The Lowdown on Tummy Tucks



What is a Tummy Tuck?


Dieting and the exercise are great, however most of the time it cannot get rid of the tummy pouch; that results from a lifetime of weight fluctuations or pregnancy. Factors such as multiple pregnancies and genetics can contribute to the development of loose skin, fat deposits, and stretch marks in the abdominal region. The changes that occur to the body – in the mid-section with one pregnancy, let alone multiple pregnancies can contribute to a lot of damage. Sagging skin, stretch marks and even muscle separation in the abdominal area is very common after a pregnancy. A tummy tuck procedure applies to both men and women alike and is one of the most common plastic surgery procedures, as any substantial weight loss can contribute to the development of loose skin in the abdomen. Even with proper diet and exercise, sometimes the abdomen will appear disproportionate with the rest of the body. . The procedure can improve the appearance of excess abdominal fat, skin and tissue in any healthy adult.



A Full Tummy Tuck


A Full Tummy Tuck or Abdominoplasty works by removing loose skin, fat deposits, and stretch marks from the abdominal region. A tummy tuck cannot correct stretch marks per se, although these may be removed or somewhat improved if they are located on the areas of excess skin that will be excised, generally those treated areas below the belly button. Tummy tuck procedures can be performed alone, but are often performed with liposuction to further improve body contours. Vertical abdominal muscles that have been stretched and weakened over time are tightened – restoring a much firmer, flatter abdomen. A full tummy tuck incision is normally made in the shape of a “smile” that goes from hip to hip. If there is sagging skin that extends up to or above the belly button, it can only be corrected by an additional incision around the navel. When the skin around the navel is released, the upper abdominal skin is pulled downward, and a new opening for the belly button is created. The surgeons do this so that the tightened skin of the abdominal area appears more natural.

The most important thing to remember with a tummy tuck is that it should not be considered as a treatment for obesity, or a substitute for proper diet and exercise. Ideally, the patient needs to be in good physical health and at a stable weight, have realistic expectations, and preferably be a non-smoker to undergo this surgical procedure. Future pregnancies and substantial changes in weight following a tummy tuck, as well as some of the scars from prior surgeries can and do affect the longevity of the treatment. There are many plastic surgeons that will not do this procedure on patients who have not remained stable at their weight for more than six months.

A tummy tuck is used to correct diastatsis, a condition where the abdominal wall muscles (rectus abdominus) have separated. The most common reason these muscles become weakened or separated is multiple pregnancies. Many women have some degree of this condition and don’t even know it. In some women who have never been pregnant, there can be a ‘bulge’ in the lower abdomen (from the belly button down) due to muscle separation that will not be closed with exercise. Exercise tends to only strengthens the muscle. Surgery closes the separation and flattens the abdomen.

The procedure of abdominoplasty is done with the skin and fat layers that lie above the abdominal wall, and they are separated from the wall by using a cautery device. The tissue is then lifted upward toward the rib cage to expose the abdominal muscles. To tighten the abdominal muscles, the surgeon then will suture the abdominal muscles, pulling them closer together, which creates a flatter, firmer abdominal wall and a slimmer waistline.

The replacement of skin and also the new navel position is completed by stretching the layer of skin and fat so that this is lifted away back tightly over the abdominal wall. The navel will remain intact and attached to the abdominal wall. It is then covered by the new layer of skin when it is pulled back into place. The surgeon will make an incision through the layers of skin and fat to create a new hole for your navel. The excess skin and fat that hangs beyond the original incision line will be removed and discarded.

The incision closure for a tummy tuck will more than likely include drainage tubes. These drains will remain in place for approximately two to three weeks. The incisions will be sutures and dressings and bandages will be applied.

Full Tummy Tuck results will take several weeks into months until you see the final end outcome. Most patients are able to return to work in one to three weeks time, however it may take several weeks until you feel you are able to return to full normal activity level – including heavy lifting and strenuous exercise. You will have a permanent scar, which will fad over time. It is important to realize that if you become pregnant or experience substantial weight gain or loss, the results from your procedure may be compromised. Proper diet and exercise and with maintaining your weight, this procedure (tummy tuck) can last several years.



A good candidate for Abdominoplasty or Tummy Tuck Surgery:

• Has realistic expectations with the surgical outcome
• The patient is emotionally stable for surgery
• The patient fully understands the risks of abdominoplasty surgery
• Ideally, the patient should be close to their ideal body weight (within 30%)
• The patient’s weight has been stable for at least 6 months or more
• Has specific areas of loose skin or fat that is completely incapable of responding to diet  and exercise
• Skin tone and elasticity are in good shape

There are a few different types of Tummy Tuck procedures. Each one will address a different type of patient and their needs.

