300 York Mills Road, Toronto, Ontario M2L 2Y5
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October
2009
21

Drains and Abdominoplasty/Tummy Tuck


Posted in "Secrets" of Cosmetic Surgery, Body Contouring, October 21st, 2009 | Posted by Dr. Michael Kreidstein

Patients often express surprise that they will not require drains after their abdominoplasty/tummy tuck. Although some surgeons continue to use drains, our experience over the past 10 years matches published reports in which drains can be eliminated if certain steps are taken during surgery. Most importantly, we place ‘progressive tension sutures’ to attach the skin back to the muscle layer. Not only does this close the space that would otherwise accumulate blood/fluid, but it allows the final wound edge closure to occur without tension. This helps to prevent the scar from riding up (above the bikini line)after surgery, and may prevent scar problems that arise from excessive tension.


  • Fiona

    hi there Dr.K.
    long story short: 38 yrs old mother of Three from Ottawa. gained over 50lbs each pregnancy and lost it after each , have had Three c-sections and am living with a large amount of sagging skin folding over my incision causing raw burning smelly painful skin , the discomfort is 24/7. the NPs i see told me to use “light days” in the fold to protect my self from the rawness, burning …
    this has been going on for years. i deal with back and hip pain and so use a shaper to keep my tummy and back muscles together during the day (control the pulling weight) but shaper contributes to the burning as well.
    The NP i see told me to live with it !
    very dissapointed i fell even deeper into depression, i have even thought of making a small cut every day until its done with. i can not be intimate with my husband, cant go swimming with my kids and always have a hand in my pants scratching the skin. i yusually wash the raw part about twice a day and have been using “light days” or paper towel for years.
    is it possible to get a surgery covered by OHIP?
    please help.
    thank you

    • http://www.drkreidstein.com/ Dr. Michael Kreidstein

      So sorry to hear of your distress. In the short-term, use a product called Interdry Ag (call 1-866-293-6349 for availability). Your symptoms may meet OHIP criteria for panniculectomy, but we would need a letter from your local MD to organize a consultation and application for coverage.

  • Karen

    Does one have to lose a significant amount of weight to be eligible for the panni surgery?

    • http://www.drkreidstein.com Dr. Kreidstein

      Weight-loss is not a requirement for panniculectomy

  • Dom

    Hi Dr.K,

    In my case, I gave birth to my son in sept 2009 but my belly button never returned to it’s place due to my abdominal muscles being pulled apart! I don’t have that much excess skin and I am back to my normal weigh prior to my pregnancy but this belly just bothers me! I was referred to a gastro dr back in 2010 by my obgyn because he thought I might have a hernia causing my belly button not to return to its normal form but the MRI/ scan showed there was nothing there! I weigh 130 and am 5″5! My belly is flat when I suck it in and don’t eat but once I put some food in it, it’s crazy how big it can get. Sometimes I look like I’m 5 mths pregnant! Do u think a mini tummy tuck can be done? And how much is that without the drainage process? Thnx for taking the time to review my questions!

    • http://www.drkreidstein.com Dr. Kreidstein

      You are likely to benefit from repair of your fascia. At rest, you tighten your muscles to shape your abdomen, but a rest your abdomen shape depends on the fascia. This repair can sometimes be done through small incisions at the pubis and umbilicus, but more commonly some skin should be removed with the net result of a tummy tuck.

  • Lilia

    Hi Dr. Kreidstein,
    Can you explain what is lower abdominoplasty is? And how much does it cost?
    Thx, Lil

    • http://www.drkreidstein.com Dr. Kreidstein

      Some patients have loose skin or stretched muscle/fascia only in the area below the belly button (umbilicus). In this situation, we may recommend a lower abdominoplasty in which surgery is limited to the area below the umbilicus. It has the advantage that there is no scar around the umbilicus, and recovery is generally quicker. Costs are also less, and may be 1/2 the fee of a full abdominoplasty.

