Drainless Tummy Tuck Surgery in NYC

Tummy Tuck

Dr Gandolfi performs a variety of tummy tucks, depending on the needs of his client. These can include the mini tuck, a lipoabdominoplasty, an extended abdominoplasty, and the drainless tummy tuck he is best known for. Even within these categories, each style of tummy tuck is customized to meet the needs of the patient.

Dr Gandolfi has crafted his unique approach to the tummy tuck over years of practice. His training spanned the United States and post-training he has dedicated himself to acquiring and applying a unique set of techniques designed to maximize comfort and results while minimizing scarring. His knowledge of the procedure led him to write “The Expert Guide to Tummy Tucks.”

Specifically, core components of every tummy tuck performed by Dr Gandolfi include:

General anesthetic modifications to improve recovery
Pre-cut numbing medication designed to treat pain before it starts
Post-surgical long-acting numbing medication to keep things comfortable
Advanced liposuction techniques designed to maintain a natural look
Progressive tension sutures to maintain results without garments and massages
Lymph node sparing techniques to improve healing and allow for drainless techniques
A custom belly button technique to hide the scar
A focus on the contour transition from the abdomen to the pubic area
Intra-operative medications designed to minimize hematoma/postoperative bleeding
Blood thinners to minimize blood clots postoperatively
Preoperative and postoperative bowel regimens
A multi-modal pain control regimen to minimize narcotics and expedite recovery

The Drainless Tummy Tuck

The signature tummy tuck of Dr Gandolfi is his drainless tuck, which is the best procedure for 75 percent of his clients. The procedure starts with one of our board-certified anesthesiologists putting the client to sleep. After this, the entire abdomen is infused with numbing medication to prevent pain before it starts. Next, fat is removed and the skin is elevated using VASER ultrasonic technology and MicroAire power assisted liposuction technology. Fat removed is either discarded or kept for use later. It is during this phase that the waist is defined, the abdomen is contoured, and the transition between the abdomen and the pubic area is shaped.

Once complete, a lymph node sparing abdominoplasty commences where skin is removed below the belly button. The belly button is left in position, and if a hernia is present it is fixed at this time. At this point, a long lasting numbing medication (exparel and bupivacaine) is injected into the muscles and skin for postoperative pain relief. The muscle layer of the abdominal wall is then assessed and repaired (the rectus diastasis) with 3 layers of suture. The area is then washed with an agent to reduce bleeding and closed using progressive tension sutures to gently bring the skin down into position. The skin edges are then brought together in meticulous fashion. A dressing is placed and you are awakened and brought to recovery!

The Skinny Tummy Tuck

Perhaps the most difficult tummy tuck is the skinny tuck! While you might expect this to be easier, the lack of fat to contour and hide sutures makes this procedure more difficult. The skinny tuck is generally a variation of the drainless tummy tuck, but may differ from above if the patient has minimal extra skin. In these cases, a small lower incision is made and the belly button is left attached to the skin. With this technique, a full diastasis repair can be performed and the only incision created is one similar to a C section scar. There is no incision around the belly button. Umbilical hernias can be repaired at the same time.

The Mini Tuck

The mini-tuck describes a skin excision under the belly button. This can be paired with liposuction to provide a result that can mimic a traditional tummy tuck without the scars and recovery in the right individual. This works best for someone that does not have a lot of extra skin or a large diastasis/abdominal bulge.

The Extended Tuck

For those patients with extra skin that wraps around the sides of the abdomen but not the back, an extended tuck is the right option. Although a larger incision is required than a standard abdominoplasty, the proper amount of excess skin is removed and prevents the need for additional procedures on the sides.

The Lower Body Lift

When the extra skin is not confined to the front of the abdomen but instead wraps around the client to the hips and lower back, a lower body lift can be used to remove all the excess skin at a single time. This extra skin can be common in someone that has lost a significant amount of weight. With this surgery, the abdominoplasty incision extends from the front to the back, riding the hips and upper butt to get the right contours. All incisions hide easily within underwear.

Excess skin and fat around the lower abdomen can be extremely frustrating and may not respond to diet and exercise. Through a plastic surgery procedure known as a tummy tuck, you can address these concerns and have the flat, athletic abdomen you have always wanted. Dr. Brad Gandolfi is a double board-certified plastic surgeon and two-time Castle Connolly NY top doctor who specializes in helping people achieve their goals. He does this using the newest drainless techniques that make his tummy tucks less painful and highly sought after. Although the drainless tummy tuck is the most common type performed, Dr. Gandolfi also performs mini-tummy tucks, traditional tummy tucks (with drains), and floating belly button tummy tucks.

