genetics or aging. 

The frustration of working out and dieting but not seeing any improvement in the abdomen is all too common. Unfortunately, this isn’t surprising. After pregnancy or weight loss, the skin loosens and often does not recover or tighten back up because it has lost some elasticity. 

For mothers, the abdominal skin has been stretched out for many months to accommodate a growing baby. This often results in the skin thinning permanently and becoming wrinkly and loose on the abdomen. Stretch marks can develop as well. 

The abdominal muscles that run up and down the middle are called the rectus abdominis muscles. These are the “six-pack” muscles of the abdomen. After weight fluctuation or pregnancy, these muscles can spread apart in the middle. This is called “rectus diastasis,” which means the strong tissue between the rectus abdominis muscles (the “fascia”) has stretched, thinned out, and resulted in a separation between the edges of the muscles. It will not get better with all the sit-ups in the world. The problem is not with the muscle itself; the problem is with the fascia. 

Commonly, patients feel like their core is weakened and their abdomen bulges outward despite maintaining a healthy weight. When rectus diastasis is quite severe, it can appear like a focal bulge at the middle of the abdomen, usually above the belly button. 

A tummy tuck typically removes all the skin and fat between the belly button and the upper part of the mons (where the pubic hair is located). In many patients, this means that the extra roll of skin at the lower abdomen gets removed entirely. Any stretch marks between the belly button and the upper part of the mons will also be removed.

The rectus diastasis is corrected by stitching the rectus abdominis muscles back together in the middle. This helps cinch in the waist and prevent the bulging that may have been present at the abdomen before surgery.

The thickness of the tissue that remains at the abdomen and at the mons is addressed during surgery. These tissues are thinned carefully so that there is a smooth transition across the incision line and so the natural contours of the abdomen are more noticeable.

To significantly reduce post-op discomfort, Dr. Rodriguez injects a long-acting numbing medication called EXPAREL® into the abdominal tissue during surgery. This is a local anesthetic that provides relief for up to 72 hours after the procedure and significantly reduces the amount of narcotic pain medication that may be needed post-op.

The incision is stitched closed in several layers with close attention to detail. The deep layers of tissue are stitched down to the abdominal wall to ensure that the scar remains low and hidden under a swimsuit or underwear. The belly button is stitched in carefully through a small hole in the overlying skin.

Natural Contours 

Dr. Rodriguez uses progressive tension sutures in each tummy tuck case. These are internal stitches that help accentuate the natural contours. Progressive tension sutures are done along the middle of the abdomen to recreate the look of the linea alba: the youthful indentation between the six-pack muscles that gives the abdomen a lean and athletic look.

Progressive tension sutures are also placed along the linea semilunaris on each side. This creates a slight indentation between the edge of the “six-pack” muscles and the lateral abdominal muscles. The final effect of the progressive tension sutures is a more natural-appearing contour to the abdomen.

No Drains 

The progressive tension sutures have the added benefit of collapsing the space between the underlying muscles and the overlying skin and soft tissue. These sutures seal the tissue back down to the muscle, which significantly reduces the amount of space where fluid can potentially collect and pool into a seroma.

For this reason, Dr. Rodriguez will not use a drain for your tummy tuck. The progressive tension suture technique is safe and reliable, eliminating the need for a drain.

Youthful Belly Button 

A common misconception is that a new belly button needs to be “made” with a tummy tuck. This is relatively rare in Dr. Rodriguez’s experience. Usually, she makes a circular incision around the belly button. At its base, the belly button remains attached to your abdominal fascia throughout the procedure.

After the extra skin from the abdomen is removed and the upper incision is pulled down to meet the lower incision, a small hole for the belly button is made in the middle. The belly button is then stitched into place with a special technique to give it a natural, deep contour that is more youthful in appearance.

Combination Surgery 

To optimize the results of a tummy tuck, Dr. Rodriguez frequently recommends combining it with liposuction of the flanks to help accentuate the waist even further. During a mommy makeover, a tummy tuck can also be safely combined with a breast lift and breast augmentation or reduction.

Most patients may return home the same day of surgery but a caregiver will be needed. Be sure to plan for childcare, especially during the first two weeks after surgery. During this early recovery period, you should not lift anything over 5 lbs (including your baby!).

You will have a binder (like a girdle) around your abdomen that you will wear for at least 6 weeks after surgery. A special surgical tape is placed along the abdominal incision during the procedure. This tape stays in place for about 3 weeks and does not need to be changed, making it easy for you and your caregiver after surgery.

It is extremely important to get out of bed at least once every 2 hours after you get home. This will help reduce your risk of blood clots and is an integral part of your early recovery.

To avoid pulling on the stitches, you will walk in a slightly stooped posture, bent forward at the waist, for the first 3-5 days after surgery. Afterward, you should gradually work on walking with a more normal, upright posture. After about a week, you should be walking fully upright.

You can gradually return to exercising about 4-6 weeks after surgery. However, please avoid sit-ups and crunches or any other abdominal muscle exercise for at least 3 months.

Swelling of the abdomen after surgery is to be expected. This means that some of the more subtle contouring of the area may not be visible for a few months. Some swelling may come and go for up to 6 months after surgery.

Scar Placement and Aftercare 

Dr. Rodriguez takes great care to minimize the amount of tension on the tummy tuck incision, which allows it to heal with a thinner scar. She also places it in a low position so it can be more easily hidden by underwear and swimsuits.

Silicone scar therapy is started about 3 weeks after surgery. The scar will likely look pink for several months as part of the normal healing process. It takes a year for it to fully mature, though the pink color will start to fade much sooner than that. Protecting the scar from sun exposure is essential, as this can cause it to darken significantly.

Dr. Rodriguez injects EXPAREL® medication during your tummy tuck surgery. It has many benefits for a smooth recovery:

During her fellowship, Dr. Rodriguez conducted a research study on progressive tension sutures in tummy tucks with leaders in the field. She presented the findings at The Aesthetic Meeting: Residents & Fellows Forum (April 2021) and the Houston Society of Plastic Surgeons meeting (June 2021). This has provided her with unique experience and insight into the benefits of progressive tension sutures and the optimal technique for placing them.

Dr. Rodriguez was also invited to give updates on safety in body contouring surgery, including abdominoplasty, to other plastic surgeons from around the world. She and her colleagues presented safety protocols and research findings in Miami at The Aesthetic Meeting (May 2021). Safety is always a top priority for Dr. Rodriguez. She constantly re-evaluates and refines her safety protocols for aesthetic surgery.

• Achieves a smoother, tighter midsection
• Removes stretch marks between the belly button and pubic area
• Repairs separated abdominal muscles (rectus diastasis) for a stronger core
• Restores a youthful belly button appearance

Don’t hesitate to contact Dr. Abigail Rodriguez if you’re interested in learning more about getting a tummy tuck in Houston, Texas. We’re here to help you achieve a look that will allow you to feel more comfortable in your body.