A Tummy Tuck (abdominoplasty) is the surgical procedure that improves the shape and contour of your tummy. The operation removes excess skin, unwanted scars, stretch marks, fat and can tighten the stomach muscles.
Suitability
Ideally you should be near your normal weight for your height (BMI <30) and be fit and healthy. The surgery aims to improve the shape of your tummy that may have been stretched after pregnancy or weight loss. You should also have a realistic expectations.
The initial consultation
At the initial consultation you will tell me about the problems you are having, which are usually difficulty wearing particular clothes or embarassment that you think you look pregnant. Your goals are very important but should be realistic. Would you like to have an improved shape or do you want to have a flat tummy. Do you have full hips or flanks and do you want these to be addressed at the same time. I will also ask if you have had previous surgery on the tummy and about your present medication and allergies. Please tell me if you have had leg clots (DVTs) or lung clots (PEs).
I will exmaine your tummy standing and lying down, looking at the quality and amount of excess skin and muscle tone and separation, as well as hernias. I will discuss the different types of surgeries available and the one that is likely to help you most.
I will ask you about your smoking history and whether you have had any mental health issues. Photographs will be taken and a BMI measurement made.
You should always remember that there is an option of not having surgery at all.
The Surgery
There are a number of different abdominoplasty procedures that may be suitable for you depending on your age and specific circumstances. These include:
Liposuction
Liposuction is suitable for patients without stretch marks on their tummy and have good-quality elastic skin and whose main problem is an excess of fat in the lower and sometimes upper tummy. Liposuction involves small incisions, through which excess fat is removed. The wounds are then closed and some skin shrinking or tightening can be expected with the use of a compression garment.
Mini-Tummy Tuck
This is performed on slightly older patients who may have had pregnancies and who have a slight excess of skin and fat below the belly-button. An ellipse of skin and fat is cut from the lower tummy, leaving a horizontal scar just above the pubic hair.
Liposuction can performed on the upper tummy and waist. The belly-button itself is displaced downwards and its new position must look aesthetically good. If too much skin needs to be removed, the tummy button will be too low and look odd. It is diffcult to tighten pull the tummy muscles together with this procedure.
Classic Tummy Tuck
In patients with more excess skin and fat and splaying of the muscles, a classic tummy tuck may be required . An incision is made from hip to hip, around the belly button and a wedge of skin is excised from below the belly button to just above the pubic hair. The skin is then undercut upto the level of the rib cage and this skin moved down to close the gap. A small hole is made at the level of the tummy button which brought out and stitched in place. Liposuction is used routinely to thin the areas in the flanks and hips and the muscles above and below the belly-button are tightened. Although this operation leaves the biggest scar, it provides the greatest degree of improvement in shape.
Other types of abdominoplasty exist and will be discussed if required.
The Risks
When performed by a qualified surgeon, abdominoplasty is safe. Nevertheless, surgery carries risks which are listed below.
Bleeding and bruising after the surgery can occur, which can rarely require a return to theatre to remove it.
Seroma is a build up of clear fluid coming from the underlying muscle.
Contour deformity if too much breast tissue/fat is removed, an indent may form, called a dinner plate deformity. This is very difficult to correct amnd may require fat transfer from another part of the body.
Wound breakdown which may occur if the wounds or too tight and the blood supply is insufficent.
Infection can occur and it usually occurs 7-10 days after surgery.
Wounds may be slow to heal and part of the tummy skin die and may need dressings.
The tummy button- can partly or fully die, but this is very unusual.
Sensation of some areas of the skin feel less sensitive or numb. This may be temporary but if the small nerve endings have been divided, this may be permanant.
Scars may become thickened or widened and treatment is available to help with this. It may also be asymmetrical, so that they are different heights on each side. It may be higher than expected.
Contour defect the skin may have undulations
Preparation for surgery.
Your BMI should be less than 30 and you should mentally and physically fit. You should stop smoking 6 weeks before surgery and can start again when the wounds have healed at 2-4 weeks. Please do not take aspirin, naproxen for 10 days before surgery. You should have a shower the night before or the day of surgery and do not need to shave the pubic hair. I will have emailed you a consent form, which you should print, read and sign and date the bottom of each page and bring the full document with you on the day of surgery , so that we can sign the last page together.
What to bring with you
Toiletries, regular medications and the compression garment.
The day of Surgery
I will mark your tummy on the ward before you go to theatre. You will have a general anaesthetic and the surgery takes about 2-3 hours. I use dissolvable stitches, waterproof dressings and apply the compressio garment. You will have 2 drains and stay at least one night in hospital. The drains after removed before going home.
Recovery
Yopu will have a wound check at one week with the hospital nurses and i will see you at 2 weeks and advise about the scars.
You should not to return to work for the 1-2 weeks after surgery, depending on your work and full recovery may take to 2-4 weeks. You will need to wear the pressure garment for 6 weeks after surgery, day and night.
You should not fly for 6 weeks after surgery.
The Results
It will take 6-12 months to see the final results and these may last for 10 years. This longevity however can not be guarenteed and is dependent on skin quality, change of weight, pregnancy and smoking.
If you are worried post operatively
Please call the hospital ward you were on or Jan Richards 07722841078 9am-2pm Monday-Friday.
In an emergency, you may need to seek advice or attend your local hospital Accident and Emergency department.
Appointments
These can be made directly through the hospitals, via my PA Jan Richards or completing the form in the 'Contact' link above.