The Benefits of a Tummy Tuck

A tummy tuck can provide you with a natural flat stomach, allowing you to look and feel your best. Some additional benefits to having a tummy tuck include:

Diastasis recti (bulging stomach) repair: The abdominal wall is often injured during pregnancy or with weight gain, causing bulging of the stomach. The only way to repair this is with a tummy tuck. Diet and exercise will not fix this problem.
Better posture and less back pain: By repositioning your stomach muscles, a tummy tuck can improve the position of your lower back and flatten your stomach, improving your posture and alleviating back pain.
Hernia repairs: Both umbilical hernias and small ventral hernias can be repaired during a tummy tuck procedure.
Fat removal, with or without transfer: Although not necessary, liposuction can be performed safely and effectively during a tummy tuck. This fat can then be transferred to areas such as the breast or hips to enhance contours.

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Am I a Good Candidate for a Tummy Tuck?

During your initial consultation, Dr. Gandolfi will perform a physical evaluation and review your medical history. Based on this information, he will verify whether you are a good candidate for a tummy tuck.

The best candidates for a tummy tuck:

Are in good health overall
Are not extremely overweight. Your BMI (body mass index) must be less than 35 to have this surgery safely. If your BMI is greater than 35, weight loss will be recommended.
Do not smoke cigarettes or use nicotine products

You may not be a good candidate if:

You are a smoker
You are looking for an “easy” way to lose weight
You think you may still wish to have children
You have a history of blood clots
You are on blood thinners

The Procedure Process Explained

Dr. Gandolfi is committed to personalization. No two patients are exactly alike, and neither are any two tummy tucks. The following details what most patients can expect before, during, and after the procedure.

To start the process, you’ll have an initial phone call with a member of our team to discuss your medical history and your aesthetic goals, and to schedule your consultation.

When you see Dr. Gandolfi, he will perform a full physical evaluation, verifying that you are eligible for a safe and successful tummy tuck. Dr. Gandolfi will also talk with you about what you are hoping to achieve through your tummy tuck, provide more information about anesthesia options, and answer your questions. This consultation usually lasts around 30 minutes and will provide you with a full roadmap for the rest of your surgical experience.

Dr. Gandolfi will provide you with guidelines about how you can prepare for your tummy tuck. This may include pausing certain medications and supplements or fasting the morning of your procedure. You will also need to make sure you avoid smoking for at least six weeks before the tummy tuck.

Your surgery will start with you arriving at the surgery center, where you will meet the surgical team. Next, you will be brought into the operating suite and will go to sleep. The next thing you know, you will be waking up in recovery!

For your tummy tuck, Dr. Gandolfi will start by contouring your abdomen using power assisted liposuction. After your abdomen has been appropriately contoured, he will make an incision above your groin, positioned so that it is easily hidden by underwear or a bathing suit. Through this incision, Dr. Gandolfi will remove the excess fat and skin tissue. Next, the abdominal muscles are tightened with a 2-3 layer inner corset suture. The remaining skin will be repositioned to create a taut, natural look.

One thing that distinguishes Dr. Gandolfi’s tummy tuck procedures is the detail that he creates using liposuction. His goal is to give you a naturally trim, taut abdomen without leaving you looking like you just had surgery.

Another differentiating feature of Dr. Gandolfi’s tummy tuck is that most of his patients don’t require a drain following the procedure. Dr. Gandolfi uses a combination of unique techniques to minimize drainage and negate the need for drains.

One of every tummy tuck patient’s greatest concerns is the scar, and that makes it one of Dr. Gandolfi’s biggest concerns as well. Dr. Gandolfi uses a layered approach to closing the incisions to minimize the appearance of scars over time. While tummy tucks do leave scars, Dr. Gandolfi positions them so that they are concealed by clothing, underwear, or swimsuits. If you have an existing C-section scar, the incision will be placed below it to remove this scar. The belly button scar is placed under the cover of the abdominal wall skin to hide it.

The overall size and height of the scar depend on the type of tummy tuck as well as the amount of excess skin.

When you wake up from surgery, you will be able to walk. It is important for your recovery that you continue to walk when home. Prior to being discharged, you will receive all the guidelines you need concerning diet, bathing, and caring for your incisions.

After a tummy tuck, you should expect to feel some discomfort for about 2 weeks. You will be given medications to help you through this time. Dr. Gandolfi also offers a new medication (Exparel) that significantly decreases postoperative pain. Depending on your job, you should plan to take 2-4 weeks off. When drains are placed (most tummy tucks are drainless), they stay in an average of 2 weeks.

For the first 30 days, your exercise will be limited to walking. After 4-6 weeks, you can start to do most exercises. After 3 months, you can resume all activities, including sit-ups and yoga.

MEET DR. GANDOLFI

Double Board-Certified Plastic Surgeon

Dr. Brad Gandolfi is a double board-certified plastic and reconstructive surgeon with offices in New York City and Englewood, NJ. He specializes in cosmetic surgery and is a member of The Aesthetic Society, a by-invitation-only society for doctors with experience and excellence in cosmetic surgery. He obtained his plastic surgery degree at Duke University Medical Center and spent additional training in facial surgery at UCLA Medical Center. Dr. Gandolfi is board certified by the American Board of Plastic Surgery and the American Board of Surgery.