  • Dawn

    Hi Dr. Kreidstein! I am seeing you in April, however, I have a rather touchy subject and question for you now! Have you ever had to give a blood transfusion? I ask because I will not accept blood and this is my big concern as to how dangerous this surgery is? Thanks, Dawn

    • http://www.drkreidstein.com Dr. Kreidstein

      Early in my career doing burn surgery, we required many blood transfusions, but I have never needed to give one in the course of elective or cosmetic surgery.

  • Bonnie

    I am 50 year old with diabetic and on insulin to control my sugars. I have a huge lower stomach which causes me distress due to the fact it gets infected underneath and can rest on my legs. I am a plus size woman, is their anyway that you know if Quebec Medicare will cover expenses, I am also First Nation ancestry. Please help.

    • http://www.drkreidstein.com Dr. Kreidstein

      Hi Bonnie,
      You do meet criteria for panniculectomy in Ontario, but you will need a surgeon in Quebec to apply on your behalf. Good luck!

  • Miguel

    Superb blog you have here but I was wanting to
    know if you knew of any community forums that cover the same topics
    discussed here? I’d really like to be a part of online community where I can get suggestions from other knowledgeable people that share the same interest. If you have any suggestions, please let me know. Many thanks!

  • laura

    Hello i am a 32 yrs old and a mother of twins. I had a c-section at 22 yrs old and i have since lost 50-60 lbs. But as i have been trying over the last 10 yrs to loose the stomach (apron) with exercise and it does not seem to be working very well. And of course with the time i have become very self conscious and my self esteem is very low do to it. i have a really hard time showing my body to my spouse and i hate trying to go clothes shopping because if my so call apron, i have do to my c-section. I was wondering if a tummy tuck is covered by RAMQ which is the Health care coverage in Quebec. I live in montreal, qc and would really like to know where to turn for all this. Please advise thank you

    • http://www.drkreidstein.com Dr. Kreidstein

      I can’t speak with authority on the Quebec insurance coverage, but a significant apron with symptoms of recurrent infection will allow an application for coverage in Ontario. We see many patients from Quebec and Maritimes, but generally they are for patients who choose to bypass the insurance application and pay for their procedures.

  • melanie

    Hi iam 29 years old and a mother of 5 and i have some belly fat i want gone tryed everything to get it to go .i was wondering how much the cost for a tummy tuck would be in toronto ? my weight is about 140 and i just have my little belly fat i want gone .

    • http://www.drkreidstein.com Dr. Kreidstein

      Fees for tummy tuck depend on the extent of the procedure. Our current fee for a lower abdominoplasty is $3500, and up to $10,000 if an extensive procedure with fascial plication and liposuction is necessary.

  • Maria

    I have had 3- C-sections, am 33 years old and am done having kids. I have been wanting to have a Tummy Tuck for 5 years now and and saved the money for it but i am so scared that I wont be happy with my results after the surgery is done. I weigh 115lbs and just have loose skin with a lot of stretch marks, and I am most concerned about my stretch marks. I want them all to go away but when I went to see the Dr he told me that I would be as flat as a wall but still have stretch marks. Is there anything i could do to get rid of these strech marks?

    • http://www.drkreidstein.com Dr. Kreidstein

      When there are stretch marks above the level of the belly-button (umbilicus), there won’t be enough skin left for closure if all the stretched skin is removed. That said, skin with stretch marks looks a lot better if it is tight than if it is loose, so the cosmetic improvement from tummy tuck will still be impressive. Many treatments have been recommended to reduce the appearance of stretch marks. Often they will show red marks before the ‘miracle treatment’, and pale stretch marks after- but that happens with time alone! There is nothing out there that is productive for removing stretch marks, although in theory, if you irritate your skin (e.g. massage) before and during pregnancy, your fibroblasts may become sufficiently responsive to keep up with the demands of your expanding belly and prevent you from getting stretch marks.

  • Carolina

    as a result of my twin pregnancy I have huge stretch marks and an apron tummy, I read on the ramq website that sometimes it is covered by the assurance maladie. Does anybody knows anything about this?

    • http://www.drkreidstein.com Dr. Kreidstein

      Hi Carolina,
      Every health plan has its own criteria for whether a apronectomy/panniculectomy is covered by insurance. You will need a consultation with a local surgeon to see if you will have partial or complete insurance coverage.

