Abdominoplasty

Abdominoplasty, known more commonly as a "tummy tuck," is a major surgical procedure to remove excess skin and fat from the middle and lower abdomen and to tighten the muscles of the abdominal wall. The procedure can dramatically reduce the appearance of a protruding abdomen. Abdominoplasty produces a permanent scar, which, depending on the extent of the original problem and the surgery required to correct it, can extend from hip to hip.

The best candidates for abdominoplasty are men or women who are in relatively good shape but are bothered by fat deposits or loose abdominal skin that will not 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 can also be improved..

Planning your Surgery

During your consultation, your goals for the surgery will be discussed and you will be asked about certain medical conditions that could cause problems during or after the procedure, such as uncontrolled high blood pressure, blood-clotting problems, or the tendency to develop large scars.

The type of surgery required varies according to extent and type of problem. Often a full abdominoplasty is required. Sometimes it is possible to perform a more limited operation.If, for example, your fat deposits are limited to the area below the navel, you may require a less complex procedure called a mini abdominoplasty. Liposuction may also be performed in conjunction with abdominoplasty

Preparation for Surgery

Specific instructions on how to prepare for surgery will be given, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins, and medications.

If you smoke, plan to give up at least one to two weeks before your surgery and not to resume for at least two weeks after your surgery. Avoid overexposure to the sun before surgery, especially to your abdomen, and do not go on a stringent diet, as both can inhibit your ability to heal. If you develop a cold or infection of any kind, 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 needed.

The Risks

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 minimize the risk of blood clots by moving around as soon after the surgery as possible.

Poor healing, which results in conspicuous scars, may necessitate a second operation. Smoking increases the risk of complications and delays healing.

The Surgery

Abdominoplasties require a general anaesthetic. Complete abdominoplasty usually takes about two hours to perform and mini abdominoplasty may take an hour or more.

Most commonly, a long incision from hipbone to hipbone is made, just above the pubic area. A second incision is made to free the navel from surrounding tissue. With mini abdominoplasty, the incision is much shorter and a scar around the navel is not necessary.

If the abdominal muscles are loose, they 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 incisions will be stitched using dissolvable sutures, dressings will be applied, and a temporary drain may be inserted. This is usually removed the next day. A tight garment is fitted to provide support after your surgery.

After your surgery

For the first few days, your tummy will probably feel swollen and you are likely to feel some pain and discomfort which can be controlled by medication. Depending on the extent of the surgery, you will stay in hospital for one or two nights.

It is often difficult to stand up straight after an abdominoplasty and lifting and housework must be avoided for two weeks after surgery. A support garment must be worn for at least two weeks after surgery.

Getting back to normal

It may take you weeks or months to return completely to normal. Some people return to work after two weeks, while others take three or four weeks to rest and recuperate.

After two to three weeks gentle exercise will help recovery. Vigorous exercise, however, should be avoided until you can do it comfortably.

Your scars may actually appear to worsen during the first three to six months as they heal, but this is normal. Expect it to take nine months to a year before your scars flatten out and lighten in colour.