MEET DR. Gandolfi

Other Things to Consider Before Getting a Tummy Tuck

Do you have additional questions about getting a tummy tuck? If so, we invite you to contact our office. We take delight in talking with our patients and educating them about different surgical options. In the meantime, here are a few of the most common inquiries.

Are There Any Risks Involved?

There are risks involved with any surgical procedure, including those associated with anesthesia. You can minimize most of these risks by ensuring that you choose a board-certified and highly experienced plastic surgeon to perform the work.

Will I Need to Request Extensive Time Off from Work?

Following a tummy tuck, it is imperative to give your body some time to heal. For most desk jobs, you can return to work after 2 weeks. If you have a physically demanding job, more time will be necessary before you are able to return to work.

Am I Too Young/Old for a Tummy Tuck?

When it comes to being a good candidate for a tummy tuck, your current lifestyle, future plans, and medical history are much more important than your age.

Does My Insurance Cover the Procedure?

Though most insurance policies will not cover a procedure like this one, we are always happy to talk with you about insurance and financing solutions.

How Long Will My Results Last?

Forever! Your new body can be thought of as a fresh starting point. You will, of course, continue to age, and you will still gain and lose weight as you do now, but the extra skin and fat that was removed will never return.

Is Getting a Tummy Tuck Really Worth it?

Ultimately, only you can make this decision. With that said, the tummy tuck is consistently rated one of the most “worth it” surgeries on Realself.com, with 96% of patients stating the surgery is a worthwhile investment.

Frequently Asked Questions

The amount of recovery time necessary after tummy tuck depends on the type of tummy tuck that is performed. For a standard tummy tuck, with muscle plication, you can expect a gradual return to your normal functions.

For the first week, we will move slowly and have some pain. The pain dissipates during the second week. Most people returned to work between 2 weeks and 2 months after the surgery.

After a month, you can begin exercising. After 3 months, you can go back to weightlifting.

The length of the scar is generally determined by the type of tummy tuck that is performed. The more excess skin is present the longer the incision will need to be to remove the skin.

The color and thickness of the scar is partially related to surgical technique and partially related to individual healing characteristics. Certain ages and skin types tend to heal better than others.

Dr. Gandolfi is aware of the effects of a scar and does everything possible to minimize the scar, before during and after the surgery. This includes layered closures, barbed sutures, skin pressure offloading devices and silicone therapy.

All procedures have associated risks and tummy tuck is no different. The most common concern after a tummy tuck is a fluid collection under the skin, otherwise known as a seroma. These are generally easy to treat. Other common issues after a tummy tuck may be a small amount of wound breakdown that does not require any surgical intervention.

Less common and more severe risks after a tummy tuck include risks associated with the administration of anesthesia, risks of infection, risks of larger skin breakdown, and risk of blood clot.

Although the list of things that can wrong during surgery and in particular during a tummy tuck is long, the risk of a severe complication associated with a tummy tuck is extremely low.

There are many variables that change the cost of a tummy tuck. The size of the client, the type of tummy tuck, and the length of surgery all contribute to the cost of the procedure. In addition to a surgeons fee, a surgery center fee and an anesthesiologist fee will also be added to the overall cost. A tummy tuck requires general anesthesia, and thus must be performed with an anesthesiologist in an accredited facility. Additionally, locality does affect the cost. In New York, high insurance premiums, cost of labor, and real estate costs increase overall costs.

Expect to pay between $15,000 and $50,000 for a tummy tuck in New York City, depending on the surgeon you pick and the above variables.

A tummy tuck is a large investment, and therefore it is common for clients to finance the procedure. Although it may seem like a lot of money, unlike a car this is something that you will use every single day for the rest of your life!

Yes, you can have more kids after having a tummy tuck. A tummy tuck is not a birth control device!

We have a variety of external financing companies that we use to get our clients the treatments that they want. When you come into the office, we can discuss these options with you as well as the terms.However, we generally recommend if you are going to have more kids that you wait until your family is complete before having a tummy tuck. This is because pregnancy changes the abdomen. Oftentimes, a tummy tuck is performed to help reverse some of the changes created by her pregnancy. Therefore, for more lasting benefits, we recommend waiting until you are done bearing children to have a tummy tuck.We have a variety of external financing companies that we use to get our clients the treatments that they want. When you come into the office, we can discuss these options with you as well as the terms.

Yes and no. For the first few days after a tummy tuck, you will need help with small children. Your body will be healing and that requires energy. To give your body the appropriate amount of time, you need help if you have small children at home. Generally speaking, we recommend 2 weeks of planning. After 2 weeks, you will be able to do everything you need to do to care for your children.

