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Tummy Tuck (Abdominoplasty) Plastic Surgery: What to Expect

This is my Personal Story of having "Tummy Tuck" Plastic Surgery (Abdominoplasty) with Lateral Thigh Lift, including "Before & After" Photographs and a daily log of my pre-operation, Day of Surgery and Recovery experiences. If you are looking to get a Tummy Tuck operation, this is what you may be in for. 

I am a 54 year old man who is 5' - 7 1/2" tall who had attained a weight of over 300 pounds. My maximum weight was probably more than 300 lbs, but I really don't know because I stopped looking at the scale at some point. I do recall being weighed during a doctor visit and my weight was 298 lbs. but I'm sure I gained more after that. 

Before the Tummy Tuck          After the Tummy Tuck           Before & After Pictures           Costs         Risks
Plastic Surgeons         Questions for the Doctor         How I Lost Weight           Pain, Swelling & Scars           Belly Button
Surgical Drains           About           Videos

Over the course of about 2 or 3 years of dieting and daily exercise I reduced my weight to 155lbs (I lost over 150 pounds). This left me with a lot of excess skin around my belly and mid section. Since I didn't want to live with this for the rest of my life, I decided to look into a Tummy Tuck operation.

The first thing I wondered was if I lost enough weight to have a Tummy Tuck operation. It was difficult for me to determine if my enlarged midsection was still due to fat or due to excess skin. I researched ideal target weights, BMIs, average weights and more trying to determine if I was ready. I determined that I was and figured that if I wasn't the doctor would tell me. In hindsight, I probably should have lost 10 more pounds. I did ask the doctor if I was ready and he indicated that he couldn't say. He did not indicate why. I think that if he did say that I was ready and had the operation with results that I was not satisfied with, I would blame him. I now think it best to go all the way down to your ideal target weight and lose 5 more lbs after that. That way, after the operation the stomach would be nice and flat.

I read all the articles, blogs and information that I could find on the internet concerning this type of plastic surgery. I found lots of horror stories as well as many success stories regarding Tummy Tuck operations. I decided to risk it and looked into finding a plastic surgeon in my area. I was fortunate to find an excellent one one in my city.  On 9/17/07 I called to make an appointment for a consultation.

Tummy Tuck Surgery
The surgeon makes a long incision just above the pubic area that runs from hipbone to hipbone. A second incision is made around the navel to release the bellybutton from the surrounding tissue. The skin is then separated from the abdominal wall up to the ribs and then lifted to reveal the vertical muscles in the abdomen. These exposed muscles are pulled close together and stitched sewn into their new position using stitches in order to tighten them. This will help to narrow the waistline and firm the abdominal wall. The skin flap is then stretched back in place and the extra unwanted skin is cut away. After cutting a new hole for the bellybutton, it is then stitched in place.
ref: http://www.plastic-surgery.net

(9/24/07) Going to his office for the initial visit was sort of intimidating, being a 54 year old male who hasn't been to many doctors, especially not a plastic surgeon with a waiting room full of mostly women. Fortunately, both he and his staff were friendly and made the visit easier. My thoughts on my drive to the consultation included:

- will I be naked for the "before" photo?

- horror stories that you read.

- is this guy really a good plastic surgeon?

- will I need liposuction as well?

- have I lost enough weight?

- cosmetic surgery is not covered by insurance.

- "Tummy Tuck" is a foolish name to say out loud and abdominoplasty is too hard to remember.

I was lead into an examining room where a nurse provided me with additional forms and literature as well as answered most of the questions that I had prepared. The initial examination by the doctor fortunately only involved stripping down to my underwear (being there was humiliating enough). It was a "brief" examination by the doctor who indicated that a Tummy Tuck as well as a Lateral Thigh Lift would be appropriate for me but that the decision was entirely mine. He indicated that I did not need liposuction and that he could not do it in conjunction with this type of operation anyway because of the complexity of it. I was shown before and after photos of previous Tummy Tucks that the doctor had performed and received a more complete description of the operation and potential complications. The nurse provide me with written quotes for the procedures and a schedule if I wanted to proceed with the operation. I indicated I would consider it and call back for another appointment. I was charged a $25 consultation fee and was quoted the following prices. I was surprised to find that they required payment in full prior to the operation. They also required a $500 deposit when they scheduled the operation. Good thing they took Amex.

