Articles
Abdominoplasty
An abdominoplasty or tummy tuck is an operation designed to address skin and fatty tissue excess in the abdomen or tummy. Abdominal muscles are usually repositioned and any associated hernias are repaired.
Large volume weight loss and after pregnancy there may be skin excess with loss of elasticity. It is a common misconception that liposuction will address this. Once skin has lost elasticity it will not take up. Removing deeper fatty tissue results in a thinner flap or apron of skin. Pregnancy also stretches and splits the muscles, these may remain apart. Part of the procedure is to tighten and reposition these muscles.
Surgery usually results in an improved contour, improved muscle function and removes excess skin and fat. This is at the expense of scarring. Scars run from the pubic hair line, or below a pre-existing caesarian section scar, across from hip to hip. There may be a slight W-shape. It is usually possible to remove all of the skin to the umbilicus or belly button. An additional scar runs around the newly postioned belly button. Sometime there may also be a small vertical scar below the belly button if the skin excess is mild. With very marked skin laxity a vertical scar is used to remove the transverse laxity.
Surgery is performed in hospital under general anaesthetic. Plastic drainage tubes are commonly used. A catheter to drain the bladder may also be placed. Through the incision the skin and fatty tissue is excised. Strong stitches reposition the muscles. Additional pleating stitches can be used to recreate a waist. At times hernias may be present and these are repaired. The original belly button is kept but placed in a new position. Wounds are closed in multiple layers to give as much support as possible.
Flank liposuction is commonly performed to smooth the lateral edges and limit scar length. This is done at the same time as the surgery.
Most people are in a slightly bent forward position for the first few days. Hospital stay is between three and five days. Regular pain relief is needed. Early mobilization, leg exercises and blood thinning medications are often used to prevent leg vein clots. A garment or tight binder is used to assist wound healing. Usually garments are worn for six weeks continuously and then for a further two weeks during the day. Detailed scar advice is given.
All surgery has risks and abdominoplasty is no different. Bleeding, bruising and swelling may occur. These vary from person to person and even side to side. Infection is rare. Wound healing issues may occur as the scars are fairly long. Seroma is a collection of fluid, this may occur and needs drainage by needle. The garment helps minimize this risk. Numbness below the belly button is common, this usually gets smaller with time. Everyone should consider being numb in an area above the pubic hair line. Scar result is not predictable and may vary from thin, pale lines to thicker, heavier scars. Careful care of the scars can help improve the outcome.
Care with lifting and carrying is needed for a number of weeks. It is possible to return to sedentary type work as early as two weeks but most will need longer. Activities are gradually and progressively reintroduced in a specific care-plan.
Abdominoplasty surgery is usually well tolerated with favourable outcomes.