Why is a tummy tuck an outpatient procedure?

Question

Hello! I am looking into skin removal due to loosing 140lbs and having 3 children. I believe I would receive a FDL or a circular/belt tummy tuck. One thing that has concerned me is I have heard this procedure is 99% of the time a outpatient procedure. Why? I am curious as someone who had 2 c sections, I was a 48 hour stay and I feel the FDL or Belt TT would be more invasive? I would love to know why Thank you for your time!

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding why a tummy tuck or fluer de lis or 360 lower body lift is an outpatient procedure. Patients spend time in the hospital for post-operative monitoring for higher-risk procedures. After pregnancy, there are many possible things that can go wrong. There is a high chance of bleeding and other potential complications after a c-section. In my opinion, the risk of complications is much higher after delivering a child and a c-section compared to a tummy tuck or FDL or 360 lower body lift. Nonetheless, I've performed hundreds of lower body lifts and tummy tucks. I agree with your statistic. Approximately 99% of tummy tucks and lower body lifts are outpatient procedures. However, for all of my FDL's and 360 circumferential lower body lifts, I have my patients monitored in a freestanding monitored unit for approximately 48 hours. This helps to monitor for potential bleeding problems, fluid imbalances, and pain relief. Though this is not mandatory for all plastic surgeons, it is mandatory for my body lift patients. When choosing a plastic surgeon, make sure you feel comfortable with their approach and their postoperative care. Check on their reviews. Your chosen plastic surgeon's plan has to make sense to you because you will be the one undergoing the procedure. Thank you for your question regarding why a tummy tuck is an outpatient procedure.

If you have any more questions regarding a tummy tuck, lower body lift, 360 circumferential lower body lift, belt lipectomy, belt abdominoplasty, or belt dermolipectomy please contact my office. Since the body lift is a big procedure, please seek an experienced, board-certified plastic surgeon with significant experience performing the lower body lift. Do your research. Make sure they have performed at least 100 tummy tuck or circumferential lower body lift surgeries and have the before and after pictures to prove it. Carefully examine their before and after pictures and check their reviews on RealSelf. If you cannot find an experienced, tummy tuck or lower body lift surgeon in your neighborhood, consider traveling out of state if you must. Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Nelson Castillo, MD · Answer

Thank you for sharing your question. A tummy tuck is typically an outpatient procedure but if a belt or body lift is being done many patients prefer staying overnight for assistance.  I would voice your concerns to your surgeon so that the best advice can be offered.

Jules Feledy, Jr., MD · Answer

Hello. You are asking a very good - and challenging - question concerning the different forces acting to influence outpatient plastic surgery. 1. Surgeries performed by board-certified plastic surgeons in accredited surgical facilities has been shown to be safe. A study including over 20 years of data and more 26,000 cases supports the safety of outpatient plastic surgery procedures&mdash;performed by qualified plastic surgeons, at an accredited outpatient surgical center (ASPS, link attached). 2. Plastic surgeons have greater flexibility to perform procedures in outpatient centers. 3. Hospitals receive greater revenue for insurance-based surgeries in hospital operating rooms, so there has been pressure to limit the amount of elective cosmetic surgical time. This has pushed plastic surgeons from the hospitals into surgical centers. 4. There have been advances in the overall care plan for outpatient surgery, such as pain medication therapy - exparel, pain pumps - that have allowed for better non-narcotic pain treatment; better garments and support wear; etc. I began my career when patients would stay in the hospital for a day or two following a larger procedure. I think it was helpful for a great many patients. Unfortunately, that system has passed. It would be nice to still have that option. Respectfully, Jules A Feledy, Jr, MD American Board of Plastic Surgery, American Society of Plastic Surgery

Camille Cash, MD · Answer

Typically tummy tucks are outpatient procedures if performed by a board certified plastic surgeon in an accredited facility.  This also assumes the patient is in general good health with a clean or well controlled medical history.  As safety is always the number one priority in surgery, if criteria are not met then the surgery will be performed in a hospital setting and may also require an overnight stay for observation.   I encourage you to speak to your surgeon about your concerns.

Gokhan Temiz, MD - Account Suspended · Answer

Hello and thanks for your question. First of all, the process of aftercare may change depends on the doctor's practice. All of my patients who has a procedure under general anesthesia stays at least one night in hospital just in case. In major procedures like tummy tuck, face lift and etc, I want my patients to stay 2 nights in hospital. I can extend their stay in the hospital depends on their healing process and situation. After the body contouring operations(tummy tuck and liposuction), the mobilization is very important. Patient should start to walk and movement. The hospital has special plastic surgery nurses to help and assist the patients.

Jeffrey C. Hamm, MD - Account Suspended · Answer

Hi and welcome to our forum!
While a tummy tuck is an invasive procedure, it does not enter the peritoneal cavity, where your internal organs reside. If the abdominal cavity is entered, deeper anesthesia and administration of a muscle paralyzer is required and may require overnight monitoring.
Performance of abdominoplasty on an outpatient basis has proven to be safe and with reliable outcomes. Since the procedure is usually an out of pocket expense, minimizing cost without sacrificing safety is of great importance to the patient.
Best wishes...

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