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What a Waist

By Catherine Winters
Posted On Sep 14, 2016
What a Waist

Our society is obsessed with tight, toned abdominal muscles, yet age makes them so hard to maintain. Is a tummy tuck right for you? 

It’s an issue  that plagues the majority of over-40 human beings. Despite eating healthfully and exercising regularly, your tummy still stubbornly pours out into a paunch. The defined waist you once flaunted has gone underground, encircled by an unfortunate layer of flab. And we’d rather not wear Spanx all the time, thank you very much.

Today, more people (women and men alike) aren’t simply yearning for a small, flat tummy and narrow waistline, they’re taking action. In 2013, approximately 112,000 tummy tucks—technically called abdominoplasty—were performed in the U.S. That’s a 5 percent jump from 2012. And who can blame them? A tummy tuck provides more than a flat abdomen. It offers a more alluring silhouette which in turn improves self-esteem and can even enhance sexual pleasure. Ladies, a little known side effect of the surgery is that it helps reposition the clitoris, allowing for improved stimulation.

Age, pregnancy, and major weight fluctuations are the driving forces behind the popularity of tummy tucks. Through the years, we have a tendency to gain weight in our midsections and accumulate fat deposits in our waist area, no matter how much salad we nibble on. During pregnancy, belly muscles separate.
Even if a woman goes back to her pre-pregnancy weight, her tummy is never as flat as it had been before. Beverly Hills plastic surgeon Andre Aboolian, M.D., sees women “in unbelievable shape with very little body fat. But because their belly muscles have separated, their guts are hanging out.”

Another common source of distress: When you gain a lot of weight, skin becomes stretched, according to Manhattan plastic surgeon Scot Bradley Glasberg, M.D., president of the American Society of Plastic Surgeons. Upon losing the weight, excess skin and fat end up dangling.

If any of these situations sound familiar, you could be a great candidate for
a tummy tuck. Here are the things you need to know:

What It Accomplishes:

A tummy tuck is a body contouring procedure, right for someone who is close to her ideal weight but wants to get rid of excess skin and fat in the abdominal area, remove extra sag around the waistline, and tighten abdominal muscles. Keep in mind that while fat may be removed during a tummy tuck, it’s no substitute for diet and exercise. Many physicians prescribe a weight-loss program to prepare for the procedure and ensure the best result. Dr. Glasberg refers overweight patients to a nutritionist, and only considers performing the surgery after they have slimmed down. Stretch marks may disappear entirely with this surgery, or their appearance may significantly improve when excess skin is removed. All stretch marks below the belly button should disappear.

How It’s Done:

Typically, a tummy tuck surgery is performed under general anesthesia and done on an outpatient basis in an approved surgery center. A thin incision is made below the bikini line. (Its length is based upon the quantity of skin that needs to be removed.) A complete abdominoplasty necessitates a longer incision to allow the surgeon to surgically remove excess skin and fat above and below the belly button. Separated muscles are repaired, tightening them. Finally, a new opening is created for the belly button, and the skin and belly button are sutured into position.

Women who only have excess fat and skin below the navel are candidates for a mini or partial abdomino-plasty, which might require a shorter incision and doesn’t involve the belly button. During an extended or circumferential ab-dominoplasty, skin and fat are removed from the abdominal area and around the hips, to the back. During a tummy tuck, liposuction may also be performed to remove fat from the waist, hips, and thighs. “This gives the patient a smaller waist and creates a more proportionate body,” says Dr. Aboolian. Remember, as we age, skin loses elasticity. “Skin may not bounce back as quickly as it would in a younger person; everyone is different,” Dr. Aboolian says. And while a tummy tuck won’t recreate the body you had at 16, Dr. Glasberg insists, “You will definitely turn back the clock.”

How Long It Takes:

Typically, skin tightening takes 90 minutes to two hours. Muscle repair? An additional hour. Liposuction can take another one to two hours. An extended tummy tuck can take an extra hour or more.

The Risks:

Though rare, certain risks are possible (as they are with any surgery) including post surgical bleeding, infection, blood clots, and scarring. And while general anesthesia is safe for healthy people, there are some risks associated with it as well, so make sure you share your full health history with both your surgeon and anesthesiologist.  Sometimes, patients may experience a temporary loss of sensation, or numbness, in the lower abdomen post-surgery. Another concern: asymmetry. Your scar or midsection may look lopsided or your belly button may be off-center if an unskilled surgeon removes uneven amounts of skin or fat, or fails to make incisions in the right place. If this occurs and extra skin remains, a second tuck may be done. All of that said, tummy tucks have earned a largely favorable safety profile and for many the rewards outweigh the risks.

Recovery:

“If you have a desk job, you can be back to work in about two weeks,” says Dr. Aboolian. And you can return to normal activities within about six weeks.

The Cost:

According to the American Society of Plastic Surgeons, a tummy tuck costs an average of $5,200, not including the cost of the surgical facility or anesthesia. The price tag varies depending upon where you live and how extensive a procedure you have. Since the procedure is elective, it’s not covered by insurance.

Finding a Doctor:

Be sure that surgery is performed by a board-certified surgeon, says Dr. Glasberg. Also, make sure your surgeon operates in an accredited facility. “Accreditation means a facility has undergone checks to ensure a safe environment,” says Dr. Glasberg. (Ask the center where your surgery will be done for the name of the accrediting agency, then call to verify.) Also, look at the surgeon’s “before and after” patient photos. The best way to gauge a surgeon’s work, says Dr. Aboolian, is to examine six “before” and six “after” views. These should consist of four standing views—front, quarter-profile, profile, and back, as well as a front and profile view of the seated patient. Each picture should have the same background and lighting and the patient should be wearing the same underwear. If this isn’t the case, be suspicious. You may want to find another surgeon.