  • Linda

    Hello, I have lost 109 pounds and of course i can’t get rid of my belly fat. I was wondering that considering all my weight loss, can this be covered under the Quebec Health Insurance Plan?

    • http://www.drkreidstein.com Dr. Kreidstein

      Hi Linda,
      A panniculectomy may be covered by insurance, but this is not a cosmetic procedure and you should anticipate an additional fee if you undertake a more extensive abdominoplasty procedure.

  • Joanne

    Hello,
    After having had abdominal surgury due to an auto accident + 2 C-sections and one hystorectomy much of my stomach muscle is gone no matter how much excercise I do. The incisions are all in different places. I have now lost a total of 69 lbs over the past 2 years and believe that is all I will be able to accomplish on my own.

    Would you suggest a tummy tuck or lyposuction? Also, I noticed that the initial incision is almost from hip to hip. Will it shrink over time as my others did? Would the tummy tuck be more beneficial if I wanted to rid myself of a couple of old scars?

    Thank you kindly for taking the time to respond.

    Joanne

    • admin

      Hi Joanne,
      A tummy tuck is a good way to minimize scars after abdominal surgery. Even in trauma surgery, the incisions through the abdominal wall usually spare the muscles, so you you may just need a repair of the midline fascia in conjunction with your tummy tuck. These issues and others would be covered at your consultation.

  • Julie

    Hi , i am 28 yrs old and wanting a tummy tuck now for 6 yrs! i have thought about this, and tried to loose weight on my own since most of my weight is abdominal!! but its very hard for me to loose there due to the fact that i have a condition that doesnt really allow me to exervice my abdomen at all…How much weight do i need to loose for this surgery? i am 5/10 weight 227pds! thank u kindly!! i am living in ottawa , on!

    • http://www.drkreidstein.com Dr. Kreidstein

      Hi Julie,
      Tummy tuck surgery does not require weight-loss to be effective. Provided you have excess skin, fat, or your abdominal muscles are pulled apart (diastasis), then tummy tuck can be helpful. Many people are better able to exercise after tummy tuck, and go on to lose further weight. If you did lose significant weight, it is possible you will get loose skin again and potentially benefit from futher surgery.

  • Sarah Evans

    I had my 2nd c-section Jan 2010. Is there an amount of time I have to wait before I can have a tummy tuck? Also should I try to obtain my pre-pregnancy wieght prior to having a tummy tuck or can I get the tummy tuck and then continue to work out and get back my pre- pregnancy body? Also how much is the procedure and how much is a consultation?
    Thanks so much,
    Sarah

    • http://www.drkreidstein.com Dr. Kreidstein

      Dear Sarah,
      We recommend waiting until 6 months after delivery before having a tummy tuck. This time allows your body to recover from pregnancy, and for your abdominal tissues to reach a new equilibrium. Surgery is best once you have done the best you can at weight reduction, but many patients lose further weight after abdominoplasty. This is because it is easier, and more gratifying, to do exercise without loose skin flopping around. Our consultation fee is $200 + hst, and surgery fees range from $2500 to $10,000.

  • Tori

    I need a tummy tuck, have had eight pregnancies, 6 live children, my breasts sag and my inside thighs are horrible cottage cheese.
    I am only 42, and feel terrible about myself.

    How much would it cost for at least the tummy tuck?

    Is it better to do it in Montreal, as I live outside Montreal and who would you recommend?

    thanks

    • http://www.drkreidstein.com Dr. Kreidstein

      Hi Tori,
      As wonderful as it is to have children, pregnancy can take a terrible toll on your body.
      In our practice, a tummy tuck can range in price from $3500 to $9000, depending on the extent of the necessary surgery.
      In general, it is better to have surgery within an hour of where you live. In this way, you are able to readily access your surgeon for scheduled and (rarely) emergency visits. That said, we have operated on patients from around the world, and after 5 days it should be safe to return to Montreal and then day trip for any further follow-up.
      Good luck!

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