Tummy Tuck (Abdominoplasty)

Tummy Tuck (Abdominoplasty)

What is abdominoplasty?

Abdominoplasty (also referred to as abdominal reduction) is a cosmetic surgical procedure designed to remove excess skin and fat from the middle or lower abdomen and to tighten the abdominal muscles. Multiple pregnancies and marked fluctuations in weight are most frequently responsible, as they stretch the abdominal wall tissues. When the deeper elastic structures of the skin (dermis) are torn, stretch marks can result.

Although proper diet and exercise may improve the contour of the lower abdomen up to a point, no amount of exercise will take away skin laxity and stretch marks. In addition, some surgical scars on the lower abdomen, such as those produced by caesarean section, may be improved by abdominoplasty. Removing skin folds, scarring and stretch marks may improve the appearance and profile of the lower abdomen.

Surgery is neither a substitute for weight reduction nor a cure for obesity.

How would this procedure help me?

A consultation with your plastic surgeon is the first step in considering abdominoplasty. You should frankly discuss your goals and expectations, and your plastic surgeon will advise you whether they are realistic. Suction lipectomy (liposuction) may be advised in addition to, or instead of, abdominoplasty. You should always keep in mind that the desired result is an improvement, not perfection.

How is abdominoplasty performed?

The procedure is performed under general anaesthetic and lasts from one to three hours. Excess skin and fat are removed from the lower abdomen and the abdominal muscles (rectus) tightened. In most patients the navel is repositioned. An incision is made above the pubic hairline in an area normally covered by a bikini.

The skin is then lifted off the deep muscle layer as far up as the ribs. The abdominal muscles may then be tightened. Finally, the skin is pulled down and excess fat and skin are removed. Stretch marks in the remaining skin usually have an improved appearance. Surgical drains are positioned, and exit in the pubic region. The major scar lies in a horizontal line across the lower part of the abdomen and a smaller scar around the navel. It may be necessary to make a vertical incision in the midline in cases with severe skin laxity such as if you have lost a great deal of weight.

Liposuction of the hips and upper thighs may be done in association with abdominoplasty.

What happens after the surgery?

Your anaesthetist will prescribe the necessary medication to relieve post-operative pain. The surgical drains will usually be removed in one to three days. You will find it difficult to stand perfectly straight for a few days, and should avoid trying too hard, as it will place excessive tension on the lower abdomen.

Over a few days the skin will slowly relax and you will feel more comfortable. Your stitches will be examined five days after surgery to ensure that the wound is healthy, and some will be removed two weeks after the operation. Your surgeon will also see you three months after your surgery. There may be some numbness and increased skin sensitivity in the lower abdominal area for several months.

You should not return to work for two to four weeks after the surgery, depending on the type of work you do. Strenuous activities and sports may be resumed after one or two months.

Will the procedure leave any scars?

Although scars are the inevitable results of any surgery, your surgeon will make every effort to make the scars as inconspicuous as possible. However, scarring is an individual characteristic and can vary from patient to patient.

What results can I expect?

The best results are obtained in patients of near normal weight with some laxity of the abdominal skin or a slight excess of fat or bulging of the abdominal muscles. The result of surgery is usually permanent although excessive weight changes or future pregnancies may undo the benefits of the surgery. Your surgeon is the best person to determine whether your expectations are realistic.

What can go wrong?

There are risks involved in any form of surgery, and although uncommon, the possibility cannot be ignored. You should discuss these risks with your surgeon.

What can I do to reduce problems with surgery?

Firstly, listen to what your surgeon has to say, and take his advice! Excessive bleeding during or after surgery is always a possibility. It is therefore essential to avoid taking aspirin or ant-inflammatory medication for two weeks before and one week after the operation.

If you are taking any medication, or if you have varicose veins or have ever had phlebitis, tell your surgeon at the visit preceding the operation. The risks of surgery are increased greatly by the use of tobacco, due to interference with circulation and wound healing. Also, being overweight significantly increases your risks.