Abdominoplasty

What is abdominoplasty (tummy tuck) and why is it performed?

An abdominoplasty is performed on men or women who wish to enhance the appearance of their abdomen.The procedure involves the surgical removal of excess abdominal skin and fat under general anaesthetic and usually involves a 2 - 3 night stay in hospital to recover.The objective of abdominoplasty is to improve and flatten the abdominal contour, tighten the abdominal muscles and remove any excess skin or visible scarring from the area

Who requests this procedure?

Men and women who would like to improve their abdominal contour by removing excess abdominal skin and fat. The common causes of loose abdominal skin are:
  • Pregnancy
  • Weight gain
  • Weight loss

The procedure is also beneficial to patients who are unable to tighten the abdominal wall skin through exercise and wish to achieve a smoother, flatter abdomen.

What are the results like?

This procedure can provide excellent results for men and women wishing to improve their abdominal contour. Those who have had successful abdominoplasty frequently report that their self-confidence and feeling of wellbeing is boosted following surgery.

This advanced corrective procedure needs to be performed by a Consultant Plastic Surgeon who is fully qualified and well experienced. However, it is important to note that no matter how high the surgical standards, this procedure cannot be performed without the introduction of visible surgical scars on the operated area.

Another important consideration is that there is no specific treatment for stretch marks (striae) which are the scars left after extreme stretching of the skin. Many will be excised during abdominal reduction and those that are left are tightened which may make them look less obvious.

How is an abdominoplasty procedure performed and what is the recovery period like?

Techniques for abdominoplasty vary slightly between surgeons and according to the individual needs of each patient. A standard abdominoplasty involves the removal of excess skin and fat from the abdominal wall between the pubic area and the umbilicus (navel) leaving the umbilicus in place. The skin of the abdominal wall is then drawn down and sutured at the pubic level and the umbilicus is re-sited. Repair of any laxity of the muscles or abdominal wall or hernia is carried out at the same time. The patient is left with a long, usually curved scar across the lower abdomen at the level of the pubic hair. There is also a scar around the umbilicus. Patients are fully anaesthetised throughout the procedure, which can take an average of 2 hours to perform.

Following your operation it is likely that you will be attached to a drip to keep you hydrated until you are able to drink.You are likely to have drains coming out of your lower abdomen to drain collections of blood and serum. These will be removed 1- 2 days after your operation. It is possible for fluid to accumulate after the drains are removed. Depending on the amount, this will either be left to disperse naturally or will be aspirated.

You may experience some moderate to severe pain, though patients often express that they experience a surprising lack of post-operative pain. However, analgesic tablets (pain killers) are provided for any discomfort experienced.You will be advised to keep your knees and hips bent to reduce the strain on your sutures.

It is usual for patients to take around a fortnight away from work following this type of surgery. Over- activity in the early days reduces healing and increases fluid accumulation. Light activities can usually be resumed from 10 days onwards, though it is important to refrain from any strenuous exercise for 8 - 12 weeks as advised by your Consultant.

Variations on the standard abdominoplasty procedure are as follows:

Mini - abdominoplasty - surplus skin below the umbilicus is removed leaving a low abdominal scar at the level of the pubic hair.The umbilicus is not disturbed but liposuction may be carried out at the same time to reduce the thickness of fat in the abdominal wall.Any laxity or hernia of the abdominal wall is carried out at the same time.

Extended abdominoplasty - surplus skin and fat of the loins and back are also removed causing the scar to extend around the flanks onto the lower back.

Endoscopic abdominoplasty - is used to tighten the muscles of the abdominal wall to give better contour. This is carried out through a short incision above the pubic hair. Liposuction may also be performed through the same incision. Skin is not removed during this procedure.

Apronectomy - is a modification of the mini - abdominoplasty, This is suitable for patients who have a large excess of skin and fat hanging down over the pubic area, only the surplus skin and fat is removed. The scar is long and transverse, it extends from one side of the apron to the other.

An alternative less invasive procedure that should always be considered before opting for the above procedures is liposuction. This procedure reduces fat and may cause a little retraction of the skin.

Are there any risks involved in abdominoplasty surgery?

All surgery involves an element of risk from developing complications. However, cosmetic surgery is usually undertaken voluntarily and only when the patient is in good health. Therefore, the probability of experiencing complications following this kind of surgery is substantially lower than for those who undergo surgery due to ill health.

Healing can be slow, particularly in the tighter central part of the wound and occasionally dressings are required for a few weeks. Smoking may adversely affect wounds from healing and heavy smokers may be precluded from having this type of surgery as a result.

Risks such as bleeding, infection, asymmetry, alteration in sensitivity and scarring will all be discussed openly at consultation.

The appearance of surgical scars (which generally fade progressively after surgery) is a highly individual matter. Usually, scars mature, soften and fade to a cosmetically acceptable level at around 12 months following surgery. Occasionally, patients can develop, red, unsightly, firm scars, known as hypertrophic scarring or keloids, which may require further corrective treatment. The process of healing and the risk of scarring will be explained to you by your surgeon at your consultation.

Numbness in the lower abdomen is expected after surgery, this is usually temporary but could potentially be permanent. Swelling above the scar is usually present due to a collection of tissue fluid that normally drains to the groin. A corset is usually helpful to reduce swelling and improve comfort in the first month. Swelling is expected to settle within a few months.

What next ?

The importance of a thorough pre-operative consultation with the Consultant Plastic Surgeon who will actually perform your operation cannot be over stressed. At One Healthcare, each consultation is tailored to an individual's needs. The process will always involve a thorough evaluation of your past and present medical history and a physical examination of the area of concern.

Your surgeon will take time to listen to your concerns regarding your abdomen, and will take care to ensure that you have a thorough understanding of what can be done to help, the procedure itself, the recovery stages and a clear explanation of the risks involved. You will need to consider all of these factors before making a decision regarding abdominal reduction.

You are positively encouraged to ask any questions that you may have and to look at photographs of others who have had the same type of surgery that you are considering. If you would find it helpful, our advisory team may be able to arrange for you to speak with a previous One Healthcare patient who is willing to discuss their experience with you over the telephone.

How to arrange a consultation with a fully qualified Consultant with GMC specialist registration

Please feel free to call our Customer Service Advisory Team at your local One Healthcare Hospital who will be pleased to answer any queries, or make an appointment for you to meet with a Consultant Surgeon who has specialist skills and experience in ear reshaping surgery.

Our Customer Advisory Service is personally manned between 9am and 5pm Monday to Friday. We will also be happy to discreetly return your call if you leave a short message, forwarding name and telephone number on our confidential answer phone after office hours.

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