• Endoscopic Tummy Tuck
• Traditional Tummy Tuck
• Mini Tummy Tuck
• Extended Tummy Tuck
• Circumferential Abdominoplasty

The Endoscopic Tummy Tuck or “The Scar-less Tummy Tuck” only involves the tightening of the abdominal muscles and the removal of small amounts of fat. No skin is removed. This is the only tummy tuck procedure that involves no skin being removed. This procedure is minimally invasive and has a fewer side effects, including less scarring, swelling and bruising. Also, it has the less recovery time. The endoscopic tummy tuck is a version of the mini tummy tuck which requires the use of an endoscope (a lighted tube with a camera on the end of it) and scars are minimized in this procedure. Because there is less bleeding and trauma done with this procedure, the recovery is shorter compared to regular abdominoplasty.

The Traditional Tummy Tuck or Full Tummy Tuck is mainly concerned with the flaws in the entire abdominal area both above and below the navel. This procedure is performed under general or twilight anesthesia, and can last anywhere from two to five hours. The traditional Tummy Tuck is the most commonly performed surgery. Traditional tummy tucks are most commonly combined with abdominal liposuction. Full tummy tuck procedures typically require two incisions. The surgeon will make an incision just above the pubic area that spans from one hip bone to the other. The length of the incision and its shape will depend on the extent of treatment as well as the contours of your body. While the surgeon will attempt to place the incision so that it is hidden by a bathing suit or undergarments, it is important to realize that you will have a permanent scar. A second incision is usually made around the navel. Hospital stays can depend on the extent of the surgery, anywhere from a few hours to several days.


The Mini Tummy Tuck – also known as the “Scar-less Tummy Tuck” - the plastic surgeon concentrates on the area below the navel. Patients who are within 10 percent of their ideal body weight are the perfect candidate for this procedure. A smaller amount of skin is removed with a mini tummy tuck, and the navel is left intact. A mini tummy tuck is definitely less invasive than a full abdominoplasty. The length of the incision involved in a mini tummy tuck will depend on the amount of skin to be removed, but will subsequently be smaller than the incision required by a traditional tummy tuck. Liposuction is commonly added with this procedure to sculpt the area more definitively. This procedure can be performed under both general anesthesia and or a local with sedation. However because this procedure is less invasive, normally most patients will receive twilight or a local with sedation.


The Extended Tummy Tuck is an expanded abdominoplasty procedure. The plastic surgeon removes excess skin from the patient’s sides and improves muscle laxity at the flank (or love handles) and hip region. This procedure is offered to those patients who have substantial weight loss and are trying to restore the tone back into these areas. Extended tummy tucks can remove excess skin sometimes weighing several pounds. Patients who have a significant amount of fat and skin in the flank, upper hip, and lower back regions are ideal candidates for this procedure. The incision goes from the entire length of the abdominal area to the hips. The plastic surgeon tightens the exposed muscles and creates a new navel to match the patient’s new body shape. Because of the extent of the surgery and the amount of tissue that was cut away, surgeons usually require that patients remain in the hospital to recover for at least one day. Drainage tubes are placed under the patient’s skin to prevent the accumulation of fluid and to allow the incisions to heal properly.


A Circumferential Abdominoplasty is performed when there has been a massive weight-loss (mostly commonly from gastric bypass surgery), leaving an apron of loose skin around the entire patient’s torso. This procedure is commonly called a Lower Body Lift. In this procedure, the surgeon will make an incision that will extend all around the entire waist line, in which they will remove excess skin and fat – and tighten the muscles. The outer thighs and buttocks are lifted. Liposuction is commonly used to re-contour the figure from the ribs to the knees.

The circumferential tummy tuck can take as long as three to five hours to complete, and requires a much longer recovery period than a traditional tummy tuck procedure. This procedure can require a hospital stay of two to four nights following the procedure, and there will be drainage tubes to keep fluid from accumulating.



