Abdominoplasty (Tummy Tuck)
Abdominoplasty is also commonly called tummy tuck. It is an operation designed to remove the excess skin and fat of the lower part of the tummy improving the patient’s appearance and often making it easier to fit clothes and removing any discomfort from the excess skin.
Who is a good candidate for this surgery?
Abdominoplasty (tummy tuck) is ideal for patients who have an excess fold of skin and fat formed at the lower part of the tummy. This fold has often formed after pregnancies or a large amount of weight loss. To get the best result from surgery patients should be at their normal weight, which they can stay at.
What can surgery do for me?
Patients with this excess skin and fat often have discomfort from the folds of skin rubbing against each other causing inflamed, moist skin. Patients often find it very difficult getting clothes to fit especially tight skirts, trousers and swimming costumes. It is not uncommon for men and women with these excess folds to be so concerned about the appearance of their tummy that they avoid activities which would expose their tummy or the shape of their tummy, such as wearing swimming costumes or trunks on a beach. By removing this excess fold of skin and fat abdominoplasty surgery can relieve the symptoms and greatly improve the appearance of the lower tummy thereby removing the discomfort and greatly enhancing patient’s quality of life. Patients often develop more confidence and undertake activities they used to be too embarrassed to do prior to surgery.
How is the surgery done?
Before your operation we may carefully draw on your lower tummy the area of skin and fat to be removed. This is the skin and fat of the lower part of the tummy between the tummy button and the pubic hair. The skin and fat is removed and the remaining skin and fat of the upper part of the tummy is then stretched down to the pubic hairline. Sometimes if the muscles of the tummy wall are very weak they can be tightened with deep stitches. The tummy button is kept and a new position is made for it in the tighter skin. A couple of tube drains are usually placed to collect any fluid that may develop in the operation site.
What type of anaesthetic do I need?
The operation is performed under general anaesthetic. The anaesthetist will see you before your operation and discuss any questions you have about the anaesthetic, they may suggest what type of pain relief would be best suited for you after the operation.
How long am I in hospital?
Most patients spend 1 to 2 nights in hospital, this depends how quickly they recover from the anaesthetic and how much drainage there is from the tube drains. Sometimes patients may go home with the drains still in place.
How quickly will I recover from my surgery?
Most patients would require 3 to 4 weeks off work. In order to leave the skin of the tummy nice and flat the tissue is pulled down quite tightly. Initially for the first 1 to 2 weeks this can cause some discomfort and patients need to lie with their knees bent and walk slightly bent forwards. This tightness relaxes over the first 1 to 2 weeks and becomes more comfortable. During the first week patients do require help with activities such as washing, dressing and preparing food. They are often quite tired and should plan a restful first few weeks. By the end of 3 to 4 weeks patients are usually ready to go back to work, but even then can find starting back quite tiring and should not plan a lot of extra activities other than work. By 2 to 3 months patients have returned to normal and are enjoying their new found looks and confidence.
You will be able to start driving again once you feel up to it. For most people this would take 2 to 3 weeks. It is advisable to check with your motor insurance company before commencing driving.
What are the potential problems with this surgery?
It is not possible to remove this fold of tissue without creating scars. The main scar will extend from one hip bone to the other in a gentle curve down to the pubic hairline. There is also another scar around the tummy button. The scars often become red and noticeable in the first 3 to 4 months after surgery. In the majority of cases these start to fade with time (up to 2 years). All patients are slightly different and occasionally some patients form permanently raised lumpy scars. Because of the fatty tissue in the tummy these wounds have a slightly increased risk of getting infected. Most infections would settle with a course of antibiotics, occasionally if it is a severe infection it may require further surgery and cause part of the skin to die back. This is very unusual. Because of the large raw area within the operation site there is a risk of bleeding that may require a second operation to remove the blood clot, this raw area can cause fluid to collect (seroma) which can still form after the drains have been removed. This is usually treated straightforwardly by removing the fluid with a needle and syringe similar to having blood taken. When the upper skin is pulled down the nerves to this area have to be divided and the area of skin between the new tummy button and the pubic hair line is invariably numb afterwards. This area of numbness usually reduces in size but most patients have a permanent area of numbness in the long term. All tummies have slightly different forms on each side and a slight difference between the two sides is invariably present after the operation.