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 301-656-6398  |  703-442-4919
Adam G. Tattlebaum M.D.

Tummy Tuck Maryland

Dr. Tattelbaum is an experienced, board-certified plastic surgeon offering abdominoplasty surgery, commonly referred to as a tummy tuck, in Maryland and nearby areas.

Office Address:
3203 Tower Oaks Blvd, Suite 200
Rockville, MD 20852
(301) 804-6832

Woman's stomach and lower body in lacy underwear

A word from the Doctor

“If you’ve landed on this page then, without doubt, you have struggled with which solution is best for your tummy.

No one goes to the tummy tuck page first.

Most desperately hope that the solution is the simple wave of a liposuction wand. But the key difference is this – liposuction is about the fat, whereas a tummy tuck is about the skin.

If your skin is loose, liposuction will just make it looser and more irregular. In such a situation, only a tummy tuck can help.

Below, we discuss whether you need a tummy tuck at all and, if you do, which kind of tummy tuck makes sense for you.”

– Dr Adam Tattelbaum M.D.

Dr. Adam Tattelbaum M.D. in scrubs

Why choose Dr Tattelbaum?

  • Double board-certified plastic surgeon
  • Member of the American Society of Plastic Surgeons
  • Member of the American Society for Aesthetic Plastic Surgery
  • Listed in “America’s Top Surgeons” by the Consumer Research Council of America

What is a tummy tuck?

A tummy tuck, known as abdominoplasty within the plastic surgery industry, is a procedure to flatten, tighten and improve the appearance of the abdomen. There are several types of tummy tucks with different purposes and outcomes, but they all remove excess skin or fat from the tummy area.

Patients looking for a tummy tuck in Maryland often have concerns about excess skin due to pregnancy or weight loss, weakened abdominal muscles, or immovable fat on the abdomen. It’s crucially important to book a consultation with a specialist plastic surgeon and have your individual needs assessed.

What are the benefits of a tummy tuck?

  • Remove excess skin and fat to flatten the stomach
  • Tighten and improve the shape of the stomach
  • Tighten the muscles in the abdominal wall

Dr Tattelbaum’s perspective:

“Many people think tummy tuck patients should simply “work it off” rather than resort to surgery.

I call it the tummy tuck paradox. Most of my patients are already doing everything they can – they diet, they exercise, and the majority are quite slender.

The paradox is that when these patients do everything right they lose body fat, when they lose body fat the loose skin actually gets looser, not tighter. You can work off fat, but you can’t work off loose skin. The gym won’t help with loose skin.

Am I a suitable candidate for a tummy tuck?

To be a suitable candidate for a tummy tuck, other than having a loose tummy, you have to be healthy and at a reasonable weight. Some patients with well-controlled medical disorders can still be candidates. Each patient is evaluated individually to minimize risk and, hopefully, maximize benefit.

You don’t have to be rail-thin to have a tummy tuck, but you should be at a reasonable, realistic weight before surgery. This is because the risks of surgery are heightened for heavier individuals.

What are the different types of tummy tuck?

There are several different types of tummy tuck. Each is explained below, but the most common are full or mini tummy tucks. The deciding factor is the amount of excess skin that needs to be removed.

Dr Tattelbaum’s perspective:

“In your consultation, I will perform a pinch test. With the patient sitting and standing, I grasp the skin of the lower abdomen to see how loose it is.

If I can grab an entire roll of fat from beneath the belly button, that patient will benefit most from a full tummy tuck. If I can only grasp a small pinch of skin, that patient may only need liposuction or a mini tummy tuck.

Full tummy tuck

A full tummy tuck is only for patients with a lot of excess skin or abdominal muscles that are significantly separated from the belly button.

This is because it removes more skin and tightens the abdominal wall from top to bottom. In the procedure, the upper abdominal skin is pulled down to the pubic area, and a new hole is made for the belly button.

Mini tummy tuck

A mini tummy tuck only removes skin from below the belly button. This is more suitable for patients with little excess skin in the pinch test.

Sometimes, it involves muscle tightening from the belly button and below. The belly button is tugged downward but left intact. It often (but not always) leaves a shorter scar than a full tummy tuck.

