Abdominoplasty (Tummy Tuck)

Also known as an abdominoplasty, a tummy tuck is a cosmetic surgical procedure to improve the general appearance of te abdomen.

During this procedure, excess skin and fat are removed from the abdomen. Usaully, the connective tissues within the abdomen are tightened with structures as well.

The remaining skin is further repositioned to create a more toned look. You might choose to have a tummy tuck if you have excess skin around the area of your belly button and a weak lower abdominal region.

A tummy tuck can also improve your physical image.

The main reason for an abdominoplasty procedure is a flabby abdomen. A flabby abdomen is not only caused by the accumulation of adipose tissue but it's also a reason for the poor elasticity of the skin, excess skin and the stretching of the inner girdle of connective tissue (abdominal fascia). And also abdominal muscles that that extend from the ribs to the pubic bone.

This inner girdle which holds the internal organs in place is responsible for the tone and appearance of the abdomen.

Your abdomen is likely to protrude after your abdominal fascia has been stretched during pregnancy or significant changes in your weight.

A tummy tuck can also remove loose, excess skin and fat and tighten a weak fascia. It can also remove stretch marks and excess skin in the lower abdominal region below the navel.

However, tummy tucks will not correct stretch marks outside this area. You might consider a  tummy tuck for the following reasons:

• Presence of excess skin in the navel area,
• weak abdominal wall,
• failed liposuction
• and if you previously had a C-section and have retracted scarring.

A tummy tuck can also be done in combination with other body contouring cosmetic procedures, such as a buttock lift (belt lipectomy).

A tummy tuck is not for everyone.

Doctors can caution against it if you

• Plan to lose a significant amount of weight,
• might consider future pregnancy,
• have a severe chronic condition,
• such as heart disease,
• diabetes or irritable bowel syndrome
• and have a body mass index greater than 40.

A tummy tuck can pose the following potential risks:

Accumulation of fluid under the skin (seroma)

This can happen due to left drainage tubes after the surgery. Sometimes areas along the incision line  poorly heal and begin to separate. The incision scar from a tummy tuck is permanent, but it is placed along the easily hidden bikini line.

Tissue necrosis

Another risk is tissue necrosis. During a tummy tuck, fatty tissue deep within your skin in the abdominal area might get damaged or die. Smoking increases the risks of necrosis.

Changes in skin sensation

During this procedure,  the reposition of your abdominal tissues can affect the superficial sensory nerves in the abdominal area and frequently in the upper thighs.

Like other kinds of major surgery, a tummy tuck poses a risk of

• bleeding,
• infection
• and adverse reaction to anaesthesia.

Initially, you will speak to the plastic surgeon how to prepare for abdominoplasty procedure.

During your fist visit, your plastic surgeon will likely:

• Review your medical history,
• do a physical examination and discuss your expectations.

But before the procedure itself, you might personally need to:

• Give up smoking as it decreases the blood flow to the skin and can slow the healing process. In addition, smoking increases the risk of tissue necrosis or tissue damage.
• You are also advised to stop taking certain medications like aspirin, anti-inflammatory drugs and herbal supplements known to increase bleeding.

Maintaining a stable weight for at least three months before the tummy tuck. If you are overweight, your doctor will suggest that you lose weight before the procedure.

Take medication to prevent complications. Shortly prior to a tummy tuck, you need to take anticoagulants medication to prevent the formation of blood clots. It is also advised to ask someone to drive you back home and stay with you for at least the first night of your recovery at home.

Here you'll find out more about what you can expect during and after an abdominoplasty procedure.

A tummy tuck is usually performed in a hospital or an outpatient facility. During this procedure, you will be asleep and comfortable with the aid of general anaesthesia.

In other cases, you might be given analgesic and be moderately sedated. During the procedure, your plastic surgeon will make an incision to remove most of the skin and fat located between your navel and pubic hair in a horizontal, elliptical or oval shape.

The fascia overlying the abdominal muscles will be tightened with permanent sutures. Your plastic surgeon will reposition the skin around your navel. It will be brought out through an incision and sutured in its normal position.

The hip to hip incision above the pubic hair will be stitched together and will leave a scar that falls along the natural crease within the bikini line.

An antibiotic will also be given to prevent infection. After a tummy tuck, your abdominal incision, and your belly button will likely be covered with a surgical dressing. Small tubes might be placed along the incision site to drain any excess blood or fluid.

Your bed will be positioned to keep your upper body slightly raised and your knees at an angle for the first few days after surgery. Members of your health care team will also help you walk as early as the first day after a tummy tuck to help prevent the formation of blood clots.

You'll likely feel moderate pain, which will initially be controlled by intravenous pain medication. It's normal to have to swell in the surgical area for about six weeks. In some cases, swelling might take up to three months to resolve.

Drains might be left in place for a week or two after surgery. Your doctor or a member of your healthcare team will show you how to empty and care for your drains.

You might need to continue taking an antibiotic and anticoagulant for 10 days after your tummy tuck. You'll wear a supportive abdominal garment (abdominal binder) for about six weeks after your tummy tuck. This will help prevent fluid buildup and provide abdominal support while you heal.

Your doctor will explain how to care for your scar. For the first three months after a tummy tuck, you'll need to take care when moving and avoid positions that strain your incision line — such as quickly bending at the waist — to prevent the re-opening of the wound. In addition, you'll need to schedule follow-up visits with your doctor for the next year.

After an abdominoplasty procedure, results will be the flattened and more toned appearance of the abdomen.

Tummy tuck results are usually long lasting as long as you don’t forget to maintain a stable weight.