Although anyone is a candidate for mini-tuck, most people will be better served by a drainless tummy tuck.

A mini tummy tuck is a tummy tuck that does not require a plication and only treats excess skin below the bellybutton. If you have a small amount of excess skin below your bellybutton and no excess skin above your bellybutton, and you do not need your muscle tightened, then a mini tummy tuck is a good option.

If you have extra skin above your bellybutton or you need your muscle tightening, then there are better options for you than a mini tummy tuck. Despite the name, a mini tummy tuck only saves a couple of inches of scar length over a traditional tummy tuck.

The return to sex after tummy tuck is a very personal decision. For most people, they can return to sex after a month with certain restrictions. Some people choose to wait longer. In all instances, it is related to how the healing process is going and should be discussed with your doctor.

Because a poorly scarred bellybutton is a hallmark of a tummy tuck, many surgeons place a lot of care and effort into its positioning and location. Dr. Gandolfi uses a custom technique that he developed over time to avoid unsightly scars on the abdomen.

Additionally, some types of tummy tuck do not make any incisions around the bellybutton. These include the mini tuck and the umbilical float procedure.

Pain is extremely relative and personal, and thus some patients will experience almost no pain after tummy tuck and others will experience a significant amount of pain.

Because of this variability, Dr. Gandolfi treats everyone intraoperatively as if they are a sensitive individual. This includes a generous use of local anesthesia during the case to prevent pain before it even starts. Additionally, we use long acting medications during the procedure to numb areas that are commonly painful for days after the procedure.

The use of massages after a tummy tuck is controversial and surgeon dependent. In Dr. Gandolfi’s practice, for most clients, massages after surgery are not allowed during the early postoperative period.

Whether or not you need help at home after a tummy tuck is mostly dependent upon your personal situation.

Everyone that undergoes this surgery is required to have someone with them for the first 24 hours for assistance. After that, most people can take care of themselves. However, most people cannot take care of an entire family after a tummy tuck. Additionally, household chores should be minimized in the early postoperative period.

Therefore, although small things like cleaning yourself and making meals while moving around and taking walks are very important for the recovery process, more significant cleaning and chores are discouraged for the first 2 weeks.

Ideally, a tummy tuck is performed at a weight that you are comfortable at. A tummy tuck should not be performed during any active weight loss phase because in these circumstances your negative calorie balance puts you at a healing disadvantage. If, you are actively losing weight and have a goal weight set, then a tummy tuck should wait until you are stable at your desired weight.

If you are more overweight (BMI 35+), then the risk of surgery increases and thus Dr Gandolfi will require weight loss to decrease the likelihood of a complication after surgery and improve your overall health and result.

The amount of time required off of work after tummy tuck is dependent upon the job that you do. For most people, they return to work between 2 weeks and 2 months after the procedure.

Oftentimes, clients ask if they can perform work within a week of the surgery. If you have a computer or desk job, you can return whenever you are comfortable and off of narcotics. On the other hand, if you are a hospital ward nurse, give yourself 2 months.

No matter when you return, understand that your body will be using a lot of energy to heal. You will feel more tired during the day and at the end of the day. You will probably require more calories. As the healing progresses, this will get better.

Dr Gandolfi utilizes some type of liposuction with every tummy tuck he performs. The areas, type, and amount of liposuction performed varies depending on the type of tummy tuck being performed.

Additionally, if the client wants liposuction in other areas, it can often be accommodated at the same time.

By definition, a tummy tuck is a cosmetic procedure and thus is not covered by insurance. In severe cases of excess skin, a panniculectomy can be covered by insurance. A panniculectomy is similar to a mini tuck, in that skin is elevated to the level of the bellybutton and then the excess skin is removed.

A hernia can be fixed at the same time as a tummy tuck. This is commonly covered by insurance. Signs that you may have a hernia include pain at the bottom of the bellybutton or an “outie” bellybutton.

Yes, a tummy tuck can address stretch marks and cellulite, depending on where these things are located. Generally speaking, all excess skin is removed from below the bellybutton. Therefore, any stretch marks or cellulite that is present on the skin below the bellybutton will be removed during the surgery. However, any stretch marks or cellulite present on the upper abdomen will not be removed.

We recommend a gradual return to the gym after a tummy tuck. Your first trip to the gym should be 1 month after your surgery. Before that, only walking is recommended. After 3 months, a full return to weight training and stretching is okay.

Driving after a tummy tuck is appropriate if you are off all pain medication and muscle relaxers and you feel comfortable moving. For most people this happens 1 week after the surgery.

Experienced at Tummy Tucks

Ready to learn more about having a tummy tuck? Contact us to schedule a consultation at (212) 287-7211.

The Benefits of a Tummy Tuck