Abdominoplasty, or the “tummy tuck,” has undergone a remarkable evolution. When we began our careers, tummy tucks were considered major, risky operations. They were usually performed in hospitals, with patients staying three to five days afterward. Blood loss was significant enough that patients were routinely cross-matched for transfusion. Procedures often lasted four to five hours.
One major advance has been the use of electrocautery dissection, which allows surgeons to cut while sealing blood vessels at the same time. This dramatically reduces bleeding and shortens surgical time. Today, blood loss in a tummy tuck is typically negligible, and most procedures are completed in about two and a half hours.
Another improvement is the use of multiple internal sutures to secure the skin and fat flap down to the muscle. This technique reduces fluid buildup and often eliminates the need for surgical drains.
Safety has also advanced enormously. Patients are now encouraged to ambulate immediately after surgery and wear intermittent compression boots, greatly lowering the risk of blood clots.
Perhaps the most exciting progress has come in anesthesia and pain control. Modern tummy tucks can often be done with a light general anesthetic, primarily intravenous sedatives, with minimal or no narcotics. Patients wake quickly and return home the same day.
