Abdominoplasty (Tummy Tuck) Q&A: Mr Simon Mackey

I'm Simon Mackey. I'm a Consultant Plastic Surgeon and I've been in cosmetic and reconstructive surgical practice at The McIndoe Centre for the last fourteen years. Abdominoplasty is a procedure that I perform very commonly. In its simplest form, it's surgery to reduce excess skin in the lower abdomen and tighten up the six muscles, and you can also lift the mons pubis. People who are best suited for abdominoplasty are people who are at about their ideal body weight, and very importantly, in my opinion, not using nicotine at all. Nicotine has a very high rate of wound complications and in an ideal world really would have you off nicotine to enable us to get the best possible results for you. There are lots of different types of tummy tucks. The most straightforward and the simplest is probably the mini abdominoplasty, which is really best regarded as procedure for tidying up the very lowest part of the abdomen. Commonly, ladies who have had caesarean sections and have troublesome or tethered caesarean scars. This involves a scar in the very lowermost parts of the abdomen, but we don't have touch the tummy button with that procedure. More commonly is the classical abdominoplasty, which will give you a long scar from hip to hip and a separate cut out around the tummy button. That enables a more powerful removal of excess skin from the anterior abdominal wall and makes it much more amenable or much easier for us to repair the six pack muscles. Very frequently, pregnancies and significant weight gain, six pack muscles can be pulled apart and this can affect the shape and the function of the anterior abdominal wall, contributing to lower back pain and pelvic dysfunction. Abdominoplasty surgery is surgery that can be combined with numerous other procedures. It might involve some liposuction to the love handles or the flanks. You might commonly also perform breast surgery, so uplifts, reductions or breast implants. You can also now consider fat transfer into the breasts for an autologous augmentation. An awful lot of my patients at the moment are on injectables for weight loss such as Wegovy and Mounjaro. There are some terrific results with these medicines. Have seen people lose eleven stone in weight, but unfortunately the skin doesn't always shrink back as we would like. You can think of it as a bit like a plastic bag. If you stretch the skin a little bit, it will recoil. If it goes too far and you develop stretch marks, there is no way that you can shrink the skin down. The excess skin can cause all sorts of problems. People can get inflammation and infection along the folds. It can be very difficult to hide that skin and people become very self conscious about it. There are numerous different types of massive weight loss abdominoplasty that can be considered. Again, extended abdominoplasties, which come further round to the flanks, circumferential abdominoplasties, which will also lift the buttocks, and Fleurs de Lis abdominoplasties, which combine a transverse scar with a vertical scar. Think really tailoring the best choice for you requires a review and examination and then discussion about the pros and cons of the different options to get you the best result.