Tummy Tuck

Lake Mary Tummy Tuck (Abdominoplasty)

Lake Mary Plastic Surgery

*Please Note: This procedure is included in our Mommy Makeover package.

Abdominoplasty, commonly referred to as a tummy tuck, removes excess fat and skin, and restores weakened or separated muscles. It also creates a smoother and firmer abdominal contour.

Sometimes a flat and well-toned abdomen cannot be achieved through exercise and weight control alone.

Tummy Tuck Gallery

Even individuals of normal body weight and proportion can develop a protruding abdomen that has loose sagging skin.
Common causes of this include:

• Pregnancy
• Aging
• Weight fluctuations
• Prior surgery

Abdominoplasty is a good option for you if you are a healthy nonsmoker with realistic goals and expectations. During your consultation in our Lake Mary office, Dr. Shoukas will discuss your goals and expectations along with likely outcomes and any potential risks or complications.

Although the results of a tummy tuck are permanent, your result can be compromised by significant fluctuations in your weight. If you are planning substantial weight loss or considering future pregnancies Dr. Shoukas may advise you to postpone abdominoplasty surgery.

What abdominoplasty will not do:
A Tummy tuck is not a weight loss substitute nor does it replace appropriate diet and exercise. Although tummy tuck operations do not correct stretch marks, they may be removed or somewhat improved if they are located on the areas of excess skin that will be excised.

Anesthesia:
Abdominoplasty is performed in the operating room under general anesthesia. This procedure is not preformed in our Lake Mary Plastic Surgery office.

Surgery:
A full tummy tuck procedure requires a low horizontal incision in the area between the pubic hairline and umbilicus. The shape and length of the incision varies with the degree of correction necessary.
Through this incision, separated abdominal muscles are repaired and sutured together while excess fat, tissue and skin is removed. A second incision around the navel is necessary to remove excess skin in the upper abdomen.

Your abdominoplasty procedure will result in a flatter, firmer abdominal contour that is more proportionate with your body type and weight. The final results may not be apparent until swelling is diminished.

Recovery:
Following your surgery, dressings or bandages will be applied to your incisions, and you will be wrapped in an elastic bandage or a compression garment to minimize swelling and to support your abdomen as it heals.

Small, thin drains may be temporarily placed under the skin to remove any excess blood or fluid that may collect. This helps to minimize swelling after tummy tuck surgery. You will not be able to stand fully upright for the first one to two weeks.

Dr. Shoukas will give you specific postoperative instructions to aid your recovery from tummy tuck surgery: how to care for the surgical site and drains, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in your general health, and when to follow-up with Dr. Shoukas in our Lake Mary Plastic Surgery office.

Panniculectomy/Abdominoplasty/Body Contouring Quick Facts 

Panniculectomy is the surgical removal of hanging excess skin/fat (panniculus, pannus, apron) from the lower abdomen via a low horizontal incision, but does not include muscle tightening, neoumbilicoplasty, or flap elevation. It does not flatten the abdomen or address underlying muscle tightening or any loose skin around belly button or above. The excess abdominal skin and fat may hang down over the genital area and thighs, and rarely to the knees. The excess abdominal skin and fat may be accompanied by laxity of the anterior abdominal wall.  

Panniculectomy meets the definition of medical necessity when ALL of the following criteria are met: Panniculus at grade 2 or above, using the following scale (medical records, including photography and/or operative reports may be required to be submitted to the health plan for review · Clinical documentation of recurrent chronic and persistent skin condition under panniculus (e.g., intertriginous dermatitis, panniculitis, cellulitis, non-healing skin ulceration, tissue necrosis, recurrent/persistent skin infection) unresponsive to 3 months of medical therapy (failed both oral and topical medications); OR · Chronic maceration of overhanging skin folds that is refractory to medical therapy; OR · There is a functional impairment, such as documented difficulty with ambulation due to the abdominal pannus. AND When ALL of the following criteria are met: · There is a functional deficit due to a severe physical deformity or disfigurement resulting from the pannus; AND · The surgery is expected to restore or improve the functional deficit; AND · The pannus is interfering with activities of daily living. 

According to the American Society of Plastic Surgeons (ASPS), the severity of abdominal deformities is graded as follows: 

 Grade 1: Panniculus covers hairline and mons pubis but not the genitals  

Grade 2: Panniculus covers genitals and upper thigh crease  

Grade 3: Panniculus covers upper thigh  

Grade 4: Panniculus covers mid-thigh  

Grade 5: Panniculus covers knees and below  

In summary panniculectomy only covers the excess skin and fat BELOW the umbilicus (belly button) and does not involve tightening the abdominal muscles nor does it include moving or translocating the umbilicus. 

Abdominoplasty, also referred to as a “tummy tuck,” is an excisional surgical procedure, which involves removal of excess abdominal skin (apron) and fat from the pubis to the umbilicus or above, and can include fascial plication of the rectus muscle diastasis and a neoumbilicoplasty. This reshaping and contouring of the abdominal wall area is often performed solely to improve the appearance of a protuberant abdomen by creating a flatter, firmer abdomen. (American Society of Plastic Surgeons (ASPS)) This is a cosmetic procedure not covered by health insurance.  

There are similarities between an abdominoplasty and a panniculectomy procedure as both procedures remove varying amounts of abdominal wall skin and fat. According to the ASPS Practice Parameter for Abdominoplasty and Panniculectomy, the procedures are most commonly performed for cosmetic indications. However, there are reconstructive indications such as abdominal wall defects, irregularities or pain caused by previous pelvic or lower abdominal surgery, umbilical hernias, intertriginous skin conditions and scarring. The ASPS recommended coverage criteria state that a panniculectomy should be considered a reconstructive procedure when performed to correct or relieve structural defects of the abdominal wall. When an abdominoplasty or panniculectomy is performed solely to enhance a patient's appearance in the absence of signs or symptoms of functional abnormalities, the procedure should be considered cosmetic. 

Patients may meet criteria for a Panniculectomy and also want the Abdominoplasty portion as well. These pts can have a “combo case.”  Insurance is billed for the panniculectomy portion of the case and the patient pays OR/Anesthesia/Surgeon fee for the Abdominoplasty part. 

This is the same principle for any patient wanting to have an insurance medically necessary procedure and also wanting a cosmetic procedure performed at the same time. We will bill your insurance for the medically necessary procedure and you have to pay for the OR/Anesthesia/Surgeon Fee for the cosmetic procedure.  

Schedule your consultation with our office. Or call our Lake Mary Plastic Surgery team today 407-333-2518.