Abdominoplasty, (Tummy Tuck)
Reasons for undergoing an abdominoplasty
Ideally a patient requesting an abdominoplasty has tried to lose weight but is unable to reduce the excess skin which sometimes hangs in folds. This situation can arise following significant weight loss or following childbirth. Abdominoplasty is requested to address abdominal wall muscle weakness caused by divarification, (splitting), of the rectus abdomens muscles. This reduces the core strength and also promotes the appearance of a bulge.
A persistent overhang over an otherwise well-heeled cesarean section or hysterectomy scar can also prove resistant to dieting and exercise. A loose tummy is often associated with a loose flank and back. These can be addressed in a secondary procedure called a post area abdominoplasty.
Surgery
All, or a significant portion, of the skin and fatty tissue below the tummy button is removed. The underlying abdominal muscles are tightened up with a vertical stitch. Locos action is often used as an additional procedure to improve the outcome.
In a few cases a vertically orientated section of tissue is also removed, (Fleur-de-lys), although can leave an unsightly scar.
Anaesthetic
General, At least an overnight stay, sometimes two.
Back to work
Two to three weeks depending on the type of work
Scars
Around the tummy button and lower abdomen, usually in the bikini line.
Depends on the distribution of the excess tissue.
Occasionally an additional vertical scar is also necessary
Fade with time
Feeling
Numb in a triangle below the tummy button to the scar.
Sometimes in the "pocket" area of the thigh
Further information
British Association of Aesthetic Plastic Surgeons (web page)
British Association of Aesthetic Plastic Surgeons (patient information)
Posterior Abdominoplasty
Whereas an abdominoplasty tightens the front of the tummy a posterior abdominoplasty tightens the hips and back. It also lifts the buttocks a little.
Surgery
Surgery is not as extensive as the initial abdominoplasty. Depending on the patient's circumstances, areas of tissue over each hip and extending round possibly to the midline at the back are excised. . The resulting scars are usually within the bikini line.
Anaesthetic
General, Overnight stay.
Back to work
Two to three weeks depending on the type of work
Scars
Around the hips towards the mid line.
Usually hidden in bikini line.
Depends on the distribution of the excess tissue.
Fade with time
Surgery Following Massive Weight Loss
Significant weight loss, by whatever means, confers dramatic health advantages. Unfortunately, however, it is only fat that reduces, the skin, although contracts to a small amount, is usually left in excess. This can result in uncomfortable and unsightly folds. It can also present a hygiene issue. The only effective way of dealing with this is through excision. This necessarily leaves significant scars which are unavoidable but do fade with time.
Massive weight loss surgery is a significant undertaking. It is essential that patients are at the peak of health. Specifically this means nutritional targets are met and that the haemoglobin is within normal limits. This is particularly pertinent in cases where absorption of nutrients and iron have been affected by any diversional gastrointestinal surgery.
Surgery
Surgery includes abdominoplasty, posteriorly abdominoplasty, thigh lifts, (medial and lateral), brachioplasty and mastopexy.
It is preferable to stage surgery rather than to undertake too many procedures at one time. The complication rates increased significantly if operations are "stacked".
Minor revisions are not uncommon.
Anaesthetic
General, At least an overnight stay, often two.
Preoperative anaesthetic assessment imperative
Back to work
Two to three weeks depending on the procedure and type of work
Scars
Depends on the distribution of the excess tissue.
Fade with time
