Maryland Tummy Tuck Surgeon - Dr. Summers
Baltimore, Annapolis

It is a relatively common practice for a plastic surgeon to perform multiple procedures during one operation.  This allows the surgeon to better “sculpt” your final appearance.  In addition, having several procedures done simultaneously saves you the expense of paying the operating room and anesthesia costs more than once.  However, having too much done at one time can lead to complications.  The decision to have multiple procedures done depends on which procedures are being done, the extent of surgery, the operating time, and your age/health.  Ultimately, the surgeon decides whether or not it is appropriate to include more than one procedure in your operation.

During your initial consultation we will discuss your desired changes and expectations, review your medical history and current health, and make an assessment on whether a tummy-tuck is the right procedure for you.  This is a good time to ask specific questions about the abdominoplasty procedure so that you are fully prepared, mentally and emotionally, for surgery.  Dr. Summers will review in detail how the abdominoplasty procedure will be performed for you and he will discuss all of the risks of the procedure with you.  Dr. Summers will also discuss if any ancillary procedures, such as liposuction, are appropriate.  At the end of your initial consultation, Dr. Summers will provide you with a quotation that outlines all of the fees associated with your selected procedure(s).  If you wish to proceed with the tummy-tuck, you will be scheduled for a second consultation.

The second consultation is designed to give you an opportunity to ask any additional questions and to make sure that you fully understand all of the pre-operative requirments, post-operative restrictions and potential risks and complications of the abominoplasty procedure.  The informed consent documents will be reviewed in detail, photographs will be obtained, laboratory work and a medical clearance (if necessary) will be requested, prescriptions will be written, a surgical date will be selected and a deposit will be collected.  We will also give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, avoidance of smoking, and the use or avoidance of certain vitamins and medications.

Generally, post-operative instructions call for rest and limited movement in order to speed up the healing process and recovery time.  The length of recovery varies with each procedure and is different for each tummy tuck Maryland patient.  Bruises usually disappear within a few days, and most swelling is gone in a matter of weeks.  If you follow our post-operative instructions carefully, you will be able to enjoy your normal activities within no time.  Your scars will fade over time but are permanent.  We take care to conceal any scars so that they are barely visible, if at all.  The image-enhancing effects of plastic surgery become more evident over time with certain procedures taking up to a year for your body to fully adjust and settle into its new look.  When you come in for your consultation we can discuss your expected recovery period and any post-operative instructions in detail.

Insurance providers generally cover costs for reconstructive surgery but not for cosmetic surgery.  For example, insurance providers will often pay for breast augmentation to reconstruct a breast following a mastectomy; breast reduction to remedy back pain caused by heavy breasts; eyelid surgery to remove sagging skin that blocks vision; nose surgery to allow for a patient to breathe better; or tummy tucks to remedy the vertical separation of abdomen muscles known as diastasis.  Insurance providers are required by law to cover breast reconstruction surgery and any cosmetic operations necessary to create symmetry in either breast. If your surgery is covered by insurance, pre-certification is required.  We will be happy to assist you with the process.

Depending on the type of procedure (abdominoplasty vs. mini-tummy tuck) and extent of procedure, we will recommend a general anesthesia or IV sedation plus local. Our Annapolis and Baltimore, Maryland tummy tuck patients always have the option of choosing a general anesthetic, if so desired.

The best candidates for abdominoplasty (tummy tuck) are men or women who are in relatively good shape but are bothered by a large fat deposit or loose abdominal skin that won't respond to diet or exercise. The surgery is particularly helpful to women who, through multiple pregnancies, have stretched their abdominal muscles and skin beyond the point where they can return to normal. Loss of skin elasticity which frequently occurs with weight loss following obesity, can also be improved. If your fat deposits are limited to the area below the navel, you may require a less complex procedure called a “mini-tummy tuck”.

You may obtain a better body contour if your abdominoplasty is done in conjunction with liposuction to remove fat deposits from the hips. Sometimes, liposuction alone can create the best result and, in some cases, a separate liposuction procedure prior to or after the abdominoplasty is required to obtain the best result. In any case, we will work with you to recommend the procedure that is right for you and will come closest to producing the desired body contour.

An abdominoplasty, whether partial ("mini-tummy tuck") or complete ("full tummy-tuck"), produces excellent results for patients with weakened abdominal muscles or excess skin.  In most cases, the results are "permanent" if you follow a balanced diet and exercise regularly.

Note: patients with stria (stretch marks) above the umbilicus (belly button) may notice that the skin below the belly-button loosens up several months after surgery.  This is because the skin is damaged (the stretch marks indicate that the collagen fibers in the skin have been torn) and has lost its elasticity.  In this case, a secondary abdominoplasty may be performed to further tight the abdomen, if necessary.

The major complications associated with abdominoplasty procedures include (but are not limited to) the following: bleeding, scarring, pain, asymmetry, dimpling of the skin, contour irregularity, fluid collections requiring drainage, loss of abdominal skin, open abdominal wounds, numbness of the abdomen, pain of the abdomen, obvious scars, widening of scars, loss of the belly-button (umbilicus), off-center positioning of the umbilicus, residual “pouching” of the abdomen, loosening (laxity or sagging) of the lower abdominal skin, firm lumps under the skin, fat necrosis (undesired loss of fat), and the potential for re-operation if any of the above should occur.

Other major post-operative complications such as infection and blood clots are rare, but can occur. Infection can be treated with drainage and antibiotics, but will prolong your healing significantly. You can minimize the risk of blood clots by moving around as soon after the surgery as possible. Poor healing, which results in conspicuous scars, may necessitate a second operation.