Non-muscle tightening tummy tuck

A tummy tuck, mini or full, can be performed without tightening the muscles. The same amount of extra skin can be removed, but the muscles will not be made flatter. Muscle tightening causes discomfort after abdominoplasty surgery, so some patients choose to avoid it.

This leads to a quicker recovery and a faster return to work, but some patients are unsuitable candidates.

Umbilical float

In tall patients, the skin above the belly button may not be loose enough to pull down to the pubic area. In this case, the belly button can be released from the abdominal wall and pulled down with the skin. It does more skin tightening than a mini tummy tuck but less than a full. Patients must be chosen carefully because the belly button will be significantly lower.

Panniculectomy

In a tummy tuck, skin is elevated off the abdominal wall, pulled and stretched down, like fitting a fresh sheet on a bed. For older, heavier, and less healthy patients, this can increase the risk of healing problems.

Instead, a panniculectomy is an alternative procedure that just removes a wedge of skin and fat in the lower abdomen. It does not elevate the abdominal wall skin.

The belly button is removed with a panniculectomy. It sounds strange, but you don’t need it.

TattleTuck

Yes, we made up a name for a tummy tuck performed at AT Cosmetics on rare occasions as we’ve never seen anyone else describe it.

The TattleTuck is for moderately tall women with enough skin laxity for a mini tummy tuck, but with muscle separation to the top of the abdomen. In this select group of patients, we do a full muscle tightening, but with only a mini tummy tuck skin excision.

While there is a scar around the belly button, like a full tummy tuck, the belly button is put back in the same place (same hole). In these patients, an umbilical float would bring the belly button down too low.

Endoscopic tummy tuck

We are yet to find a patient for whom an endoscopic tummy tuck makes sense.

An endoscopic tummy tuck tightens the abdominal wall muscles but does not remove any skin. It is a very rare patient that has enough muscle separation (diastasis) to make the surgery worthwhile with no extra skin.

Fleur de Lis tummy tuck

Most people have never heard of a Fleur de Lis tummy tuck. It is mainly used for patients with massive weight loss.

A standard tummy tuck pulls out extra skin from top to bottom, which is enough for most post-pregnancy patients.

However, massive weight loss patients are not just loose up and down (vertical laxity), they are loose side to side (horizontal laxity). A Fleur de Lis tummy tuck pulls top to bottom and side to side. The downside is that it leaves a verticle scar in the middle of the abdomen. Some patients would rather not have this scar.

Extended or circumferential tummy tuck

Some patients have laxity that extends toward the backside or, in some cases, all around the trunk. Some surgeons call extending toward the backside an extended tummy tuck.

We extend tummy tucks as needed, depending upon the degree of frontal laxity. In select cases, usually after massive weight loss, we will excise skin from the back and front at the same time. This is known as ‘belt lipectomy’.

Where does liposuction fit in?

We commonly perform liposuction of the flank (love handle) area as part of a tummy tuck for appropriate candidates. This improves the results.

Some patients carry their flank fullness all the way around above the buttocks. For these patients, we may recommend a “posterior flank” liposuction. This area cannot be reached from the front, so in these patients, the surgery starts face-down to perform the posterior flank liposuction.

Fortunately, neither hip nor flank liposuction interferes with the blood supply to the abdominal skin we pull down. Some surgeons will liposuction the upper abdominal skin to thin it. We believe this is risky and often unnecessary. Lifting and pulling on the skin as part of the tummy tuck already changes and stresses its blood supply, so performing liposuction on this area simultaneously is double the stress and can lead to healing problems.

If we have a patient with fatty fullness in the upper abdomen, we discuss staged upper abdominal liposuction after the abdomen has healed. It is a much safer option.

Do I need a tummy tuck or just liposuction?

When patients come to us about improving the appearance of their abdomen they are often confused about whether they require liposuction or a tummy tuck with liposuction.

The key is in the skin.

If a patient has a bulge of fat, but the overlying skin is tight, then liposuction alone will remove the fat, and the skin will shrink nicely.