After Massive Weight-Loss


Increasing numbers of people are losing massive amounts of weight – 100 pounds or more – with surgical assistance. But what many don’t realize is that gastric bypass is a minor surgical procedure compared to the reconstruction some need after losing all that weight. Excess weight stresses and stretches the skin dramatically. Rapid weight loss does not allow skin to conform to the new body size and shape. The result is excess hanging skin that can only be corrected through surgical body lifts. It is not just an appearance issue for some. Sagging loose skin may become macerated (wet and infected) if not removed, possibly turning into a serious health problem.

After massive weight loss, even young patients with good skin quality may need a lift. Procedures sometimes are staged over many months for comfort, health and safety. Plastic surgeons want their patients to have a safe operation and get through the procedure with minimal risk. The most important thing to remember is not to expect perfection, as with any uplifting procedure there will be visible scarring, and not all contours will be perfectly smooth, symmetrical and proportionately balanced. But to most patients who have undergone massive weight loss, this does not deter them. Massive weight loss patients have the ability to accept scars where they might not have ever considered them before – simply because they want a better shape.

Panniculectomy – often confused with a tummy tuck – reduces excess skin and fat which hang below the abdomen like an apron. The degree of overhang can be moderate, with the folds hanging down to just above the public region, or much more severe; such as low as the knees, over the hips, and around the back. A tummy tuck is performed on people of relatively normal weight, but a panniculectomy can be performed on patients with weight ranges from normal to severely obese, and who have lost significant weight. An incision is made from the lower area below the navel to the pubic bone. Another horizontal incision is made at the pubic area where the excess fat and skin can be removed. The skin remains is then pulled together and closed. The reduction of excess fat and skin through panniculectomy can greatly improve quality of life for many patients with these conditions interfering with everyday life, such as walking, standing, or even sitting. The health issues that are caused by this excess skin include back problems, rashes, ulcers and many different skin disorders.

The procedure is often performed under general anesthesia and requires a hospital stay, typically ranging from one day to one week. Insurance coverage for the cost of the panniculectomy varies. If the procedure is strictly for cosmetic reasons, insurance will not cover the procedure. However, the insurance carrier may cover all or a portion of the costs if medical conditions are correlated with excessive weight loss.

 

Preparing for your Abdominoplasty


Your actual tummy tuck procedure with the length of time you will be spending in surgery depends on the extent of tissue removal and if there is the necessity for an additional procedure such as liposuction. Most Full Tummy Tuck or Abdominoplasty procedures can last anywhere from two to five hours. Prior to the start of your Tummy Tuck, the treatment area is cleansed with betadine solution and also the incision guidelines will be drawn on your abdominal wall. Because of the time constraints with a full Tummy Tuck procedure, more than likely you will have general anesthesia. This will make you more comfortable due to the length of the procedure. For less invasive procedures, some plastic surgeons will prefer a local anesthetic with a sedative (commonly referred to as twilight sedation).

Abdominoplasty is not a substitute for weight loss or even for an appropriate exercise program. The results are permanent; however a less than positive outcome can arise from this surgery if you are not at your optimal weight when having this procedure. Any weight fluctuations will diminish the outcome. Be sure you are done with having children, as any subsequent pregnancies as well can wreck havoc on your results. Most plastic surgeons will recommend that you should postpone a tummy tuck if you are considering future pregnancies.

Stretch marks may see an improvement after this procedure, but they are not completely removed. If the stretch marks are in the area where the surgeon will be excising the excess skin, then those stretch marks will be removed – and normally this is in the area below the belly button.

Reducing your risks for complications for abdominoplasty surgery should include you being in good physical health before the procedure. Your diet should not be overly rigid and you should make sure that you have not over exposed your skin to the effects of the ultra violet rays from the sun or a tanning bed. Having your body well rested and properly nourished prior to surgery will help with wound healing. If you notice you are feeling ill or you notice you have gotten a cold, you need to tell your plastic surgeon immediately. Any kind of slight symptom with a cold or the flu can sometimes lead to some serious abdominoplasty risks from surgery. Delay of a surgical procedure is better than taking the chance with the procedure when you are sick.

