Tummy Tuck Surgery (Abdominoplasty)
A Tummy Tuck, technically referred to as abdominoplasty, is a procedure that will remove excess fat and skin from around the waist and removes excess skin to leave a flatter, lower body profile and younger-looking abdomen. It can also remove or reduce the appearance of stretch marks on your lower abdomen. The operation can remove folds of skin left behind after losing a lot of weight, and tighten stretched skin and muscles after pregnancy.
Am I Suitable For Tummy Tuck Surgery?
Watch Mr David Floyd, Consultant Plastic Surgeon at the Royal Free Hospital, explain who could potentially benefit from a Tummy Tuck procedure:
"The main group of patients that require a tummy tuck are women who have had children. The effects of pregnancy cause usually three different things, it causes separation of the rectus muscles, which are the six pack muscles that run on the side of the tummy button. It causes separation of those muscles which gives a sort of central fullness to the abdomen when women stand up that can sometimes be so severe that it makes them look still pregnant.
That’s the first thing that happens with pregnancy, the second thing is that all the skin stretches out, you get stretch marks, and when the baby is born and everything settles down sometimes women are left with an overhang of skin. And the third thing that can happen is there could be a small hernia through the umbilicus.
Now a tummy tuck is designed to deal with these issues."
Mr David Floyd, Consultant Plastic Surgeon at the Royal Free Hospital
How Much Weight/Skin Can I Lose?
A tummy tuck is normally performed to remove excess skin following extreme weight loss or childbirth. As such it does not generally result in a huge loss of weight, but you can expect to lose around 5-10% of the total amount of weight you have lost. For example if you are having a tummy tuck following a weight loss of 150lb, you can expect to lose around 7.5-15lb following your procedure. The most dramatic results are actually seen in the reduction in your excess skin, which can be reduced by several inches.
A fully tummy tuck procedure usually results in the biggest loss of inches as it is performed on patients with a large amount of excess abdominal skin. This procedure is very invasive and involves your surgeon making a large incision from one hip to another and up to you belly button.
A mini tummy tuck sees a more modest reduction in your excess skin, as it is performed on patients who have less excess skin to start with. During this procedure only a small incision is made (just above your pubic area).
How Long Does The Procedure Take?
Tummy tuck surgery, depending on the amount of fat due to be removed, and whether the surgery is combined with another, generally last between 1 and 2 hours. As it is a rather extensive procedure that requires a certain amount of invasive surgery, patients are required to spend between 1 and 2 nights at the hospital following the operation.
As the procedure is rather complex and extensive, it is carried out under general anaesthetic, which means that patients should avoid eating and drinking for up to six hours before a tummy tuck surgery. Before the operation begins patients must either be given compression stockings or an injection of an anti-clotting medicine called heparin to help prevent blood clots forming in the veins in your legs.
Nowadays there is wealth of variations to the surgery. For example, patients can choose to have a mini tummy tuck, an extended tummy tuck or a standard tummy tuck. The standard tummy tuck surgery will be explained here.
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The Abdominoplasty Procedure
The procedure will begin with the surgeon drawing an outline of the areas which are to be operated on. Following this, he or she will the make a long incision from hipbone to hipbone, which should run just above the pubic bone. A second is then subsequently made in order to free the navel from the surrounding tissue. The skin will then be separated from the abdominal wall by the surgeon, who will then lift a large skin flap to reveal the vertical muscles found in the abdomen.
Once this flap has been made, the muscles are then pulled together and stitched into a new, tighter position. The section of skin that was cut as the flap is then stretched downwards in the direction of the first incision, while any extra or excess tissue is removed. The belly button is, if necessary, repositioned to ensure symmetry. Once the belly button has been repositioned, the incisions are then sutures closed to leave patients with a flatter and younger looking abdomen.
Mini Tummy Tucks
During a mini tummy tuck procedure, only the skin and excess far from below the belly button are removed, while an extended tummy tuck surgery involves the removal of excess skin and fat from the back as well as the abdomen.
After the surgery, your surgeon will provide you with some painkillers as well as a protective garment which needs to be worn for between 1 and 6 weeks. Some mild pain and discomfort is highly likely, but this should start to dissipate after a few weeks. Swelling and bruising is also likely, but these should start to disappear after a few days. Scarring is of course a side effect, but due to the positions of the incisions, they should not be overtly visible and will continue fading for up to a year until they are hardly noticeable.
Stages Of Recovery
The recovery process begins right when patients wake up from the surgery. Initially their abdomen may be very swollen, and it may even be throbbing. Patients should begin taking their pain medication immediately because that stops the pain before it gets too bad. After a few days, the swelling and pain will dissipate. The patients will most likely still have bruising, but this will go away as well. Bruising and swelling are normal and only to be expected after most surgeries.
The skin on the abdomen may feel numb at first; there is a reason for this. Abdominoplasty involves loosening the skin from its previous attachments and redraping it. This action, along with the incisions, means that some nerves were cut. Sensation will usually come back gradually over the course of several months.
It is recommended that patients sleep with their head and shoulders elevated for the first two weeks or however long the surgeon suggests. Use two or three good fluffy pillows to keep the head up.
Although the recovery process will take some time to get used to, and will be concerning at times, patients get through it, and can soon see the benefits of their surgery. Any time along the way, they can always refer back to their doctor for more assurance and encouragement, as they anxiously await the results.
Is It Safe? What Are The Risks?
As with any invasive surgery, tummy tucks come with a number of general risks, such as postoperative nausea and vomiting, potential infections, internal bleeding or reactions to the anaesthetic used.
In addition the procedure comes with a number of specific risks, such as:
- Swelling - You will most likely experience a large amount of swelling following your surgery (full tummy tucks will be worse than the mini procedure). This swelling should be reduced by the support garment you will be asked to wear for 4-8 weeks following your procedure. If the swelling is due to the collection of fluid under the skin (which is common), your surgeon will most likely remove this fluid using a syringe.
- Numbness or persistent pain around the incision - All patients will experience some numbness following the procedure which may well be permanent. If you experience pain following your tummy tuck you should consult your surgeon to discuss possible treatments.
- Unsightly scarring - Mini tummy tucks will have relatively small scars but full procedures will result in a large scar across your abdomen. These scars will look very red and noticeable for the first 3-4 months following your procedure but should fade into being less noticeable with time.