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Guide To Cosmetic Surgery - Tummy Tuck

Tummy tuck surgery

The tummy tuck or ‘abdominoplasty’ is one of the most popular cosmetic surgery procedures and is number 4 in the list of top 5 procedures for women.

The tummy tuck has become the favoured choice of procedure for celebrities and film stars alike who see it is a great way of removing excess fat and skin around the stomach.

Why is it so popular? The reason for this may be the fact that it can give you a flatter and youthful looking abdomen. An increasing number of men are choosing this procedure and combining it with liposuction in order to remove excess fat. Men do tend to store fat around the abdomen and this is one way of removing that.

A flat, toned and shapelier looking abdomen is both desirable and aesthetic. In other words, it looks and feels so much better than one which is flabby and overweight.

It is also very useful for removing excess skin caused by childbirth or excessive weight loss. Obese patients will find that they are left with loose, sagging folds of fat and skin as a result of dramatic weight loss, especially following obesity surgery. These folds will hang around various parts of the body including the abdomen and are both uncomfortable and unsightly.

This surgery can improve your appearance but will not give you the perfect figure. It tends to work best for those patients who exercise and follow a sensible diet as they may have some stubborn fat and skin around their abdomen which cannot be shifted even with their healthy regime.

Most people think of abdominoplasty as a single procedure but there are in fact, 3 versions of this surgery. They are as follows:

• Full abdominoplasty
  
• Partial or ‘mini’ abdominoplasty
  
• Extended abdominoplasty

The full abdominoplasty involves the surgeon removing excess fat and skin from the midsection and re-positioning the belly button (navel) as well. This is an extensive procedure which can take up to 5 hours in some cases.

The mini abdominoplasty is a shorter procedure in which a smaller incision is made and fat and skin trimmed away It is ideal for those patients who don’t have a great deal of fat and skin around their midsection or are fairly slim but want their abdomen sculptured into an improved shape.

The extended abdominoplasty involves removing fat and skin from additional areas of the body such as the hips, thighs and back. It is suitable for removing ‘love handles’ or ‘mandles’ (male love handles) and other unwanted fat deposits.

For some people this is the only way of removing those loose folds of skin and fat which diet and exercise cannot shift.

Suitability for tummy tuck surgery

Who is suitable for this procedure? Well, most people are suitable for an abdominoplasty as long as they are in good health, emotionally stable and fully understand what this procedure is and why they want it.

Both men and women, young and old can benefit from this surgery. If you are an older person who has noticed that you have some rolls of fat or ‘spare tires’ around your waist then this may be an option. Our metabolisms do tend to slow down as we age which may also be due to the fact that we are less active as well. If so then weight will be gained and this will show itself as extra fat around the midriff.

If you are a woman who has recently had a baby then you may find that you have some loose folds of skin and fat which have stretched as a result of childbirth. These will not return to their normal
pre-childbirth state but surgery may be able to help.

It is an extensive form of surgery which carries some risks although this applies to all forms of surgery.

Your suitability will be decided during the consultation between you and your surgeon. This consultation will include him/her taking a full medical history. This is routine procedure and is designed to ensure that you are fit and healthy for surgery. If you have any allergies, current medical conditions, taking any medication or have undergone surgery before, especially abdominal surgery then this is the time to mention this. 

As long as you are clear about what this surgery can achieve then this and other factors will ensure that you are considered for this procedure.

Preparation for surgery

Your preparation will be helped by the addition of a set of instructions given to you by the surgeon at your consultation. These guidelines are meant to help you get into the best shape you can be for your operation.

The fitter and healthier you are the better. All cosmetic surgery has risks although these are very small. However, it is as well to be aware of these and weigh these up against the benefits when deciding whether to have surgery or not.

So, this set will include some of the following:

• Stop smoking (if you are a smoker). Smoking has been shown to have an adverse affect on a patient’s recovery. It can cause a delay in wound healing which means it might not heal properly and can increase your recovery time as a whole. If you want to stop smoking then you will find that your surgeon may be able to help with this. He or she can often recommend a stop smoking programme. If this is too difficult to do at the moment then please ensure that you stop at least 2 weeks before your operation and wait for at least 2 weeks afterwards before having a cigarette.
  
• Have your last meal (and any drinks but not alcohol) 6 hours before surgery. This particularly applies to those patients who are having a general anaesthetic.
  
• If you are taking aspirin, an anti-inflammatory medicine or Warfarin then stop taking these as they can cause bleeding during or after surgery. Your surgeon will be able to advise you as to what medications you can and cannot take.
• This equally applies to any over the counter or homeopathic medicines such as evening primrose oil, valerian, St John’s Wort and ginseng.
  
• Preparing things at home ready for your recovery. This may seem too soon but it can help to do this well in advance. You will not be up to doing any housework, cooking or other everyday activities after surgery. So it is a good idea to do all of these before your operation so that you don’t have to when you are meant to be recovering.
• This can include cooking and preparing enough meals to last you during your recovery (or buying in ready-made meals), cleaning and any other household tasks; taking care of any bills; arranging time off work; preparing ice packs (frozen bags of vegetables such as peas are good for this) and ensuring you have enough painkillers and any other medications you may need.
  