Possible risks of Abdominoplasty include:

• Scarring
• Bleeding (Hematoma)
• Seroma – fluid accumulation
• Infection
• Poor wound healing
• Skin loss
• Blood clots
• Numbness or other changes in skin sensation
• Anesthesia risks
• Fat Necrosis - Fatty tissue that has died off
• Wound separation – from the incision site
• Asymmetry
• Looseness of skin – can occur if you are not at your ideal weight
• Pain
• Deep vein thrombosis, cardiac and pulmonary complications
• Swelling in the lower extremities
• Nerve damage
• Possibility of having a revision surgery
• Substandard aesthetic result


 

Blood Clots

Blood clots are a risk that is associated with abdominoplasty surgery. Any surgery that involves the use of general anesthesia for longer than 30 minutes carries a high elevated risk of causing internal blood clots. Blood clotting is nature’s way of controlling bleeding after an injury or an incision is made, however; blood clots can become dangerous. When a clot forms inside a blood vessel, it can interfere with your circulation or become lodged in an artery inside the heart, causing a heart attack. Clots can also travel to the brain and can become the cause of having a stroke, as well as the lung in which it would end up being a pulmonary embolism.

At the initial consultation you will be asked to give your medical history along with any and all medication you are taking on a regular basis. It is this information that the surgeon will be able to ascertain whether or not you are at an increased risk of forming blood clots following surgery.


Patients who fit the following profile need to be considered for the possibility of forming blood clots:

• Women who take birth control pills
• Women who take Hormone Replacement Therapy
• Women who are over the age of 40 years
• Patients who are taking cancer treatments
• Patients with heart problems
• Patients who recently have been pregnant

The timeline for developing blood clots after abdominoplasty surgery can vary, however the greatest risk is the first few days following surgery.

Your surgeon might suggest the following to decrease the risk of blood clots forming in the legs:

• Take short walks inside your room as soon as you are able after surgery
• Take short walks outside your home within a week after surgery
• Avoid all heavy lifting for 4-6 weeks after surgery
• No vigorous activities (jogging or running) for 4-6 weeks after surgery


 

Infections

Unfortunately sometimes infection happen no matter how careful a surgeon is with keeping their surgical room clean and sterile. Most infections following abdominoplasty procedure is from the patient with failing to care for their incisions properly. As stated so many times before, it is very important to follow your surgeon’s instructions of when and where to change the bandages. More than likely you will have drains which will help with the bleeding and leakage right after surgery. It is the drain incisions sometimes that are culprit with introducing bacteria to this area, so being proactive with any changes to the surgical area is paramount.


Please make sure if you get any of the following signs to call your surgeon immediately:

• Fever – temperature of 101 degrees or higher
• Chills
• Sweating
• Excessive pain or redness from the incision site
• General malaise
• Drainage from the incision has a greenish tint
• Bad odor coming from the incision site
• Draining too steadily

All the above symptoms are signs of an early infection, and if caught early enough, then sometimes all the patient might need is an increase in antibiotics. Infections can cause a delay in wound healing as well as prolong the recovery time for abdominoplasty surgery. Because of the risks that are associated with an infection with this surgery, you need to be in the best of health at the time or the procedure to give you the very best odds.

Skin Necrosis

Skin necrosis results from the loss of skin from a poor blood supply. It is more common in larger operations and smokers. The skin changes coloration from a light red to a darker color over the course of a few days. This skin might blister and peel, and also turn black over a period of a week. Patients who are still smoking and also ex-smokers who newly quit will be at a higher risk for this severe complication. Large scale skin necrosis in abdominoplasty surgery occurs normally lower on the abdomen area and can include the pubic area as well. In smaller skin necrosis cases, areas of the incision will scab over and take a very long time to heal. This complication is very rare in non-smokers.

Prolonged Wound Healing

All patients are going to be different with their healing times from any surgical procedure. There are some risks that are considered much higher in abdominoplasty surgery who tend to heal at a slower rate. Age and physical condition of the patient is always going to dictate how someone is going to heal. Of course those patients who exercise are physically fit, and are younger will always bounce back a little bit easier than those patients that were not.

Normal healing time with abdominoplasty is approximately between four to six weeks. Patients that are experiencing pain and severe discomfort beyond that time are considered to be slow healers. Skin necrosis or tissue death is one complication that can occur with patients who do heal slowly. If this does happen, then a skin graft is sometimes needed, which is not a simple procedure. The scarring can also tend to be more pronounced on patients who were slow healing, developing into hypertrophic scars or keloids.

Presence of an infection of course will delay healing time as well, as it depletes the body’s immune resources from closing the wound. So the quicker you have an infection under control, the better off the patient will be.

Smoking and the effects on your abdominoplasty surgery

The number one reason for slow healing is from patients who smoke or are exposed to second hand cigarette smoke. Because smoking decreases the size of the blood vessels in your skin, less oxygen will get to the surgical area to help promote healing. Larger blood vessels are needed for circulation to carry oxygen to your skin cells. Oxygen speeds up the recovery process, and cigarette smoking depletes these oxygen levels making it more difficult for patients to have a rapid recovery.

