Pregnancy, weight loss and the natural ageing process can all cause the abdominal muscles and the skin on the tummy to become weak and loose, which in turn can mean that no amount of exercise will smooth or tighten the area.
Abdominoplasty also known as ‘Tummy Tuck’ surgery, involves the surgical removal of excess skin and fat in the abdominal region. Tummy Tuck is part of the group of ‘body-contouring’ procedures, which also includes Fat Removal (liposuction), Skin-Tightening (arm, thigh and buttock lifts) and Muscle enhancing (calf, buttock and pectoral implants, and abdominal six-pack etching).
Ideal candidates for abdominoplasty
Best candidates for Tummy Tuck surgery include individuals with loose abdominal skin and lax abdominal muscles, stretch marks, and/or extra fat build-up which is persistent despite regular exercise and healthy diets.
People who would benefit from abdominoplasty are:
- Women with excess skin and fat following pregnancy, etc.
- Patients with residual folds of skin following significant weight loss.
- Patients with stretch marks following pregnancy or significant weight loss.
- Patients with weak abdominal wall muscles following significant weight loss, pregnancy, etc.
- Those with realistic expectations who are in good health.
What to consider at this stage
Before you see Mr Rezai, it is important to consider exactly what you are trying to achieve from your surgery. In particular, you must understand that Abdominoplasty surgery is most definitely not a treatment for weight loss or obesity.
Abdominoplasty - technical variations
Mini-Abdominoplasty also known as mini-tuck,
- Excess skin and fat above the pubic bone are removed.
- The Abdominal muscles below the belly button (umbilicus) can also be tightened if needed.
- The belly button remains intact.
- The procedure is performed under general anaesthesia, takes sixty to ninety minutes, and is occasionally done as a day case. However, most patients stay in hospital overnight.
Apronectomy (a form of mini-abdominoplasty)
- Involves removal of larger excess skin and fat (the apron) hanging down over the pubic area and genitals.
- The belly button remains intact.
- The procedure is performed under general anaesthesia and may take up to two hours. Patients stay in hospital overnight.
Standard Abdominoplasty
- Excess skin and fat between the pubic bone and belly button is removed and the abdominal muscles are tightened.
- This leaves the belly button itself in place. However, in pulling the skin at the level of the umbilicus down to the pubic level, the umbilicus must be brought through the new skin lying over it. Consequently, this form of tuck results in a long curved scar at the pubic level, along with a circular scar around the umbilicus.
- The procedure is performed under general anaesthesia and may take up to three hours. Drains may be used, and patients remain in hospital for at least one night.
Extended Abdominoplasty
- This is a more radical extensive procedure than standard abdominoplasty.
- The incision is continued around the waist and onto the back.
- Excess skin and fat are removed from this wider area around the flanks, resulting in a longer scar.
- As with the standard abdominoplasty, the umbilicus must be brought through the skin, resulting in a scar around it.
- The procedure is again performed under general anaesthesia, and may take between three to five hours to perform, especially as the patient has to be turned during surgery. Patients remain in hospital for at least one night.
All the above procedures can be combined with Muscle Plication, in which the muscles over the abdominal wall are sutured back in to position, tightening the muscles, flattening the tummy and reducing the waistline.
Abdominoplasty - types & patient selection
Patient indications and preference determines which technique to perform. A thorough consultation including patient’s medical history and a physical examination usually reveals the best treatment option for a given patient.
Patients with excess abdominal wall fat usually benefit from weight loss prior to an operation. Successful preoperative weight loss heralds a motivated patient and promises a pleasing outcome. Certain patients will present with a somewhat bulging abdomen with minimal to moderate excess abdominal wall fat, normal abdominal muscles and no excess skin. Typically, these patients will have significant excess intraabdominal fat. Weight loss is encouraged in these patients as well.
The following is a classification system developed to better determine the type of procedure required:
Type 1
Indication: Fat deposit with normal/tight abdominal muscles and skin. Treatment: Liposuction only
Type 2
Indication: Mild excess skin, normal/tight abdominal muscles with or without excess fat
Treatment: Mini-abdominoplasty with or without liposuction
Type 3
Indication: Mild excess skin, abdominal muscle laxity below the umbilicus with mild to moderate excess fat:
Treatment: Apronectomy with muscle plication, with or without Liposuction
Type 4
Indication: Mild excess skin, total (above and below umbilicus) abdominal muscle laxity with or without excess fat:
Treatment: Mini or Standard Abdominoplasty with muscle plication, with or without Liposuction
Type 5
Indication: Large excess skin, total muscle laxity, with or without excess fat:
Treatment: Standard or Extended Abdominoplasty and flankoplasty with muscle plicaton, with or without liposuction.
An important point of consideration with abdominoplasty, is scarring. Scarring will fade over time and, in many patients, will heal to form very faint white lines. However, it is important to remember that surgical scars are permanent and will never totally disappear.
Abdominoplasty - the procedure
- The abdominoplasty operation is performed under general anaesthetic.
- Surgery takes anywhere between 1 and 3 hours depending on the type of abdominoplasty.
- Patients stay in hospital overnight and sometimes for 2 nights.
- For those not engaged in physically demanding work, you can expect to return to work after 1 to 2 weeks.
- You can anticipate resuming normal physical exercise after 6 to 8 weeks.
Following the operation
As with all surgery, following tummy tuck surgery you must expect to feel bruised and sore. The treated areas are likely to be swollen. It will be necessary for you to wear a tight compression garment for several weeks. Most patients are able to fully resume their normal activities within 3 to 4 weeks. Sutures will be removed after ten to fourteen days.
Mr Rezai and his team will provide you with detailed post-surgery instructions to expedite your recovery. Should you develop any doubts or concerns following your treatment, however, they would encourage you to contact them straight away.
Risks & complications
Fortunately, worrisome complications of abdominoplasty rarely occur. However, all patients must understand and accept that no surgical procedure is absolutely free from risk. It is important to appreciate that abdominoplasty is a significant surgical procedure. Mr Rezai will discuss these risks with you at your consultation. For further information please refer to Risks and Complications of Abdominoplasty.
How long will the results of your abdominoplasty last?
Tummy tuck surgery can produce considerable benefits, and these benefits last exceptionally well. By maintaining a sensible weight, and preferably exercising, the patient can both maintain and even improve upon the results of their surgery. However, any subsequent pregnancy or weight gain, may, again, produce new fat cells and some degree of skin sagging.
It is important to remember that all tummy tuck surgery will leave scars. Many may be hidden by underwear and fade over time to leave a very faint line. However, it is important to remember that no surgical scar will ever totally disappear.
