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Abdominoplasty (tummy tuck)

Introduction

An abdominoplasty or tummy-tuck operation is designed to improve the contour of the abdomen and waist. This is achieved by removal of excess skin and fat, and tightening of the tummy muscles. It is most commonly requested by people who have lost weight, or by women who wish to restore the appearance of their abdomen following completion of their family. It is also a useful procedure for improving the appearance of caesarean section and hysterectomy scars, particularly where excess skin or bulging of the tissues is of concern. Like any body contouring procedure, it is important to realise that this procedure is a reshaping rather than a weight loss operation, and that the best results are achieved when you are at a stable weight, ideally within the ‘normal’ range.

ABDOMINOPLASTY/ TUMMY TUCK

  • Type of anaesthetic
    General anaesthetic
    Length of surgery
    2-4 hours
    Nights in hospital
    1-2 nights
    Scars
    Lower abdomen/ bikini-line scar ± around belly button

  • Recovery
    1-3 weeks off work
    4 weeks gentle exercise
    8 weeks strenuous exercise
    Follow-up
    2 weeks (dressing clinic)
    6 weeks
    6 months
    1 year

My approach

This is an operation in which the difference between a reasonable and good result is determined by attention to detail and subtle adjustments of surgical technique. I use as short a scar as possible, and may recommend combining the technique with liposuction in order to fine-tune contour adjustments.

The Surgery

There are two main types of abdominoplasty. During a standard/ full abdominoplasty, the excess skin and fat between the pubic bone and the bellybutton are removed. This is achieved by lifting up all the abdominal skin, pulling it down, and removing the excess. The bellybutton is repositioned within the relocated skin, resulting in a scar around/ within the bellybutton. Any looseness of the abdominal muscles (e.g. diastasis recti) is repaired at the same time. A mini abdominoplasty involves removal of excess skin below the bellybutton, without disturbing its position. Limited tightening of the abdominal muscles may be performed if necessary during this procedure. During an extended abdominoplasty, surplus skin and fat of the loins and back are also removed so the scar extends around the flanks onto the lower back.

Consequences and limitations

An abdominoplasty is a major operation, with significant down-time in terms of lifting/ driving, etc.. The scars, even with short-scar techniques, are significant, and while positioned in such a manner as to be covered by most underwear, they will never fade completely. Like any surgical scar, there is a risk of slow healing or infection. The skin above the scar will be numb immediately following the operation: this is usually temporary but on occasion is permanent. Swelling of the abdomen may occur following the procedure, this can be due to oedema (tissue swelling), or a seroma (a collection of tissue fluid from the raw surfaces inside). Oedema will settle of its own accord over a few weeks to months, while a seroma may require a straightforward drainage procedure (which is generally not painful and is done in the office setting).

Significant changes in weight after the operation or subsequent pregnancies are likely to impact upon the long-term result, which is why I recommend waiting until after completion of your family and/ or reaching a stable target weight before proceeding. Another factor that needs to be considered are the fact that, while stretch marks on the lower abdomen, in the area that is cut away, will obviously be treated by the procedure, those on the upper abdomen or flanks will not be improved, and indeed may appear worse after the skin is repositioned.

A patient’s perspective

If you want to get an idea what it’s like to undergo surgery, you could have a look at www.offthecouch.ie: this is a blog written by a former patient in which she chronicles her experience of surgery. She’s also put together a really practical guide for patients having this operation, including tips on how to prepare, what to pack, and what to expect during your recovery. I am very grateful to her for sharing her experience.