Risks of Smoking with Abdominoplasty Surgery:

• Smoking starves your heart of oxygen
• Forms blood clots in your veins
• Difficulty breathing during and after surgery
• Increase your risk of infection
• Impair the healing of skin and wounds
• Change the breakdown of certain drugs in your bloodstream

When you have surgery, the anesthesia that is used puts your body under stress. It has a tendency to lower your resistance to infection, and if you are unconscious, you’re breathing and heart needs to be monitored to prevent problems. If you smoke the body is less able to cope with the stress. The nicotine that is found in cigarettes increases your heart rate and or course will increase your blood pressure every time you smoke. The heart will therefore work harder because it needs more oxygen. The carbon monoxide in cigarette smoke competes literally for the oxygen in your blood. Nicotine reduces the supply of oxygen to the tissue by up to 15%. Smokers have up to ten times more carbon monoxide in their blood than non-smokers. This makes it harder for oxygen to be carried in your blood stream from your heart to your surgical area; and oxygen is needed in order for the wounds to heal.

It is so important to always make sure you are on the same page with communication with your surgeon during the pre operative and post operative periods. Early intervention on any post op complication is always the best. Experiencing complications on abdominoplasty are rare, as most patients normally sail through this procedure with no problems at all. But because this is major surgery, it is best you know of all the possible things that could possibly go wrong so if you find something happening to you, you will know how to act on it. Good patient – doctor relationships and communication makes for a positive outcome with an easy recovery process.

Full Tummy Tuck Recovery


Recovering from a tummy tuck is individual as any surgical procedure will be. Some patients heal faster and have minimal pain than others. Everyone has their own pain threshold so comparing recoveries can sometimes seem like you are comparing apple to oranges. In general, the normal amount of time you should be off of work with a tummy tuck is at least two weeks. Sometimes it is longer if the patient has had complications. So if your recovery ends up being around the four week mark, know that this is still very normal. It is going to take some time to see your final tummy tuck results, as you will have some swelling for a significant amount of time. Or course, patients who are in good physical health are always going to bounce back sooner. Depending on the type of tummy tuck procedure you ended up getting, you could require a hospital stay for a night or two.

More than likely you will have to wear some sort of compression garment after the surgery, which resembles a girdle. This garment should be tight fitting and helps in the reduction of swelling by preventing fluid build up, as well as provide comfort and support as you heal. Wearing of this garment can be for a few weeks or can extend longer depending on how fast you heal. It is possible you will not be able to stand up fully after surgery, but it is important to being walking for short periods of time after your procedure to facilitate blood flow. Your incisions might be closed with staples, sutures or surgical glue or a combination of glue and sutures. The fact that this is major surgery you will experience pain, bruising, and swelling which will eventually subside in a few weeks.

Getting up and moving will help you heal faster, so try to set little goals each day with walking. This form of exercise is the best medicine as well as other non-aerobic exercises. Walking can help reduce swelling, prevent blood clots, and strengthen your immune system. More than likely your plastic surgeon will give you post operative instructions with not doing anything too strenuous for at least six weeks after surgery. You don’t want to do too much, as this could possibly compromise your incision with reopening your wounds.

Swell Hell

With abdominoplasty surgery the inner lymphatic system has been compromised by the incision. When lymphatic tissues or lymph nodes become damaged, destroyed or removed – this causes a reaction where the lymph cannot drain normally from the affected surgical area. The lymph accumulates and gives what we experience in abdominoplasty surgery as “Swell Hell”.

Lymph originates in blood plasma and is part of the circulatory system running through the entire body. It is responsible for collecting and removing waste products left behind in the tissue. As our lymph system continues to circulate between the cells it collects waste products that were left behind including dead blood cells, pathogens and cancer cells. The clear fluid becomes protein rich as it absorbs dissolved protein from between the cells.

Swelling from the abdominoplasty procedure varies of course with the size or the extent of your procedure. Your overall general health contributes to this as well. The use of drains in abdominoplasty makes it less uncomfortable for the patient as well as helping with the healing with discard of the fluid that has accumulated.

