These days the Abdominoplasty is also commonly known as a “Tummy Tuck”. Modern Abdominoplasty uses two surgical procedures in tandem to flatten and re contour the abdomen. It primarily involves surgical tightening of the underlying musculature of the abdomen and removal of excess fat and skin. So it is often combined with some liposculpture.
How is a Tummy Tuck done? A lower transverse abdominal incision sometimes referred to as a bikini line incision is made across the lower section of the abdomen. This is a long, gently curved incision from hip to hip. The tissue including fat and skin from the front of the abdomen is detached from the rectus muscles (the six pack). The rectus muscles are then tightened up and the loosened skin is pulled down to the incision site at the pubic region and the excess skin and fat is excised. At this stage of the operation the waist line can be tightened on each side if necessary.
The umbilicus or belly button is left in place attached to the underlying muscles and once the flap of fat and skin has been pulled down and sutured into place, the umbilicus is cleverly brought through a small opening in the skin and sutured into place. Liposculpture may then be used to refine the results.
So who is suited to Tummy Tuck? Probably the most common patients I see who are looking for Tummy Tuck surgery are women who have had their tummy’s stretched by having babies. Another group of candidates are those men and women who have experienced significant weight loss. Having that large fold of skin removed is the last rewarding step in their sometimes long journey of weight reduction.
These women and men can develop overhanging folds of skin and fat and a central bulge of the abdomen. These people are very conscious of the bulging of their lower abdomen when they sit or wear firmer fitting clothing. Occasionally they may even have problems and discomfort from chaffing and skin irritations in the folds of skin.
The stretched skin embodied typically by stretch marks is a result of the collagen and elastin fibres in the skin having been irreparably damaged during pregnancy. Similarly the rectus abdominis muscles stretch apart and sideways leaving weakness in a vertical line down the centre of the abdomen. Unfortunately creams and lotions will not repair the stretch marks and exercise will not repair the stretched tendon between the muscles. The only satisfactory way of altering the appearance and shape is to remove the stretched skin surgically and repair the muscles thus reshaping the abdomen by means of an Abdominoplasty.
At the initial consultation it is very important that you discuss your concerns with your surgeon. He needs to know whether it is the stretch marks, the loose skin, the sloppy tissue, the generalised thickening around the abdomen or all of these factors which trouble you. It will also be important that you provide him with information about previous pregnancies and any abdominal surgery which you may have had. All this information is important when determining the type of operation best suited to you.
The operation itself takes around two to three hours depending on its complexity.
When you wake up after the surgery you can expect to have a wound dressing, at least one and possibly two drains from your tummy wound and a urinary catheter. As with all major surgery some pain and discomfort is to be expected, however this is well controlled with pain relief medication.
The day after surgery you will be helped into a firm, supportive compression garment. The garment is very important during the recovery phase as it provides continuous compression to the abdomen and reduces post- operative swelling, and the risk of fluid collections or (seromas). Furthermore, it does provide a good firm support to your tummy when mobilising. I strongly recommend that my patients wear their support garment for a prolonged period following their operation, aiding a better outcome.
The usual amount of time in hospital is two to four days so by the time you go home you will be feeling reasonably comfortable. The full recovery period extends out as far as twelve weeks but it is the first three to four weeks which are the most critical.
Abdominoplasty is a major operation and as such it does have complications. Surgeons who perform this procedure take every precaution to minimise the potential for such complications.
So, if you’ve decided to go ahead with a tummy tuck here are a few things you may need to take into consideration;
The first four weeks is the most critical time to look after yourself, so having family and friends close by to support you with the normal daily living activities is helpful. The simple activities such as grocery shopping, housework and lifting, including lifting your children should be avoided or kept to a minimum during this time.
Taking enough time off work. This will vary depending on your occupation and the physical requirements needed to resume work. In general, you should plan to take between four and six weeks off work for a full Abdominoplasty.
If you are a smoker, the single most important thing that you as the patient can do is to be completely nicotine free for a minimum of four weeks before your operation and during your recovery period. For a complication free recovery and with a view to an optimal result, I can’t stress this enough.
If exercise is an important part of your daily routine, you will need to consider and realise that time away from strenuous activities will be necessary in order to prevent complications and achieve the best possible outcome.
The scar itself is a pay off in regard to this surgery. There will be a small scar around the umbilicus and a long scar across the lower tummy. This scar may be very noticeable to start with but it will fade after some months. Whilst it has been difficult for surgeons to keep up with the changes in fashion there is no doubt you will be able to find underwear and swimwear which will hide your scar. There are many effective products available that can aid the recovery of your scar.
I have performed a lot of Tummy Tucks over the years and one of the recurrent joys of my profession has been the patients whose life has literally been changed by such surgeries. One young mum broke down in tears at her six monthly follow up as she now felt very comfortable to go to the beach with her two young daughters. This was something she had been highly embarrassed to do before her Abdominoplasty.
What about Abdominoplasty?
Aka Tummy Tuck!
Dr Newton’s knowledge and experience will
guide you through the process of choosing the
right procedure for your body.