Abdominoplasty (Tummy Tuck)

Women and men who have loose abdominal skin and fat that is concentrated in the abdomen can benefit from abdominoplasty. Sometimes these conditions are inherited. In other instances, substantial weight loss may cause abdominal skin to become flaccid. Abdominoplasty also can tighten muscles that have been separated and weakened by pregnancy. The procedure may somewhat improve the appearance of stretch marks, especially those located below the navel.

Are you a good candidate for abdominoplasty?

You may be a good candidate for abdominoplasty if you have one or more of the following conditions: 

• Excess or sagging abdominal skin
• An abdomen that protrudes and is out of proportion to the rest of your body
• Abdominal muscles that have been separated and weakened
• Excess fatty tissue that is concentrated in your abdomen

Your Personal Consultation 

During the consultation, you will be asked about the results you would like to achieve from abdominoplasty. This will help your surgeon to understand your expectations and determine whether they realistically can be achieved. 

How will I be evaluated for abdominoplasty? 

Your plastic surgeon may examine your abdomen while you are standing as well as lying down. Your skin tone and the degree of loose skin in the abdominal region will be assessed. Your surgeon also will evaluate the amount of excess fat in your abdomen and the condition of your abdominal muscles. 

You should come to the consultation prepared to discuss your medical history. This will include information about any medical conditions, drug allergies, medical treatments you have received, pregnancies, previous surgeries and medications that you currently take. It is important for you to provide complete information. 

How Abdominoplasty Is Performed

Individual factors and personal preferences will determine the specific technique selected to smooth and flatten your abdomen. 

Where are the incisions placed?

Generally, a horizontal incision is placed just within or above the pubic area. The length of the incision, which extends laterally toward the pelvic bones, depends largely on the amount of skin to be removed. The contour of this incision will vary somewhat according to the structure of your abdomen and the style of bathing suit or undergarments that you prefer. Your plastic surgeon will try to keep the incision within your bathing suit lines, but this may not always be possible. 

Some patients have loose skin above the navel. In such cases, the surgeon may make a second incision around the navel so that the redundant skin above it can be pulled down. The excess abdominal skin is then removed. The position of the navel remains unchanged. 

Skin of the lower abdomen that contains stretch marks may be removed as well. Any remaining stretch marks may be somewhat flattened and improved, but you should not expect a dramatic change in their appearance. 

The procedure may include tightening of the underlying abdominal muscles using sutures.

What are some variations to the common abdominoplasty technique? 

There are many variations both to the design of the incisions and the technique itself. In some instances, it may be possible to avoid an incision around the navel. When the amount of loose skin is minimal and the excess fat deposits are located below the navel, a short horizontal incision is all that is necessary. This procedure is called a partial, or "mini," abdominoplasty. 

Sometimes liposuction may be used alone, or in conjunction with abdominoplasty, to remove abdominal fat. Your plastic surgeon will discuss with you the particular method that he or she recommends for achieving the best result in your particular case.

Understanding Risks

Fortunately, significant complications from abdominoplasty are infrequent.

Every year, many thousands of people undergo successful aesthetic surgery of the abdomen, experience no major problems and are pleased with the results.

Anyone considering surgery, however, should be aware of both the benefits and risks.

Potential Complications

• Scarring: Permanent, visible, may be lumpy or stretched. Revision surgery is sometimes helpful in certain instances where incisions may have healed poorly. Occasionally when the abdomen cannot be closed with a horizontal incision alone, a vertical component may need to be introduced.
• Bleeding, collection of blood (haematoma). The need to put in drains, which are removed when they stop draining.
• Following surgery, occasionally, fluid may accumulate under the skin (Seroma). Removal of this serum is a painless process but may require several visits.
• Infection
• Wound breakdown secondary to tension or a tight closure. Tissue loss along portions of the horizontal incision is a possibility when the abdominoplasty is very extensive. This complication, which delays healing and prolongs recovery, is more common in patients who smoke or have medical conditions such as diabetes.
• Alteration of sensation over the tummy
• Asymmetry of the scarring
• Alteration in shape of the umbilicus
• Reactions to anaesthesia. You can help to lessen certain risks by following the advice and instructions of your plastic surgeon, both before and after surgery.

How should I prepare for surgery? 

If you are a smoker, you will be asked to stop smoking well in advance of surgery. Aspirin and certain anti-inflammatory drugs can cause increased bleeding, so you should avoid taking these medications for a period of time before surgery. Your surgeon will provide you with additional preoperative instructions. 

Please start a mild laxative (Syp. Of Figs), two nights prior to the surgery. This will help in the immediate postoperative phase.

How will I look and feel initially?

The day after surgery, you will be encouraged to get out of bed for short walks to promote blood circulation. Although you may not be able to stand up completely straight, it is best if you do not sit for long periods of time during the first several days. Straining, bending and lifting must be avoided, since these activities might cause increased swelling or even bleeding. You may be instructed to sleep on your back with a pillow under your knees. 

Any surgical drains probably will be removed within a week following surgery, at which time your dressings may also be changed or removed. Depending on the abdominoplasty technique used, you may be instructed to wear a support garment for several weeks. Generally, stitches will be removed in stages over a period of approximately one or two weeks. 

You will notice swelling and bruising, which is to be expected. The bruising and much of the swelling will disappear over a period of weeks. However, it may be months before all swelling subsides and you see the final result of your abdominoplasty. You may also notice some numbness over portions of the abdominal area, and this may persist for several months. Incisions will initially be red or pink in color. They will remain this way for many months following surgery and may even appear to worsen before they finally begin to fade.

When can I resume my normal activities?

It is important to realize that the amount of time it takes for recovery varies greatly among individuals. Depending on the extent of your abdominoplasty and your general physical condition, you may be able to return to non-strenuous work anywhere from one to three weeks after surgery. In many instances, you can resume most of your normal activities, including some form of mild exercise, after a few weeks. You may continue to experience some mild, periodic discomfort and swelling during this time, but such feelings are normal. Severe pain should be reported to your doctor. 

Any sexual activity should be avoided for a minimum of two weeks, and your plastic surgeon may advise you to wait longer.

Results of Your Abdominoplasty

Abdominoplasty will enhance your body contour by making your abdomen firmer and flatter. You may find that you feel more comfortable in your clothing and are more confident about your appearance. 

The incisions from the procedure will heal and fade over time. It is important to realize, however, that the incision lines will be permanently visible. In some instances, they will eventually be only faint lines. Certain individuals may have incision lines that are more noticeable. Fortunately, the incisions for your abdominoplasty are usually in locations concealed by most bathing suits and undergarments.

How long will the results last?

Unless you gain or lose a significant amount of weight or become pregnant, your abdomen should remain firmer and flatter for many years. However, gravity and the effects of aging will eventually take their toll. If, after a period of years, you again become dissatisfied with the appearance of your abdomen, you may choose to undergo a second procedure to restore a more youthful body contour.