Tummy Tuck Mobile, AL

Tummy tuck surgery is one of several plastic surgery procedures popular today. Among women whose tummies have excess skin, fat, or muscle weakness after pregnancy or weight gain, it can be life changing. Many women can diet and exercise to help reduce their abdominal bulge while for many it just isn’t enough. Once the skin and muscle layer have been stretched with pregnancy, the elasticity of the tissues may not be able to rebound to pre-pregnancy proportions. With the advances in weight loss surgery (gastric bypass and banding) Dr. Proffitt sees the effects of loose skin and lax abdominal walls.

Remember that all patients are unique, so results vary depending on many factors.

How is the surgery done?

Abdominoplasty is done either as an outpatient procedure or overnight stay, depending on each patient’s health requirements. It is done under general anesthesia and takes from one to two hours depending on the length of the incision. After a transverse incision in the lower abdomen, the skin and fat is elevated off the muscle layer up to the ribs. This allows exposure to tighten the muscle layer with sutures. The belly button remains where it always has been. Then the skin and fat is pulled tight and the excess fat removed. The belly button is brought out through its new location in the skin and sutured in place. The remaining incision under is closed with absorbable sutures under the skin. One or two drains also are placed prior to closure. The drains allow excess fluid to escape and reduce swelling. Usually the patient will go home with dressings and drains intact. After four to six days they are removed in Dr. Proffitt’s office. For the next six weeks the patient wears a snug-fitting girdle.

This graphic illustrates a common incision for a tummy tuck

A mini tummy tuck is a variation where surgery is performed only below the belly button. Some women only have looseness of skin and muscle below the belly button and don’t need a full Abdominoplasty. This incision is also shorter in length.

Will fat be removed?

In all tummy tucks the fat immediately below the skin that is removed is also taken out. In a full tummy tuck, liposuction is not performed under the remaining skin that has been mobilized. Liposuction can be done over hip areas or pubic area at the same time. However, with a mini tummy tuck, liposuction may be used on the areas where the skin was not mobilized.

Do I have to wear a girdle?

A compression garment or girdle must be worn for six weeks following your surgery. It reduces swelling and helps to re-drape the skin.

Planning Your Surgery

In order to prepare for your surgery, Dr. Proffitt has several recommendations:

• If you smoke, you must completely stop smoking for at least 6 weeks before your surgery. Dr. Proffitt will prescribe a medication that may help you stop.
• Many medicines, herbal remedies, vitamins and over the counter medicines should be avoided at least two weeks before your surgery and one week after. We will provide you with a list of drugs to avoid before your surgery.
• As with many abdominal surgeries, exercise, lifting more than ten pounds, and driving are not allowed for a period of time after surgery. You will need to plan on help after your surgery and a leave from work if necessary.
• Usually a tummy tuck can be performed as an outpatient surgery but sometimes it may be necessary to stay overnight. This depends on your overall health and extent of surgery.
• An abdominoplasty (tummy tuck) is best suited for the patient who has completed her family planning.
• A tummy tuck is also best suited to the patient who is at their desired weight. If you are planning a major weight loss campaign, a tummy tuck should wait until weight loss has reached a plateau.

Risks

Many risks associated with surgery can be lessened or avoided with careful planning. Risk of excessive bleeding, infection and poor healing can be minimized with avoidance of certain medications before surgery and appropriate antibiotics at the time of surgery. Risk of blood clots in leg veins is greatly reduced with compression leg pumps. In patients at high risk for blood clots a blood thinner may be administered. Patient compliance with all of Dr. Proffitt’s recommendations before and after surgery will diminish many risks.

Your New Look

The scar from your surgery will be pink for one to two months and then gradually fade but never completely disappear. It will also soften over time. Most of the swelling from your surgery should have resolved after six weeks but in some patients may take up to six months.

When you’re ready to discuss tummy tuck surgery in Mobile, Alabama, with a board-certified plastic surgeon, call or email the office of Dr. Randy Proffitt. Use the online email form to get in touch or call 251-344-0322.

Insurance Coverage

Many patients are interested in seeing if their insurance company will pay for their “tummy tuck” or “abdominoplasty”. Indeed, there are certain circumstances under which the insurance company will consider a “panniculectomy” medically necessary. What is the difference between and abdominoplasty and panniculectomy? An abdominoplasty involves excision of redundant skin and fat on the anterior abdomen, as well as “plication” or tightening of the muscle layer. A panniculectomy involves removal of the redundant skin and fat only. It does not include tightening of the muscle layer.

During my 25 years practicing plastic surgery, I have never seen an insurance company pay for or consider tightening of the abdominal muscle layer medically necessary. If a patient is undergoing a panniculectomy which is being covered by their medical insurance company and desire to have the muscle layer tightened, this can be performed at an additional fee.

Those patients who desire to see if their insurance company will cover their panniculectomy procedure, it is the patient’s responsibility to obtain supporting documents from their primary care physician or gynecologist. Insurance companies will require the office notes from the treating physician’s office documenting that the patient has skin problems (rash or infection) underneath the overhanging abdominal skin which is directly caused by the redundant skin. Records also have to include treatment in the form of a prescription for antibacterial cream and/or pills or antifungal cream and/or pills for this skin problem. Documents also have to include a second visit 3-6 months later noting that the treatment has been ineffective. Letters from the treating physician or a note written on a prescription pad saying the patient needs this procedure or that they consider it medically necessary, are not acceptable. Only office records made at the time of the office visit are acceptable. Once these documents are received by my office, then I will dictate a letter, as well as take photographs of the patient’s abdomen in the frontal as well as side views, and a photograph of the skin rash/infection itself. Occasionally insurance companies will only approve coverage if the overhanging skin and fat completely obscures the pubic area in addition. Again, it is the responsibility of the patient to supply these documents before a letter can be sent to the insurance company requesting coverage.

I have enclosed links below for two insurance company websites outlining their policy regarding coverage for abdominal panniculectomy.

• Blue Cross/Blue Shield of Alabama: “Management of Excessive Skin and Subcutaneous Tissue”
• United Healthcare