Tummy Tuck Preliminary Steps

Innovations Medical is the first practice in the Metroplex to offer the new Smart Lipo MPX

Dr. Bill Johnson is the 1st physician in Texas with the new SmartLipo MPX, a safe alternative liposuction. SmartLipo is performed while you are awake and melts fat. Dr. Johnson has been performing SmartLipo longer than any other physician in Dallas Fort Worth.


What is Awake (Avelar) Tummy Tuck?

The Awake Tummy Tuck technique was introduced by Dr. Juarez Avelar, MD in 1999. The Awake Tummy Tuck combines abdominal liposuction with excision or surgical removal of the excess skin on the lower abdomen. The liposuction is performed using tumescent anesthesia. Tumescent anesthesia is a form of local anesthesia where a special fluid is pumped into the surgical area. The fluid numbs the area as well as reducing bleeding and bruising. This allows the liposuction and later the excess skin removal to be done comfortably with the patient awake. Since the patient is awake, the term Awake Abdominoplasty or Awake Tummy Tuck has become popular. The end result is a flat stomach with no excess skin.

Why have an Awake Tummy Tuck?

Simply put, anyone who has a significant abdominal bulge should consider an Awake Tummy Tuck. Abdominoplasty or tummy tuck gives the very best result of any abdomen reducing cosmetic procedure a smooth, flat stomach. Thermage works well with limited amounts of loose skin. Liposuction can greatly reduce fat and size, and when SmartLipo is used it can give excellent results. However, when a large bulge or a large amount of loose skin is present, tummy tuck should always be considered as an alternative. Awake Tummy Tuck has several advantages over conventional procedures:

  • Use of local anesthesia avoids the potential complications of general anesthesia.
  • Use of liposuction with skin reduction allows a more complete removal of abdominal fat and often a more natural and sleeker look.
  • Use of local anesthesia and liposuction as part of the tummy tuck reduces down time to essentially that of liposuction.
  • Avoiding sewing of the abdominal musculature reduces the pain and recovery time.
  • Use of a closed suturing technique to close the incision all but eliminates post operative wound care.
  • Use of a closed suturing technique promotes a thin less noticeable scar.

When compared to other, less aggressive methods of abdominal reduction, tummy tuck gives the flattest result and can handle the most excess abdominal tissue.

What are the steps leading to the Awake Tummy Tuck?

It is important to understand what you will experience when you undergo an Awake Tummy Tuck procedure. The procedure usually proceeds in this manner:

  • You will come in for consultation to determine if Awake Tummy Tuck is a good procedure for you. After discussion and evaluation Awake Tummy Tuck is chosen as the best procedure. A pre-operative evaluation is scheduled for you.
  • Prior to your pre-operative evaluation you will be given some written materials to review. These include:

    • Written consents for liposuction and Awake (Avelar) Abdominoplasty
    • Instructions for the day of surgery.
    • Medication instructions.
    • Written prescriptions for your post-operative period.
    • Some written information to help you post-operatively and during recovery


  • Dr. Johnson performs the pre-operative evaluation. This includes blood work done in our office a review of your medical history and a directed physical exam. On rare occasions some additional tests like more blood work or an EKG may be needed. Once it is determined that you are a good candidate the procedure is scheduled. The pre-operative evaluation can be done on the day of the surgery but we prefer to do it a few days ahead of time. We often do the pre-operative evaluation on the same day as your initial consultation.

    You are now ready for your procedure.