This is because liposuction just removes fat, not skin. Despite many claims, no form of liposuction tightens skin well. In fact, to some extent, liposuction makes us looser by removing the fat that’s already filling the skin. This means liposuction works best on younger patients, who have tighter skin and smaller fatty areas.

How long will the scar be?

No patient ever wants a scar, let alone a long scar. However, the scar is the trade-off and you have to ask yourself “Is it worth it?”.

For most people, the trade-off is usually worthwhile but never let any plastic surgeon push you to a scar you can’t live with.

As plastic surgeons, we are trained to hide the scars as best scars we can. We perform multiple layers of closure, with buried nonreactive sutures to minimize the impact of the scar. Unfortunately, even today, genetics still plays a large role.

But, to answer the question, the size of your scar will depend on how loose your skin is and the type of tummy tuck performed. Generally, looser-skinned people have longer scars than tighter-skinned people, whilst those who only have a mini tummy tuck will have less scarring.

How do you hide the scar?

We ask patients to bring in their favorite underwear or bathing suits (no thongs, strings, or laces/frills). Aim for a timeless style about an inch and a half wide on the hip. And makes sure it’s not too expensive, in case we get marker on it.

We will then plan the incisions low in the underwear/bathing suit line because when skin is pulled tight, the pubis and the scar can rise. Every effort is made to keep the scar as low as possible.

For men, we usually plan a more horizontal scar in keeping with their underwear waistband.

What will happen to my belly button in a tummy tuck?

In a full tummy tuck, your belly button is left attached to the abdominal wall. The upper abdominal skin is pulled down over the belly button stalk. A new hole is made at the proper location, and the stalk is pulled through. So, it’s still the same belly button, but it is coming through a new hole. There is a scar around the belly button where it is sewn in. In people with a thicker fatty layer, the scar is pulled inward and can be less visible.

Your belly button is completely unaffected in a mini tummy tuck.

Will I need a tummy tuck drain afterward?

When skin is elevated, tugged on, and put back down as part of the tummy tuck, oozing occurs until the skin sticks to the abdominal wall. This is normal.

However, if this fluid accumulates, it can become infected. A drain is a tube attached to a bulb that sucks the fluid away. We leave at least one drain on patients.

We usually bring it out through the right hip incision. Some surgeons will bring the drain out through the pubis, but we see no need to make an additional scar.
In addition, we sew the skin, so it heals more quickly to the abdominal wall. Some surgeons will do this and not leave a drain. However, we believe the drain is a good safety precaution. It usually comes out at the first or second post-operation check-up.

Do you use a pain pump?

A pain pump is a balloon filled with local anesthetic that drizzles the anesthetic under the skin via small tubes placed internally at the time of surgery. The tubes are removed 3-5 days after surgery.

We will place a pump if requested, but we generally prefer not to add additional tubes penetrating the skin.

For most patients, we use a long-acting local anesthetic injected into the tummy while the patients are asleep instead of a pain pump.

How flat will I be?

Your body, a living tissue, is smarter than your doctor. Your tissue responds to tension and will relax if there is too much. We believe two factors contribute to how flat you will stay:
  1. The strength of your tissue – we bring the abdominal wall muscles back together in a tummy tuck, but we are not sewing the muscles. We are sewing a strong layer of tissue that surrounds the muscle known as fascia. The stronger the fascia, the better it holds. Large or multiple pregnancies can weaken the fascia.
  2. The weight you carry inside your belly – Dolly Parton once said, “You can’t put ten pounds of potatoes in a five-pound bag”. She was referring to a different part of her anatomy, but the same is true for the abdomen.
A slender person with less abdominal weight is likely to stay flattest. Midweight patients will tend to see more relaxation but find an improvement. Full-figured patients may ultimately stretch back to where they were. In all cases, patients and their bodies will find their best abdominal wall equilibrium.

Do I have to tighten the muscles in a tummy tuck?

No, you do not have to tighten the muscle in a tummy tuck. The muscle tightening part of a tummy tuck is what causes the most discomfort, so some patients choose to skip it. Even so, most choose muscle tightening to flatten the abdominal wall as much as possible.

Will I be thin after a tummy tuck?

Tummy tuck surgery does not make people thin, it makes them more streamlined.

