Tummy Tuck (Abdominoplasty)
Abdominoplasty improves appearance and contour of the abdomen. This is achieved by removal of excess skin, fat, scars andf/or stretch marks from the lower part of the tummy and tightening of the abdominal wall muscles. The operation can correct small weaknesses (hernias) in the underlying muscles and fascia, but can also greatly help lower abdominal dermatitis and skin irritation caused by tissue excess (often called “a skin apron”).
Surgery is carried out under general anaesthesia and takes approximately two hours. You will be treated as an inpatient and should expect to stay in the hospital for 1-2 nights.
The operation involves a long incision placed in the suprapubic area and the crease of the lower abdomen extending from one hip bone to the other. In most cases there is also a round incision around the naval (umbilicus) as the new hole needs to be created through the mobilised tissues in order to maintain normal (anatomical) position of the belly button.
Skin and fat layer are raised of the underlying muscles all the way from the lower tummy to the level of the ribcage. This undermining allows mobilisation of the upper abdominal tissues downwards, towards the belly button and pubic area and creation of a large segment of redundant skin and fat which is then excised. Exposure of the muscle wall offers an opportunity to repair minor muscle/fascia weaknesses and tightening of the vertical tummy muscles fascia (rectus abdominis muscles) with sutures which contribute significantly in flattening of the abdominal contour and to some extent, better waistline. In vast majority of cases only one long horisontal, suprapubic scar exists in the lower abdomen after the surgery (Pictures 1,2,3). Occasionally, a scar may have “inverted T” shape (Picture 4). The later is indicated either in patients with mild skin excess, unsighty pre-existing scars, deformity and buldging in the upper abdomen or indeed, in those who have excessive tissue excess over the flanks too so it is important to excise and tighten tissues in both, horisonal and vertical direction.
Usually two drains (drainage tubes) are left outside the wound to prevent build up of tissue fluid and blood within the operated area. Drains are removed from the wound 24-48 hours after operation. In most cases, I close the wounds with dissolvable sutures and cover wounds with a very light dressings (just a fine surgical tape). Elasticated binder or corset is applied a day or two later aiming to provide external support for the whole abdomen for the first few weeks. As patients are encouraged to wear support for up to 4-6 weeks postoperatively, many find lycra-like cycling or gym shorts are very useful, comforting and more practical then surgical binders.
As you will be in hospital for one or two nights, you will be looked after myself, on call doctor and experienced nursing staff. You should be restful and comfortable after the surgery, but it is important that you begin to walk short periods as soon as possible after operation to stimulate blood flow and recover faster. You should not stand fully upright immediately and for the first few days after operation as wound will feel tight. Mild pain, bruising and swelling around the wound are almost inevitable, but are only temporary, rarely troublesome and “quickly forgotten”.
The skin will heal within the first two weeks, whereas tightened fascia and muscles will take up to 2 months to strengthen entirely. This is why you will be advised to wear the supportive pants for the next 12 weeks, during which time you should avoid vigorous exercise. The scars will continue to improve (fade and soften) for up to 12-14 months after the operation and eventually become hardly noticeable.
Potential risks and complications
Unfortunately, complications can occur following any surgery and patients need to be fully aware of
this. I always tend to carry out surgery in a safe manner and take all sensible measures to minimise risks and complication rate. Below are the commonest, operation specific complications associated with abdominoplasty:
- Bleeding and haematoma (incl the need to return you to the operating theatre)
- Wound healing problems
- Numbness (along the scars, lower tummy, supra-pubic and thigh area)
- Diminished sensation below the umbilicus
- Prolonged swelling of mons pubis (suprapubic triangle)
- Hypertrophic (lumpy) scars
- Asymmetry between the sides
- Seroma (tissue fluid collection under the skin which might need repeated aspirations)
- Leg and ling clots
- Fatty lumps due to necrosis of fat
- Scar irregularities
Abdominoplasty is an extensive operation, but in trained hands considered very safe. It yields predictably good results and is associated with very high patients satisfaction rate. It is one of the most rewarding aesthetic procedures. Please note that If you experience significant weight change or become pregnant after the tummy tuck, the results from your procedure may be compromised.
I am keen to show patients schematic illustrations of the tummy tuck and pre and post-operative results achieved in some of my patients during our consultation. Some examples on what can be achieved are shown on the right.
This leaflet provides only basic and generic information. Full details and explanations are provided at the consultation as no two patients are the same and personal circumstances are highly individual. Patients will be provided with detailed leaflet, comprehensive informed consent on risks and complications associated with this operation, few of which are mentioned above.
If you have any concerns following your surgery please contact:
- Hospital where you were operated:
Ashtead 01372 221 442; St Anthony’s 020 8337 6691; Parkside 020 8971 8000
- Your GP practice
- My secretary on 0845 026 7776 (Monday – Friday, 9:30 – 18:00)
|Hospital stay||1-2 nights|
|Surgery time||1.5-2 hours|
|Wound healing||12-14 days|
|Shower / Bath||from week 1|
|Time off work||2-3 weeks|
|Sports and exercise||from week 4|
|Full recovery||4-6 weeks|
Picture 1: Appearance after 3 weeks (front view)
Picture 2: Appearance after 3 weeks (lateral view)
Picture 3: Appearance after 6 weeks
Picture 4: Horisontal and vertical wounds (patient had pre-existing vertical scar)
2 weeks after surgery
4 weeks after surgery