Smokers must stop smoking at least one month prior to surgery to avoid an increased risk of these complications.

It may take you weeks or months to feel like your old self again.  If you start out in top physical condition with strong abdominal muscles, recovery from abdominoplasty will be much faster.  Some people return to work after one week, while others take three or four weeks to rest and recuperate.

Because Dr. Summers performs the abdominoplasty procedure in a way which minimizes post-operative discomfort, the typical patient having an abdominoplasty (tummy-tuck) at the Maryland Plastic Surgery Center is able to walk immediately afterwards.  Most patients only need to take narcotics for 48 hours, after which time ibuprofen is adequate.  This rapid recovery is significantly different than the type of recovery patients typically experience at other plastic surgery centers.

It is impossible to predict how your scar will appear following surgery.  Some patients have a scar that is virtually invisible while others have a very noticable scar.  Dr. Summers will do everything possible to help you obtain the best possible scar.

Your scars may actually appear to worsen during the first three to six months as they heal, but this is normal. Expect it to take nine months to a year before your scars flatten out and lighten in color. While they'll never disappear completely, abdominal scars will not show under most clothing, even under bathing suits.

Prior to surgery, engaging in a regular exercise routine will help you heal better. Even people who have never exercised before should begin an exercise program to reduce swelling, lower the chance of blood clots, and tone muscles. Vigorous exercise, however, should be avoided until you can do it comfortably.

Although we encourage walking after surgery, we do not want you to return to your exercise routine for approximately one month after sugery. If you start on an exercise routine too soon, you will develop fluid collections in your abdomen which will require drainage with a needle and/or additional surgery.

For the first few days, your abdomen will probably be swollen around the pubic area and you will feel some discomfort – this is controlled by medication prescribed to you prior to the procedure. You will return to the office for your first dressing change one or two days following the procedure, so plan to have someone available to drive you to your appointment. You should wear your abdominal binder and/or compression girdle for three weeks following surgery. 

Your drain tube will need to be emptied several times a day – you will record the amount of fluid in the collection reservoir each time you empty the drain. If you have had liposuction at the same time as your abdominoplasty, there will be a lot of drainage in the first two days – this is normal and is the liposuction fluid coming out of your tissues.

Although you may not be able to stand straight at first, you should start walking immediately after surgery – most patients are able to walk upright within one week of surgery. Because we want you to keep the the incision dry, you will not be able to get in the bathtub. One week after surgery, you will return to the office for your second post-operative visit. At that time, surface stitches, if used, will be removed. Surgical tape will be applied over the incision to help protect it during the early healing phase. The drain tube may be removed, after which time you will be able to shower.

When showering, keep your back to the shower stream to minimize wetting of the surgical tape – it is important that these tapes stay on securely. Bathtubs, jaccuzis, swimming pools and hot tubs are off-limits for another 3 weeks. You will return each of the next two weeks for changing of your surgical tape. After three full weeks, we will typically remove the surgical tape completely and allow you to start using scar fading cream (e.g. “Mederma”) or Vitamin E oil. These creams/oils should be massaged into the scar to help soften and fade the scar. Additional scar treatments and/or therapies will be recommended based on your individual needs.

A “mini” abdominoplasty at the Maryland Plastic Surgery Center usually takes about two hours. With a mini-tummy tuck, the incision is much shorter and there is no incision around the umbilicus, although it may be pulled down a bit as the skin is tightened. Typically, with a mini-tummy tuck, the skin is separated only between the incision line and the navel. After the skin is stretched and the excess skin is removed, the skin is stitched back into place. Sometimes a drain tube is inserted – this is typically determined at the time of surgery.

A “complete” or "full" abdominoplasty at the Maryland Plastic Surgery Center usually takes about three hours, depending on the extent of work required. Most commonly, the incision extends from hip to hip, just above the pubic area. A second incision around the umbilicus is made to free the navel from surrounding tissue. Next, the skin is separated from the abdominal wall all the way up to your ribs. The underlying abdominal muscles are tightened by pulling them close together and stitching them into their new position. This provides a firmer abdominal wall and narrows the waistline. The excess skin is then stretched and removed. A new hole is cut for your navel, which is then stitched in place. Finally, the incisions will be stitched, dressings will be applied, and a temporary tube will be inserted to drain excess fluid from the surgical site.

Most abdominoplasties are performed at the Maryland Plastic Surgery Center - this is our out-patient certified surgical center and patients are sent home shortly after surgery. However, in rare cases patient factors or desires may necessitate that the procedure be performed in the hospital – in this case, patients occasionally choose to recover in the hospital for one or two nights.

If you smoke, plan to quit at least one month before your surgery and not to resume for at least one month after your surgery.

Avoid overexposure to the sun before surgery as this can worsen the appearance of scars.

If you have been trying to loose weight, avoid starting on a strict diet prior to the procedure, as this can inhibit your ability to heal.

Notet: If you develop a cold or infection of any kind the week prior to surgery, your surgery will probably be postponed.

In order to avoid constipation, we recommend that you cleanse your bowels with a laxitive two days prior to surgery. This can be with prune juice or an over-the-counter laxitive. Following this routine, drink a lot of fluid for the next day to keep well hydrated.

Avoid eating large or “heavy” meals for several days prior to surgery. You should also have an over-the-counter stool softener available to take immediately after surgery.

Please arrange for someone to drive you to the surgery and to drive you home after your surgery. Also, you will need someone to help you out for the first week following the procedure. Do not expect to be able to drive yourself for up to two weeks following surgery.