HMT Sancta Maria Hospital, Swansea
|
Choose text size
 
|
|
Abdominal reduction (tummy tuck)
Some
people may have excessive or sagging skin around their abdomen, even if they are
not overweight. The problem may be
a result of dramatic weight loss, multiple pregnancies, or twin and triplet
pregnancies. There may also be the added problem of lax abdominal muscles. The sagging may not be corrected by
further dieting and exercise. In
this case the only remedy is surgical removal of the excess skin. Treatment The
surgical procedure to remove the excess skin is known as abdominoplasty. Excess
skin and fat is removed from the abdomen between the pubic area and the
umbilicus (belly button). If lax muscles are a problem, these can be tightened
at the same time. Occasionally,
liposuction may also be carried out, but this is not a routine part of the
operation. Procedure An
ellipse of skin is removed between the umbilicus and the pubic area, along with
the underlying fat. The umbilicus is left in place. Once this skin has been
removed, the skin above the umbilicus is pulled down firmly towards the pubic
area where it is sutured into place. Post
Surgical Care Two
drainage tubes are usually used which are removed once the drainage has subsided
— usually 24-48 hours. Surgeons
will request that a supportive garment is placed around the abdomen before you
leave theatre. A pillow will be
placed under your calves to keep your legs slightly bent at the hips. This
reduces tension on your abdomen in the initial post operative
period. You
will be given fluids intravenously (a drip) on the first day of surgery. You
will be able to eat and drink normally on the next day. Some patients experience
nausea. The nursing staff will be able to give you medication to alleviate
this. A
degree of pain is expected following surgery but this can be controlled by pain
killers, either by injection or in tablet form. Your abdomen will feel extremely tight
when you first get up following surgery. This will ease and nursing staff will
help and encourage you to mobilise. This helps to reduce the likelihood of post
surgical complications. Most
patients will stay two nights in hospital following abdominoplasty. Limitations Abdominoplasty
is NOT a substitute for weight loss. You should aim to be at or near your ideal
weight before undergoing this procedure. Continued weight loss following surgery
could result in further drooping of the abdomen. In addition, an abdominoplasty
tightens your abdomen skin downwards - it does not tighten or slim the
waist. It
is possible to have a slight bulge above the scar because there is naturally
more fat in the abdominal wall than in the groin. This can be corrected with
liposuction. Your surgeon will discuss whether you are likely to need
liposuction. The
effects of an abdominoplasty generally last well. This can be maintained by
keeping at a steady weight, exercising regularly and avoiding becoming
pregnant.
In
some cases minor adjustments under local anaesthetic are required at a later
date. What
to expect following surgery: You
will be encouraged to be mobile and return to normal activities as soon as
possible following surgery. Pain and tightness will subside over the coming
week. You
will be able to return to work within 2-4 weeks of surgery, depending upon how
physical your job is. Strenuous activities such as sport and heavy lifting
should be avoided until 6 weeks following surgery. Your
surgeon may advise wearing a garment such as supportive underwear or shorts
during the initial weeks to avoid strain on the incisions. Some
surgeons prefer you to avoid getting the surgical wounds wet during washing
until you have had your first follow up appointment. Risks There
are potential risks inherent in undergoing any surgical procedure such as pain,
bleeding, infection and thrombosis.
The
risk of thrombosis is reduced by using anti embolic stockings and administering
a low dose of heparin by injection whilst in hospital. Early mobilisation is
also important to prevent thrombosis and chest infection. The
risks of infection, poor wound healing and thrombosis are increased in smokers,
diabetics and overweight patients.
Collections of blood (haematomas) or fluid (seromas) can occur. These can resolve spontaneously but
sometimes require drainage with a needle or, more rarely, return to the
operating theatre. Over-activity in
the early days can contribute to delayed healing and fluid accumulation. Numbness of the abdomen can occur after
surgery and will sometimes be permanent.
The
information contained in this website is not exhaustive. A full consultation with a suitably
qualified surgeon is essential to ensure
that your individual risks are assessed and to ensure that this type of
surgery is suitable for you. Sources/Further
Information: · British Association of Aesthetic Plastic
Surgeons (BAAPS) · British Association of Plastic Reconstructive & Aesthetic
Surgeons (BAPRAS) · Department of Health Cosmetic Surgery:
Information for Patients (August 2006) · NICE Venous Thromboembolism (April
2007) · NICE Surgical Site Infection Prevention &
Treatment of Surgical Site Infection (October 2008)
|
|