Tummy Tuck with Lateral Thigh Lift: $11,200 
(included facility and support personnel – $10,000 for the doctors fee and $1200 for the anesthesia fee). Doctors fee included facility and support personnel.

Medial Thigh Lift: $5500 for the doctors fee and $850 for the anesthesia. $6350 total.

Tummy Tuck is where they cut away and stitch "tight" the sagging skin in be belly area. The Lateral Thigh Lift is where they continue along the sides of the waist and back area and do the same thing to lift the hips and the butt. The Medial Thigh Lift is where they remove the sagging skin from the inside upper area of the legs and thighs. I decided against having the Medial Thigh Lift done because it would have to be a separate operation, cost more money and I figured I could live with what I had.

A few weeks later I made another appointment where I received additional paperwork and information as how to proceed. They also gave me a "Medical Clearance for Surgery" form for me to get signed by my family doctor. That meant another trip to my doctor for an additional examination, blood analysis and an EKG test.

Since I would need continual care and monitoring for 24 hours after the surgery (according to them), I needed some additional help. They provided me with the name and number of a home healthcare nurse. I called and made arrangements with Donna (the nurse) to pick me up, take me to surgery, take me home and stay with me overnight tending to my needs.

(10/3/07) I went to my family doctor for the required examination and tests and to get the "Medical Clearance for Surgery" form signed by the doctor. I needed blood tests and an EKG (electrocardiogram is a recording of the electrical activity of the heart) for him to complete the form.

(11/9/07) I paid the $500 deposit and scheduled the surgery date for December 4, 2007.

(11/20/08) Last office visit prior to surgery. I provided the signed "Medical Clearance for Surgery" form and paid the balance in full ($10,700) with my Amex credit card. The doctor took the "Before" photographs. I told him I didn't want to see these plastered all over the internet. He said not to worry.  I was then provided surgery pre-operation and post-operation  instructions and I received prescriptions to get filled prior to the day of the operation (12/4/08). The two prescriptions that I received were for Keflex 500mg an antibiotic (20 pills) and Mepergan Fortis for pain (40 pills).

I was all set, now all I had to do was wait and follow their Pre-Operation and Post-Operation Instructions.

Dec. 4, 2007  -  Day of "Tummy Tuck" Surgery

Donna, the home health care nurse arrived at my house at 10:30am as planned. I called the doctor's office and they told me to be there at 11:30am. Donna drove me to the doctor's office and escorted me to the waiting room. She asked if I wanted her to wait with me and I told her I was fine and that she could leave. She left. I waited about ten minutes till Becky the plastic surgeon's nurse came and escorted me to a private room where she told me the doctor would be in shortly to draw the "cut lines" on me followed by Bob the anesthesiologist. She instructed me to don the gown with the opening in front. After she left, I took off my clothes and put on the gown. I had a little bit of trouble getting the ties to stay tied so that it wouldn't inadvertently open as I walked.

After about 10-15 minutes of sitting alone, then standing, then sitting, then pretending to look at a magazine the surgeon entered the room with what looked like a ten cent plastic ruler (they type that a kindergartener would have) and a marker pen. He rummaged through a drawer and pulled out a "see through" tiny bikini for me to wear. He instructed me to put on the bikini and take off the gown so he could draw his alignment and cut marks on me with the marker. I commented on the high tech device that he was using to draw straight lines (the cheap plastic ruler).  The marking procedure took about 10 minutes to complete. He finished up and told me that Bob, the anesthesiologist would be in shortly to talk to me.

Alone again. Soon, Bob entered the room. Bob was a friendly 40ish year old man dressed in his surgery outfit. He asked some questions about my medical history, told me what he will be doing during the procedure and chatted with me for a few minutes. I was impressed with him in that he was professional, competent and I felt good with him being the one handling my anesthesia. I signed a piece of paper pertaining to the anesthesia and he left.