Whilst it does take away some skin and fat, the weight loss is not as much as you would think. Our organs and muscles are dense and heavy, but fat is not.

It is always best to be at a healthy, stable, and sustainable weight before surgery. If you lose a significant amount of weight after surgery, your skin will get looser again, meaning you could even need a second tummy tuck.

Do men have tummy tucks?

Although a tummy tuck is a very common choice for postpartum women, both men and women can undergo a tummy tuck. For men, the procedure is usually performed following significant weight loss.

What are the risks of a tummy tuck?

All the risks of abdominoplasty (tummy tucks) are discussed in great detail during a consultation.

Furthermore, consultations are followed up with a consent form that has everything laid out in print.

We make a point to educate patients about the tummy tuck and its risks, but we do everything we can to minimize them.

How much does a tummy tuck in Maryland cost?

We understand that one of the main concerns for people considering a tummy tuck is the cost of the procedure. We believe in transparency and, more importantly, that the fee we display should be all-inclusive. Many practices will display a price that seems lower at first but does not include additional costs like the anesthesia fee or the facility fee.

Our tummy tucks are priced as follows, and they include the cost of the procedure, the anesthesia fee, the surgical fee, and check-up fees:

  • Full tummy tuck – $9600 
  • Mini tummy tuck – $8600 
  • Fleur de Lis tummy tuck for massive weight loss – $10,600
  • Additional liposuction priced per site.

“I decided to have my tummy tuck done by Dr Tattelbaun because he kept it real, he did not try to sugarcoat the procedure and he was very honest about the recovery and side effects… My results are amazing, I am now able to wear a bikini.”

Rebecca B.

Further information

Preparation

To prepare for a tummy tuck in Maryland, we recommend that you:
  • Note down your objectives, concerns, and questions for Dr. Tattelbaum ahead of the consultation
  • Stop smoking, reduce alcohol intake, and maintain a healthy diet in the weeks leading up to surgery
  • Exercise regularly and get plenty of rest, this proactive approach will aid recovery afterward
  • If you are dieting, do so with a safe and sustainable plan before surgery. Then, try to maintain a stable weight for a while before surgery. If you continue to lose weight until the day of surgery then you won’t have the proper nutrition to heal.
  • Organize for someone to take you home and stay with you for a few days after surgery.
  • Prepare several meals in advance, so you don’t have to exert yourself after surgery.

Recovery

Most patients recover well from a tummy tuck, although there is the usual period of swelling and soreness associated with any surgical procedure.

For a full tummy tuck with muscle tightening, the average patient takes roughly two weeks off work. Even so, we recommend taking a third week if you can. It’s nice to have the third week and not need it, rather than the other way around.

We also recommend:
  • Avoid strenuous activity for several weeks after surgery – Dr. Tattelbaum can give you a timeline based on the type of tummy tuck performed
  • Sleep on your back to keep the pressure off your abdomen
  • Take the medication and painkillers prescribed by Dr. Tattelbaum to combat swelling and soreness
  • Eat a healthy, balanced diet
  • Drink plenty of water
  • Get as much rest as you possibly can

Before and after tummy tuck

You can see an entire gallery of before and after pictures from our tummy tuck patients here:

Tummy Tuck Gallery

Example

In the case study shown below, you’ll see before and after pictures from a post-partum woman. 

We performed a full tummy tuck.

You can see how this has both flattened and tightened the stomach area. If you’re looking for similar results, please get in touch today.

Location

Patients seeking a tummy tuck in Maryland can attend our practice in Rockville:

3203 Tower Oaks Blvd, Suite 200
Rockville, MD 20852

To reach us by car from the center of Rockville, head southwards on the I-270 S. Take exit 4A and merge eastwards onto Monrose Road. Then, take the first left onto Tower Oaks Boulevard.

Schedule your consultation

To schedule an appointment for a tummy tuck, please get in touch today.

The consultation lasts for roughly one hour. In the consultation, Dr Tattelbaum will evaluate your health and starting situation and answer any questions you may have. Plus, we’ll cover the risks, benefits, and alternatives to abdominoplasty supported with teaching diagrams and photos.
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