Abdominoplasty (tummy tuck)
What is an abdominoplasty?
Abdominoplasty is an operation to surgically improve the appearance and contour of the abdomen. Abdominoplasty is more commonly known as a "tummy tuck". The surgeon removes excess skin and fat from the middle and lower abdomen in order to tighten and improve the appearance and comfort of the abdomen. It may also include tightening of the abdominal muscles and liposculpture of the waist and flanks.
The best candidates for abdominoplasty are men or woman who are concerned by abdominal fat deposit or loose skin that has not improved after diet or exercise. This procedure is particularly helpful for women that have stretched abdominal muscles after childbirth.
If you are planning to lose a large amount of weight or become pregnant the procedure is best performed after this. Thousands of abdominoplasties are performed each year and patients are very happy with the results.
How is the procedure performed?
An incision is made across the lower abdomen, extending out to the hips. The skin and fat are elevated up to the rib cage. The muscles are tightened if necessary. Excess skin and fat are removed and upper abdominal skin is brought down. A new opening is made for the navel in its normal position. Abdominoplasty is performed under general anaesthetic and takes approximately three hours.
What should I expect after surgery?
After surgery you will be wearing a garment to provide support to your abdomen. This garment is ordered and fitted prior to the operation. It is worn for 6 weeks following surgery. Sutures, if present, are removed 1-2 weeks after surgery. Although you will not be able to stand straight in the early stage after surgery, walking as soon as possible will help circulation and lessen the risk of complications. It is important to rest after surgery.
When can I return to normal activities?
Usually 2 weeks are required off work although some people require a longer recovery period. Gentle exercises can be commenced after 3-4 weeks, however, vigorous exercise should be avoided for 6-8 weeks. It may take 2-3 months before you will feel you have returned completely to normal.
- Is there anything I should do before surgery?
- Avoid taking aspirin for two weeks before surgery.
- Do not smoke for two weeks after surgery as this will delay the healing.
- The oral contraceptive should be ceased from the time you decide to proceed with surgery.
Are there any risks?
As with any surgical procedure, there is a small risk of complications. Surgery and anaesthesia are very safe and it is most unlikely you will experience any difficulty. However, there are areas of potential problems you need to understand before proceeding with your surgery. You can reduce your risk of complications by closely following instructions after surgery.
Bleeding: Pressure garment and binder are used to prevent bleeding. Bleeding can occur in about 2-3% of cases. It is most likely immediately following surgery or that evening. It is possible in some cases of bleeding that a return to the operating theatre will be required. The likelihood of this is very rare.
Infection: Antibiotics are given for 48 hours to prevent infection. If infection occurs it will usually become evident within one week of surgery and may delay the healing process or result in the development of scar tissue. In the unlikely event of infection, the ultimate result of the surgery may be adversely affected.
Anaesthesia: You will have a general anaesthetic and your anaesthetist will examine you and discuss the procedure. Any questions you have regarding your anaesthetic will be answered by your anaesthetist before surgery.
Scarring: All surgery leaves a scar. The long scar is never invisible but is placed in a position that is inconspicuous when wearing most clothing or swimming costumes. The scars will often look red and lumpy at about three months after surgery (as you can see in the photo). This is normal and will settle over the following 3-6 months. It takes 12-18 months before the scars mature completely, flatten out and lighten in colour. The quality of the scar cannot be predicted prior to surgery as this varies with individual healing. Because excess tissue is pulled down, there can be a tendency for the pubic hair to be pulled up a little. For this reason I prefer a low scar keeping the final scar hidden.
Sensation: Areas of your lower abdomen may be numb for up to six months as the disturbed nerves are recovering. This numbness although usually temporary, can in rare cases be permanent. Fluid Collection: A seroma is a collection of fluid under the skin and fat. If this occurs it may take a few weeks to absorb. Wearing the pressure garment will help reduce this risk.
Circulation: Although rare, there is a risk of clotting in the veins of the legs. Such a thrombosis may rarely be complicated by pulmonary embolism ( a clot going to the lung). The risk of this is about one in 500 and is increased with use of the oral contraceptive pill. This can be reduced by flexing your calves after surgery to maintain leg circulation and moving around as soon as possible.
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Important points to remember before proceeding with surgery:
- There can be no absolute guarantee with any surgery. In the hands of any experienced surgeon, a secondary operation to correct a minor irregularity may be needed.
- Should there be any questions regarding abdominoplasty, be sure they are answered in advance by your surgeon. Well meaning friends are not a good source of information. Find out everything before the operation - a well informed patient is a happy one.
- The best candidates for cosmetic surgery are those who want to enhance or improve their appearance, not those who seek perfection. You will be satisfied with the results of surgery if you have realistic expectations. It is important that you make the decision to proceed with surgery for yourself, not anyone else.
The next step when considering cosmetic surgery is a consultation with your surgeon. You will be shown before and after photos and will be given the opportunity to discuss the procedure with previous patients. The above information mentions only some of the benefits and complications of abdominoplasty. This information should not be regarded as a substitute for information and advice provided by your surgeon during consultation.