Tummy Tuck in Mexico by Dr. Manuel Gutierrez Romero

The operation described as a tummy tuck in Mexico is designed to eliminate the excess skin located in the lower part of the abdomen, usually from the belly button down to the pubic area.  It reinforces the abdominal wall, and the objective is to eliminate the excess skin, and obtain a more flat and firm abdomen.

Who is a good candidate?

Typically, females who have had multiple pregnancies are good candidates.  The skin stretches during pregnancy.  Women end up with sagginess and redundancy of skin, and fat deposits and stretch marks mostly in the lower part of the abdomen.  There are many other circumstances when patients will need a Tummy tuck: male or female patients who gain and lose a substantial amount of weight, or those who have gone through major weight loss (gastric bypass or lap band). These areas persist even with exercise and appropriate diet, and can give the appearance of disproportion with the rest of the body.

The best way to know if you need a tummy tuck is: remove your clothes, sit down ina chair and pinch the excess skin in the lower part of your stomach.  If you are able to grab a good amount of excess skin, you are a good candidate. Part of the evaluation is to look for previous abdominal operations or hernias.  We also evaluate the different fat deposits, and discuss with the patient all of the advantages and disadvantages.

When is the best time to have a tummy tuck?

The best time to have a tummy tuck if you are female, is after you have had pregnancies.  It is always advisable to wait until you decide not to have more children.

The other type of patient would be those who are in the process of losing weight.  It is very highly recommended to get to your ideal weight before getting your tummy tuck, so you will get the best result.

The operation is technically very simple: usually under epidural anesthesia placed by the anesthesiologist, we begin with an incision in the lower part of the abdomen (it can be designed to the type of underwear you like). We proceed to undermine the skin and fat from the abdominal wall, realign the belly button, and continue with the undermining up to the rib cage. We proceed with tightening muscles.

Vertical abdominal muscles that have been stretched and weakened over time are tightened, restoring the appearance of a firmer, flatter abdomen.

We proceed to tighten the musclesand stretch the excess of skin.  We then remove the excess, and make a small incision to pop up your belly button in the same location.  The wound is closed in 4 different layers. We always leave a small drainage.

There are some technical refinements in a tummy tuck that will make the operation stand more than any average tummy tuck.  In order to eliminate the excess skin in the corners (called the ear dogs or folds of skin), we must extend the incision as far as necessary, as a small incision most likely would leave excess in the corners.

Another important problem is a lot of fat in the pubic area.  Most of the Doctors don’t remove the fat in the pubic area which results in a flat stomach with a large and bulgy pubis. The way to address this problem is at the time we do the incision.From the center we elevate the pubis, trim half of the fat and then we remove the excess skin (all of our patients love this procedure).

The last refinement is a small belly button.  At the time we undermine and realign the belly button, we cut in a triangular shape.  Then, at the time of stretching the skin, we do another incision in an inverted “V” that adapts nicely with the triangular one. The result is a small triangular incision which is less likely to close up or show a large scar.

Tummy tuck procedures can be performed alone, but are often performed with liposuction to further improve body contours. A tummy tuck should not be considered as a treatment for obesity, or a substitute for proper diet and exercise. Individuals considering a tummy tuck should be healthy and relatively fit. Future pregnancies and substantial changes in weight following a tummy tuck, as well as the presence of scars from prior surgeries may decrease the effectiveness and longevity of treatment.

Upon completion of the operation, the patient is transferred to the recovery room with sterile strips in the wound, drainage, and a compression garment. The patient must sleep and rest at 45 degrees. The next morning they must walk and have a daily shower.

Postoperative Instruction

Daily shower (no baths), blow dry the tape that covers the wound, clean your belly with q-tip and hydrogen peroxide once a day.  Take your medication according to instructions (antibiotic 3 times a day, pain relief medication alternate up to every 4 hours), empty the drainage 3 times a day.  Sleep at 45 degrees, you can sleep on your side but not your stomach.  You must walk every 2 hours,and must have a bottle of water every 2 hours with regular bathroom breaks.You can eat anything excepthard to digest foods (no red meat).  You must wear a firm compression garment all day and night for 4 weeks with no exercise for 4 to 6 weeks.  During the first week you are allowed small walks inside the house.  Whenever you are resting, keep your legs elevated.  Avoid constipation, if you suffer begin prevention on day one (papaya, plums, orange juice, fiber), and the most important, avoid dehydration. Avoid walking a lot, going up and down stairs, no walking the dogs, etc.  Never apply any heat on the abdomen. You can begin exercising after 4 to 6 weeks, with abdominal work in 3 months.

In the long run, patients can have a permanent numbness in the lower part of the abdomen.  The scar is permanent and the best result of the scar is after one year.  If you want to have the best result, you must wear the tape for the first month, and after you must wear the silicone sheets.  This is a self-adhesive sticker made of silicone that will create pressure on the wound.  It will control the production of collagen and minimize scarring.  You must wear it for 4 to 6 months nonstop.