A few moments later Becky returned and escorted me down the hall to a bathroom where I was instructed to relieve myself to empty my bladder prior to the operation. Ironically, the bathroom was in the employee break room where a girl was preparing and eating delicious smelling Italian food, buffet style, like for the whole crew.  It smelled very good. I entered the small bathroom and did my best to relieve myself. I did the best I could but under the circumstances (having just gone at home and not having anything to eat or drink since the night before).

Becky then escorted me to the operating room where the plastic surgeon was waiting as well as 2 or 3 others. In the center of the room was the operating table. It was smaller than what I would have envisioned and was about the size of a pool side reclining lounge chair with arm pads extending from each side. I was then introduced to a couple of girls in the adjacent room who would be participating in the surgery. Bob was also there.

I was instructed to walk around to the far side of the table where on the floor lay some towels for me to stand on. With me positioned in the center of the towels the plastic surgeon brought out a small towel and small metal container filled with a reddish brown liquid (the antiseptic that they put on the patient prior to operating to keep thing sterile). I was instructed to remove my gown and he proceeded to get on his knees and "paint" my body with the antiseptic liquid. He generously applied the liquid over my entire body except, my hands, my head and my private parts. When he was satisfied that I was sufficiently coated with the material, I was cautioned to extend my arms and  not to touch anything with my hands as they would contaminate the sterile environment. Must have been quite a site. Me, almost naked, painted red with my arms extended out being asked to maneuver myself to step on the stool adjacent to the operating table and sit on the table, then lie back without touching anything with my hands.

Once I was on my back they covered my body with a blanket to keep me warm and probably for my privacy.

Bob then came out and proceed to hook me up with his electrodes and stuff to monitor my heart, blood pressure and other vitals that he needs to monitor to ensure that I am properly asleep during the surgery. He explained everything that he was doing as he was doing it, so I felt fully informed and there was no surprises.

At this point I commented that I was surprised at myself for being as calm and relaxed as I was for being where I was and what I was doing. I did feel fairly comfortable and not nearly as shy or as intimidated as one would think.

Bob then proceeded to insert the IV needle (intravenous, giving of liquid substances directly into a vein) into the back of my left hand through which he would later introduce the anesthesia and/or other medications required for the operation. Insertion of the IV into the back of my hand did not hurt at all. He then made a remark that he would soon give me a "taste" of the stuff and that it would "take the edge off".

I intentionally looked around the room trying to identify things and remember things before they knocked me out so that I might better remember it later. It seems that about a minute of this observing had passed.

All of a sudden I magically woke up in the recovery room. Surprisingly, I was more clear headed than I thought I would be. I found that I was wearing a large compression garment around my midsection along with two surgical drains connected to my body with plastic tubing. They sat me up, put on my pullover type shirt and asked me a couple of questions. I don't remember them putting on my shorts (I assume they did that in the operating room). I had no pain whatsoever. The doctor and his nurse got on either side of me and escorted me to the bathroom where he told me they put a lot of fluids in me and that I probably had to pee. I did not really feel like I had to but they guided me there anyway. Well, if I didn't have to go in the first place, now I was standing in front of the toilet with the doctor under one arm and the nurse under the other "waiting patiently" as I tried to "relieve myself". Talk about pressure!

They then placed me into Donna's (my home health care nurse) car for the ride home, which was pleasant and uneventful. I did not have any trouble walking from the car to the house then to the bed with the help of my nurse. After saying hi to the dog and taking my pills I went to bed. Throughout the evening and night, every four hours Donna would empty my drains and give me my medications.

See how I recovered After the Surgery.

About Surgical Drains
As a result of all of the surgical cutting and suturing that is done during the Tummy Tuck operation there is a certain amount of internal bleeding that occurs. This blood tends to run "down hill" towards the groin area (and yes there is a certain amount of swelling in that area). To remove this blood from the body, during surgery they poke a hole just above the groin area and insert a length of plastic tubing (see pictures). For my operation they inserted two drains a few inches apart. I would guess that the tubing goes into the body for a depth of about 4 to six inches (at least that's what I think I remember when they pulled them out). The total length of the tubing was about 4 -5 feet with the other end connected to a flexible plastic container with a drain port on it. The drain is measured for the amount of blood collected, then drained (with the blood being discarded down the toilet) every four hours. Every day the amount of blood collected would slowly decrease. It took 6 days until they slowed enough until my drains were removed.