Abdominoplasty or “tummy-tuck” surgery aims to improve the appearance and function of the abdominal wall. Here, Consultant Plastic Surgeon Simon Mackey provides an overview of abdominoplasty.
Weight-loss, pregnancy and abdominal surgery can lead to an abnormal shape to the lower abdomen, scars, loose skin, or stretch marks. During abdominoplasty, excess skin and fat is removed from the lower abdomen. Tightening the skin and the “six-pack” muscles can produce a flatter tummy, define the waistline and improve abdominal wall function.
Keeping the scar as low,as possible, below the “bikini-line”, an incision is made from hip to hip. For a “full-abdominoplasty” there will also be a scar around the “tummy-button”.
Depending on the degree of skin and muscle laxity, any one of a number of different techniques may be most appropriate for you.
Sometimes it may be possible to perform a “mini-abdominoplasty” leaving the “tummy-button” alone, and a shorter scar along the bikini-line.
After significant weight loss, a “fleur-de-Lis” abdominoplasty leaving a scar along the “bikini-line”, and also a vertical scar along the centre of the abdomen may provide the best result.
Other techniques include “Brazillian-abdominoplasty”, “circumferential–abdominoplasty”, and “melon-slice” abdominoplasty. The precise technique should be tailored to you specifically.
It’s often possible to combine abdominoplasty with other operations such as liposuction, or breast enlargement, reduction or lift. Combination surgery can mean fewer anaesthetics, and shorter total recovery.
The best candidates are ladies or men who have excess skin or an abnormal shape in the lower abdomen. You should ideally be at, or close to your ideal weight before proceeding.
You should be medically well, and a non-smoker. Taking steroids and blood-thinners may make you unsuitable for this type of surgery – but this should be discussed with your surgeon.
To get the best results from abdominoplasty, you should be close to your ideal weight before proceeding with surgery. The only way to get rid of the fat that lies within your abdominal cavity is through weight-loss. This fat, can make the tummy bulge even after abdominoplasty, and cannot be directly removed with any form of surgery. Losing a lot of weight after an abdominoplasty can lead to loosening of the skin and abdominal muscles.
Although you may lose several kilograms of abdominal fat and skin with an abdominoplasty, a tummy-tuck should not be regarded as a “weight-loss procedure”.
In general, you will be in hospital for 1-2 nights following surgery. Wounds are closed with “dissolving” stitches, and dressed with paper tapes. It may be necessary to have surgical drains for 1-2 days. You will be relatively mobile within 2-3 days. I encourage you to take 2-3 weeks off work and driving. I would normally expect a return to normal activities within 6-12 weeks following surgery. A compression garment is worn for 6 weeks to reduce post-operative swelling.
Any surgical procedure can be painful, but good pain-relief and use of long-acting local anaesthetics make it manageable. Tightness can be uncomfortable particularly after re-positioning the abdominal muscles, but this improves in the weeks following surgery.
It is important to attend any post-operative check-ups arranged by your surgeon, as these are important for optimizing the outcome of surgery.
Your operation needs to be specifically tailored to you. Surgeons should arrange to see you at least twice prior to surgery, to allow ample opportunity to review your past medical history, discuss the limitations and complications of surgery, and to complete the consent process.
As safety is the key priority with this type of treatment, I would recommend that you check that your surgeon is on the GMC’s Specialist Register for Plastic Surgery, and is ideally a full member of BAPRAS (the British Association of Plastic Reconstructive & Aesthetic Surgeons), or BAAPS (the British Association of Aesthetic Plastic Surgeons).