Abdominoplasty (tummy tuck)

Abdominoplasty, known more commonly as a “tummy tuck,” is a major surgical procedure to remove excess skin and fat from the middle and lower abdominal and to tighten the muscles of the abdomen wall.

If you’re considering abdominoplasty or a tummy tuck

The procedure can dramatically reduce the appearance of a protruding abdomen. However, it does leave a permanent scar: this will depend on the extent of the problem but can extend from hip to hip, and around the belly button. If you’re considering a tummy tuck or abdominoplasty, this will give you a basic understanding of the procedure: when it can help, how it’s performed, and what results you can expect. It can’t answer all of your questions, so ask your surgeon about anything you don’t understand.
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The best candidates for abdominoplasty

The best candidates for abdominoplasty are men or women who are in relatively good shape but are bothered by a large fat deposit or loose abdominal skin that won’t respond to diet or exercise. The surgery is particularly helpful to women who, through multiple pregnancies, have stretched their abdominal muscles and skin beyond the point where they can return to normal. Loss of skin elasticity in older patients, which frequently occurs with slight obesity, can also be corrected.

Patients who intend to lose a lot of weight should postpone the surgery. Also, women who plan future pregnancies should wait, as the vertical muscles in the abdomen that are tightened during surgery can separate again during pregnancy. If you have scarring from previous abdominal surgery, your operation may need to be modified.

Abdominoplasty can enhance your appearance and your self-confidence, but it won’t necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.
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All surgery carries some uncertainty and risk

Many abdominoplasties are performed successfully each year. When done by a qualified plastic surgeon trained in body contouring, the results are generally good. Nevertheless, there are always risks and specific complications associated with surgery.

Post-operative complications such as infection and blood clots are rare, but can occur. Infection can be treated with drainage and antibiotics, but will prolong your hospital stay. You can minimise the risk of blood clots by moving around as soon after the surgery as possible.

Abdominoplasty 01

Poor healing, which results in conspicuous scars, may necessitate a second operation. Smokers should be advised to stop smoking, as continuing to do so may increase the risk of complications and delay healing.

You can reduce your risk of complications by closely following your surgeon’s instructions before and after the surgery, especially with regard to when and how you should resume physical activity.
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Planning your surgery

In your initial consultation, I will evaluate your health, determine the extent of fat deposits in your abdominal region, and carefully assess your skin tone.

Be frank in discussing your expectations. This will allow me to discuss your alternatives and the risks and limitations of each. If, for example, your fat deposits are limited to the area below the navel, you may require a less complex procedure called a partial abdominoplasty. You may, on the other hand, benefit more from partial or complete abdominoplasty done in conjunction with liposuction to remove fat deposits from the hips, for a better body contour. Alternatively, liposuction alone may provide the best result.

In any case, I’ll work with you and recommend the procedure that is right for you and will come closest to producing the desired body contour.

The operation is performed under general anaesthesia and is not usually covered by health insurance.
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Preparing for your surgery

You will be given specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding medication. If you smoke, you should try to stop if possible at least one to two weeks before your surgery and not to resume for at least two weeks after your surgery. If you develop a cold or infection, your surgery will probably be postponed. You should arrange for someone to drive you home after your surgery, and to help you out for a day or two after you leave the hospital, if possible.

Preparing for your surgery

Your operation will be performed under general anaesthesia as an in-patient.

Clinical photographs will be taken before your operation.
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The surgery
Complete abdominoplasty usually takes two to three hours, depending on the extent of work required. Partial abdominoplasty may take an hour or two.

An incision just above the pubic area is used to remove excess skin and fat from the middle and lower abdomen.

Most commonly, a long incision will be made from hipbone to hipbone, just above the pubic area. A second incision is made to free the navel from surrounding tissue. With partial abdominoplasty, the incision is much shorter and the navel may not be moved. Skin is separated from the abdominal wall all the way up to the ribs.

Next, the skin is separated from the abdominal wall all the way up to your ribs and lifts a large skin flap to reveal the vertical muscles in your abdomen. These muscles are tightened by pulling them close together and stitching them into their new position. This provides a firmer abdominal wall and narrows the waistline.

The underlying muscle and tissue are drawn together, thereby narrowing the waistline and strengthening the abdominal wall.

The skin flap is then stretched down and the excess skin is removed. A new hole is cut for your navel, which is then stitched in place. Finally, the incisions will be stitched, dressings will be applied, and a temporary tube inserted to drain excess fluid from beneath the skin.

Abdominal skin is drawn down and excess is removed. With complete abdominoplasty, a new opening is cut for the navel. Both incisions are stitched closed. In partial abdominoplasty, the skin is separated only between the incision line and the navel. This skin flap is stretched down, the excess is removed, and the flap is stitched back into place.
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After your surgery

For the first few days, your abdomen will probably be swollen and you’re likely to feel some pain and discomfort which can be controlled by medication. Depending on the extent of the surgery, you may be released the next day but usually you have to remain hospitalised for two days.

After your surgery

You will be given instructions for showering and changing your dressings. And although you may not be able to stand straight at first, you should start walking as soon as possible.

Stitches are usually absorbable although some stitches need removal. You will be fitted with a support garment to wear for two to three weeks.
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Getting back to normal

It may take you some weeks to feel like your old self again. If you start out in top physical condition with strong abdominal muscles, your recovery from abdominoplasty will be much faster. Some people return to work after two weeks, while others take three or four weeks to rest and recuperate.

Exercise before surgery will help you heal better. Even people who have never exercised before should begin an exercise programme to lessen the chance of blood clots, and tone muscles. Vigorous exercise, however, should be avoided until you can do it comfortably.

Your scars may actually appear to worsen during the first three months as they heal, but this is normal. Expect it to take six months to a year before your scars flatten out and lighten in colour. While they’ll never disappear completely, abdominal scars will not show under most clothing, even under bathing suits.
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Your new look

Abdominoplasty, whether partial or complete, produces excellent results for patients with weakened abdominal muscles or excess skin. And in most cases, the results are long lasting, if you follow a balanced diet and exercise regularly.

After surgery, you’ll have a flatter, trimmer abdomen. Scars are permanent, but will fade with time.

If you’re realistic in your expectations and prepared for the consequences of a permanent scar and a lengthy recovery period, a tummy tuck or abdominoplasty may be just the answer for you.
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