Tummy Tuck St. Louis


Abdominoplasty, Dr. Michele Koo, St Louis, or more affectionately known as, a tummy tuck, is a wonderful way to remove stretch marks and all the excess skin from pregnancy, weight gain and loss, or simply non-elastic extra skin and fat.

Most of my patients hate that thick wad of skin and fat in the mid-section that they can grab. They hate not being able to tuck a shirt into their pants or skirt or looking like a pear. They hate looking matronly. They hate all that “stuff” flowing over their pants. They hate not having a waist. If you’ve ever had similar thoughts, a tummy tuck can safely restore your youthful waist.

Who is a good candidate for a tummy tuck?

The best candidates for abdominoplasty are in good physical condition with pockets of fat or loose skin that haven’t responded well to diet and exercise. I can also help older, slightly obese people whose skin has lost some of its elasticity.

Abdominoplasty can also be useful for women with stretched skin and muscles from pregnancy. Results from the tummy tuck procedure will likely diminish if women continue to bear children, so we advise patients who plan to become pregnant to delay abdominoplasty.

I also encourage patients who intend to lose a lot of weight to wait before undergoing the procedure, since skin in the abdominal area typically loosens after substantial weight loss.

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Customized Treatment for Optimal Cosmetic Results

I take the time during every pre-operative consultation to learn what her patients want to achieve from a tummy tuck both for their bodies and for their self-confidence. By listening to what patients have to say and closely examining them rather than performing a one-size-fits-all procedure on every person, I am able to provide patients with completely customized treatment that takes into account their specific goals.

The Tummy Tuck Procedure

When I perform an abdominoplasty, I repair the rectus abdominus muscles (6 pack muscles) that have separated from pregnancy, weight gain, or age. This will tighten the mid-section and prevent the nine month pregnant belly look; however, if you have a significant amount of “internal” fat and fullness, the repair of the rectus muscles will hold your round belly in more but will not completely flatten your abdomen. It will still significantly improve the midsection. The removal of the excess skin will get rid of the “panniculus” or the skin and fat you see hanging over your pants and that you can grab. The stretch marks that extend to just above the belly button will also be removed.

You will still have your own belly button, but it will be brought out through a new “button hole.” All the stretch marks between the pubic area and the belly button can be removed to create a smooth flat abdominal area.

The surgery is usually performed under general anesthesia and can be an outpatient surgery going home that day or staying for 23 hours. The length of surgery depends on how much skin is removed and if liposuction or another procedure such as a breast augmentation or lift is performed at the same time. Typically, I do not allow my patients to drive for two weeks following the surgery, and some type of compressive garment is worn continuously during that time. My patients are able to return to an office job after approximately 2-3 weeks and to a strenuous occupation after 4-6 weeks. Drains also usually remain in place for 10-14 days. The length of the scar can be quite long, from hip to hip but can be kept quite low at the bikini line. The actual length however is determined by how much skin needs to be removed.

If most of your excess skin is below the belly button, you might only need a “mini” tummy tuck with a shorter scar. This is determined at the time of surgical consultation. I also take into account my patients’ personal preference of how flat they truly want the abdomen and the trade off of the length of the scar. The more excess skin, the longer the scar is a good rule of thumb.

During your initial consultation, I am very honest about what can be achieved to flatten your tummy. So many of my patients want to only get liposuction or laser lipo/fat freezing and do not want “surgery” and certainly do not want the hip to hip scar. After I examine you and hear your preferences, I will be very honest and realistic about what results can be achieved. I would rather you not have any surgery at all than waste your time and money on liposuction if a tummy tuck is actually what you need to achieve your results. Too many of my patients, return to my office having spent a great deal of money, as well as emotional energy, on a surgery which still did not achieve their goals. I will not do that. I believe in being your best advocate and only telling you what you will need to know; not perhaps, what you would like to hear.

Recovery after Abdominoplasty

A temporary tube may be inserted to drain excess fluid from the surgical site. There is not a significant amount of pain following the surgery, but your back is often sore because you will not be able to stand upright for approximately 10-14 days after the tummy tuck. The skin and muscles are tight after the surgery. They need time to relax and the swelling must resolve before you will be able to fully stand up straight.

Tummy Tuck Results

The result can be a wonderful flat or fairly flat belly area. If liposuction is added at the same time to contour the hips, waist and thighs, your entire trunk can be restored to a tighter, more youthful appearance. Abdominoplasty will leave a scar spanning the lower abdomen from hip to hip. I am very careful to make the incision low enough for even a bikini to conceal the scar. With a balanced diet and regular exercise, results are long-lasting.

Risks of Abdominoplasty

Though rare, post-operative complications from surgery are possible. They may include infection, blood clots, and poor healing, which may require further surgery. Patients who have had previous abdominal surgery should know that their old scars could be raised, stretched or generally more noticeable after the procedure. A scar revision procedure after abdominoplasty may minimize the appearance of an unsightly scar.

The most important thing about a tummy tuck – abdominoplasty is that it is indeed safe. If you have a tremendous amount of excess skin because you have undergone bariatric surgery, you might need an extended tummy tuck that may require both a horizontal and vertical scar. You might even need to stage the tummy tuck into 2 surgeries, addressing the front and the back if there is a significant amount of back skin and the buttock is dropped and flat. I will address this under the TUMMY TUCK AFTER BARIATRIC SURGERY Section.

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