What is abdominoplasty surgery?
Abdominoplasty, probably better known as a tummy tuck, are operations to remove excess skin and fat from the abdomen or tummy.
The majority of patients opting for these procedures will inevitably be women who dislike the effects childbirth has had on their body shape and appearance. Following pregnancy the abdominal skin can stretch and cause excessive loose skin with an overhang of tissue in the lower abdomen. Pregnancy also pushes the tummy muscles apart and although exercise may tone them up, it will not bring them back together.
This procedure does not correct obesity and ideally patients should be within several pounds of their ideal weight. The reason for this is that obesity increases the complication rate and can result in unsatisfactory results.
Following an examination, Mr Chana will be able to show you where the scar will be placed. The scar runs from hip to hip and is designed to be covered by normal pants (the bikini line). There may be a slight variation on these scars depending on the type of clothing the individual may wish to wear after surgery but please bear in mind fashions change constantly.
Watch a video of one of Mr Chana’s male patients talking about his abdominoplasty on the BBC news.
What are the different types of abdominoplasty?
The miniabdominoplasty is a procedure in which a variable amount of skin is removed from the lower abdomen leaving the scar in the bikiniline. The bellybutton is untouched.
The standard abdominoplasty is a procedure in which all the skin between the bikini line and belly button is removed in an elliptical design. The muscles are tightened to achieve a flatter appearance. The skin is then stretched down to the bikini line and the belly button is stitched into the original position by making an opening in the skin that has been pulled down.
What happens during the operation?
The abdominoplasty is an operation which is carried out under general anaesthesia and requires 1-2 nights postoperative stay in hospital.
An elliptical area of skin and underlying fat is removed from hip to hip above the pubic area and below the belly button (umbilicus).
During an abdominoplasty, the umbilicus is left attached on a stalk. The skin and fat of the upper abdomen is lifted as far as the ribs and this skin is then stretched downwards to join the lower incision. It is also necessary to tighten the tummy muscles to improve the abdominal contour. Having closed the skin edges, a small opening is made at the new site of the umbilicus which is then sewn back in its new position.
A miniabdominoplasty is not quite as radical as the abdominoplasty and the umbilicus is left in place. In this procedure a smaller amount of skin is removed from lowermost part of the abdomen above the pubic area.
Drainage tubes are sometimes but not always placed under the skin to collect any excess fluid that may accumulate. However Mr Chana uses an advanced new technique which uses many deep stitches to close the space under the skin and this avoids the use of drains in the vast majority of cases. This technique also reduces the rate of late fluid collections (seroma) under the skin. A dressing is then applied over the main suture line and umbilicus. A special compression garment is also required to help with healing.
What is the recovery?
If used the drainage tubes are removed before discharge from hospital. A light dressing may be required for one or two weeks and this should be kept dry. The compression garment should be worn for 6 weeks.
Immediately after the operation the abdominal skin may feel very tight and indeed it may be difficult to stand up completely straight for the first few days.
It is normal to feel moderate discomfort after abdominoplasty. However, this is usually controlled by mild analgesia which will be prescribed (but do not take Aspirin or non-steroidal medication).
Bruising will occur but this is normal and usually settles well within two or three weeks. We recommend taking Arnica for one week prior to surgery and two weeks afterwards to lessen the bruising.
Occasionally, fluid continues to collect under the skin even 1 to 2 weeks after the operation. This is called a seroma and may need to be drained with a needle at the time of your follow up visits. However, with the use of advanced techniques the rate of seroma formation is significantly reduced.
Numbness of the lower abdomen is usual after this procedure. It will gradually return to normal over a few months but a small residual numb area may remain near the middle of the scar.
As with all surgery there are risks involved but with abdominoplasty but they are small and infrequent in occurrence. Blood clotting problems can be a factor and as a precaution you will wear T.E.D. stockings before, during and after the operation and mobilisation will be expected although adequate rest is essential.
Wound infection can occasionally occur but usually is readily treated with antibiotics. However, severe infections are very rare. Patients who smoke have an increased risk of delayed wound healing. Heavy smokers risk poor circulation to the skin which is pulled down to just above the pubic area. If this happens and any skin dies, it would form a leathery scab. This would need to be removed and the wound allowed to slowly heal.
The scar after an abdominoplasty is quite long, initially red and perhaps itchy. It may take several months to settle to a light colour. Some distortion of the skin, particularly around the hip area may occur after abdominoplasty and it may occasionally be necessary to carry out a small adjustment procedure in order to reduce this should it persist once the initial swelling has subsided.
A very small ‘roll’ or prominence may reemerge just above the scar after many months, especially if the initial problem was severe. If this is of concern, it can be dealt with in a revision procedure of lower cost.