 


The Benefits of Drains


Most plastic surgeons have seen the benefits of using drains with tummy tucks, so the likelihood that you might have these is high. They are annoying; however serve a very important purpose. The purpose of tummy tuck drains is to decrease the risk of a seroma formation (fluid collecting between the muscle layer and the skin flap). The use of drains in a tummy tuck procedure provides a place for this fluid to escape from the body, which will reduce the chances of any risks or complications from occurring. Depending on how much your incisions are draining each day will tell the plastic surgeon how long the drains should remain. Normally most patients get the drains removed within one week – but could be as long as three weeks.

 
The drains that are used for abdominoplasty have thin silicone tubing that are inserted into your abdominal area either through a specially made incision or through the actual tummy tuck incision. The thin tubing connects to “bulbs” that provide suction for excess fluid that accumulates during your recovery time.

You will need to empty out your drains at least two to three times a day, depending on how much drainage is coming from the incision site. You will need to keep track of how much drainage you are getting each day, as the surgeon will want to know exactly how much fluid is being accumulated. The fluid that is in the drain should be pink, reddish or brownish. If you notice that the fluid draining from the incision has a greenish tint or is draining too steadily, then please notify your plastic surgeon immediately. This could be signs of an infection. Tummy tuck drains are definitely an inconvenience however the job they perform is well worth it.

To remove the drains the surgeon will pull the thin tubing out. Some patients have remarked that there is no pain associated with this, and others have complained that it did feel like a strange sensation when it was being removed. Regardless, these devices do serve a very important purpose with your abdominoplasty recovery, and most patients accept this as part of the procedure.



Showering After your Abdominoplasty


Every plastic surgeon will have their own timeline in which they feel it is safe for you to shower after your surgical procedure. Some surgeons allow you to shower as soon as two or three days after surgery, and others make you wait until you have suture removal, which can be a couple of weeks. If you are told no showering until your sutures are removed, then more than likely sponge baths will suffice.

If you are released to shower, you might be told to do this with your support garments on, so it is important to have at least two garments available for you, while one is usually drying. Feeling dizzy and lightheaded after this surgery is not uncommon, so make sure you have another adult in the house with you during your first shower. Before your abdominoplasty surgery, you might want to consider going to the medical supply store, and get a little stool to use so that you can site down in the shower if you are feeling lightheaded. Make sure you pin your drains up on your garment if you are showering so that they do not get in the way.

It is very important you do everything your surgeon tells you to do on the post operative instructions. If you ever have any questions or concerns, please always contact your surgeon first before doing something you are unsure of. The post operative instructions will include how to bandage your incision, and how often you should change the bandages. Normally with abdominoplasty, the outer edges of the incision will always heal first and the center area will heal last.



Your New Navel’s Healing Time…the Marble Trick/ Ear-Plug Trick~

Your new navel that you get after your abdominoplasty will have a tendency to take on many shapes and sizes. It can appear square – triangular – oblong – or even start to close up completely with healing into a tiny slit. Ultimately we all want that nice round navel to heal perfectly, so in order to help this along – there is the “marble trick” or the “earplug trick”.

As everything with your surgery concerns, both pre operative and post operative, you need to run this by your own surgeon to see if he agrees with this. You do need to wait until the incision around the navel is completely healed and closed. The marble trick will stretch the navel somewhat, so you might experience some pain when doing this initially, however it has worked for many tummy tuck patients.

If you decide on the marble trick – you will need to start off by locating some standard size glass marbles, either at a toy store or a variety store. If you feel the standard size marble is going to be too big, then you can also use smaller size marbles as well.

Sterilizing the marbles is a must, so either boil the marbles in hot water or wash them thoroughly with antibacterial soap such as Dial Soap.

Substituting the marble for a soft “earplug” has proven to be beneficial with keeping the navel open so that it will heal in a round shape. Earplugs do have an advantage over marbles; first, they are much softer and not so cumbersome to work with. The earplug conforms to the shape of the navel with being able to be squished to the desired size you need. Once the size is shaped, then place it in your navel with a piece of tape/or a bandage over the earplug to ensure it will stay in place.

The incision around the navel must be completely healed before doing this.

You can either tape the marble to hold it in place or have your binder help hold the marble in place. Some patients have to start out slow with short intervals with time with this until they feel comfortable with the marble inside the navel. Once you work your way up to that point, then it can be worn 24/7.

Massaging the scar tissue around the navel four times a day will definitely help the scar tissue to stretch. This might be a little bit painful at first, but it does get better each time you do it.

Whether you use an earplug or a marble, there are ways of shaping your new navel. Just make sure you sterilize whatever you are using first and that your incisions are completely closed around the navel.
 

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