Ghada Y. Afifi, MD, FACS
Board Certified Newport Beach Plastic Surgeon
You. Just Better.

Tummy Tuck

Sometimes simply dieting and exercising are not enough to take care of waistline problems.  In such cases, a patient may wish to consider a tummy tuck (or abdominoplasty).  A tummy tuck is the surgical removal of excess skin or fatty deposits from the abdomen, along with the repositioning of abdomen muscles into a tighter formation.  This bodily enhancement procedure is designed for those who wish to have a flatter and tighter stomach.  It is also helpful in remedying the vertical separation of abdomen muscles known as diastasis, which can occur following pregnancy.

Reasons for Considering an Abdominoplasty:

  • Inability of dieting and exercise to improve the abdomen area.
  • Excessive accumulation of skin following weight loss.
  • Loss of skin elasticity or diastases (loose abdomen muscles) due to pregnancy.
  • The removal of unsightly skin and fat deposits as well as the proper alignment of the abdomen muscles to produce a more flattering look.

General Procedure

Abdominoplasty surgery lasts anywhere from one to five hours, depending on the desired look and the patient’s unique physiology.  To begin the procedure, an incision is made just above the pubic bone area.  This incision goes horizontally across the lower abdomen and sometimes around to the back.  The skin is then stretched away from the muscle tissue, and excess skin is removed.  The abdomen muscle tissue is tightened to provide a firmly contoured stomach and well-defined waistline.  Finally, the incision is closed; and the skin is stitched back into place.  Sometimes the procedure requires an additional incision around the navel in order to provide the best results.

Recovery Process

Generally, post-operative instructions call for plenty of rest and limited movement in order to speed up the healing process and recovery time.  As the body recuperates, the patient can expect some swelling, pain, and discomfort.  Medication can be prescribed to relieve any pain caused by the procedure.  The stitches will be removed shortly after the surgery depending on the procedure(s) involved.  Normal activities can generally be resumed within two weeks.  It may take up to a year for the body to completely adapt to the new abdominal configuration.  With proper diet and exercise the striking results of the surgery will be long lasting.

NEW DEVELOPMENTS:  TISSU - GLU to decrease postoperative use of drains

TissuGlu® Surgical Adhesive is the only FDA approved, high-strength synthetic surgical adhesive designed for internal use. TissuGlu forms a strong bond between tissue layers after abdominoplasty, helping to hold tissue in place to facilitate healing. TissuGlu is a clinically proven, safe alternative to postoperative surgical drains in most abdominoplasty patients. 

High Strength – More than 10x the strength of a fibrin sealant.

By forming a strong bond between tissue planes and reducing dead space in the surgical wound, TissuGlu Surgical Adhesive helps improve healing and can eliminate the need for drains in most abdominoplasty patients.

Single Component, No mixing, No thawing.

The adhesive begins as a prepolymer. The adhesive cures in the presence of moisture in the tissue, cross-linking with itself and with the tissue surface to form a strong bond between layers. This means there is no mixing required, and no clogging of the applicator during application.


The cured adhesive forms a network of large polymeric chains that allows the adhesive to remain soft and flexible while also creating a strong tissue bond. As tissues continue to heal, the adhesive eventually breaks down into safe, absorbable subcomponents.

A clinically proven safe alternative to drains.

Currently, most patients who undergo large flap procedures have drains inserted to remove fluid that accumulates under the skin at the surgical site. Drains are often uncomfortable for the patient and can lead to additional complications. TissuGlu Surgical Adhesive forms a strong bond between tissue layers, helping to reduce the space where fluid can accumulate during healing.

Cohera Medical’s recently completed ‘No Drain’ clinical study supports that TissuGlu Surgical Adhesive can eliminate the need for drains in most abdominoplasty procedures. In the clinical trial, when TissuGlu Surgical Adhesive was used, patients required fewer postoperative treatments and resumed normal activities, such as going to work, showering and using the stairs, more quickly.


For more complicated abdominoplasty procedures, another option is placement of Quill sutures or "locking" sutures that are placed under the tummy tuck tissue (hidden sutures) that gradually close the tissue down so that there is much less risk for postoperative fluid collections, which are called seromas.

These are very successful and decrease swelling of the tummy tuck area, accelerating ahdesion of tissue and decreasing the tension from the final scar.


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