• Ask someone to drive you to the clinic or hospital and to take you home afterwards. If possible, ask them to help you out the first 2 to 3 days after surgery. This is especially important if you live alone. This person can be your partner, member of your family or a good friend.
  
• Pack a small case the day before your surgery with your nightwear, dressing gown and comfy slippers, any medications that you are allowed to take and a couple of magazines or books. If you wear glasses then make sure you bring your glasses case with you. If you wear contact lenses then remove these and wear glasses whilst you are in hospital.
• Do not wear any make up, jewellery or nail polish. Leave any valuables at home.

The tummy tuck procedure

This will depend on whether you are having the full, mini or extended procedure.

The full abdominoplasty involves the surgeon making a long incision which runs in a vertical fashion from left to right hipbone. He or she will then lift this incised skin to one side to reveal the vertical abdominal muscles.

The belly button is freed up via a second incision. This will be repositioned afterwards.

These muscles are pulled together – which tightens them and stitched into a new position.
He or she will then trim away any excess fat or skin before pulling the flap of skin downwards which will flatten the abdomen. A new hole for your navel (belly button) is cut and the belly button itself is stitched into its new position.

The flap of skin is closed with stitches and a dressing is applied. You will be given a special support garment similar to a corset to wear for the next 6 weeks.

This procedure takes 2 to 3 hours to complete and is usually carried out under a general anaesthetic. It means a one to two nights stay in hospital.

The mini or partial abdominoplasty differs from the full version in that the belly button remains in place.

It is performed on those patients with a smaller amount of excess fat around their abdomen; or are in relatively good shape with a toned abdomen which has a small amount of loose skin and fat.

The surgeon will make a single incision around your bikini line before trimming away any excess fat and skin. This incision is closed with stitches as per normal. A dressing will be applied and you will be given a support garment to wear. This should be worn for 6 weeks after your surgery.

This will take around 1 to 2 hours to complete and is performed under a general anaesthetic. It will require an overnight stay in hospital.

The extended abdominoplasty is a more extensive form of surgery in that it will remove excess fat and skin from other parts of the body. It will involve the removal of fat from the abdomen, back, hips and thighs and can be combined with liposuction or breast reduction surgery.

The surgeon will make a long incision across your abdomen which runs down to the tops of your thighs and across your lower back. Any excess fat and skin is removed and the belly button is repositioned in the same way as the full abdominoplasty.

The skin flap is pulled down and stitched into place which results in a flatter, more toned abdomen.

This extensive surgery takes around 3 hours to complete. It is carried out under a general anaesthetic and requires 1 to 2 days stay in hospital.

Recovery

Your abdomen will feel sore, stiff and swollen and there may be bruising as well. The support garment will help to reduce any swelling and must be worn for 6 weeks after surgery.

You will experience some pain and discomfort but pain relief will deal with this.

You will find that for the first couple of days you are a bit groggy, tired and ‘under the weather’. This is a completely normal reaction to a general anaesthetic and will soon pass. The best thing to do is to get as much rest as you can.

Read, watch television or listen to music. Keep a few blankets handy as you may find that you feel the cold more than usual (this is very common amongst patients who have had surgery). And, when sitting down, place a couple of pillows under your knees to keep them bent. This will reduce any strain on your abdominal area.

You will find it difficult to stand up straight at first although this will get much easier.

Whilst you are resting and taking things easy, ensure that someone can take over the normal household tasks. If you have managed to arrange this in advance (see ‘preparation for surgery’) then so much the better. It is also handy having someone around in case something goes wrong.

Don’t worry; complications are rare but can occur in a small minority of cases and if they do so then you will need to contact your surgeon.

The recovery period will vary from one patient to another: but in general, you are looking at 3 to 4 weeks. Some people return to work after a couple of weeks but others require 3 or 4 weeks before they do so.

It will be 6 weeks before you are fully recovered.

If the surgeon used clips as well as stitches during surgery then you will need to return to the hospital to have these removed. The stitches are the dissolvable ones so there is no need for their removal. This will happen 5 days after surgery.

There will be a series of follow up visits after this surgery which form part of your aftercare service. These will check upon your progress and answer any questions you may have.

Avoid sports or other strenuous activities for at least 6 weeks. You can undertake some gentle walking or swimming to help maintain your fitness.  

The benefits of tummy tuck surgery

Many patients are pleased with the results. They report a sense of increased self-confidence and sense of self-worth as a result of this.

For those patients who have a flabby midsection as a result of excessive weight loss then a tummy tuck is often the only answer.

Your abdomen will be taut, trimmer and younger looking.

For those women who have a tummy bulge or loose skin as a result of childbirth then a tummy tuck can get rid of this and any stretch marks as well.

The risks of tummy tuck surgery

There are thousands of people who undergo this procedure every year and they are very happy with the results. Thankfully, complications are rare but they do happen and you need to be aware of these.

If you are a smoker, have a medical condition or scarring from previous abdominal surgery then this will place you at greater risk.

The complications from tummy tuck surgery are:

• Serum collection
  Serum is the straw coloured fluid which can collect after surgery but this can be removed by your surgeon.
  
• Haematoma (blood clot under the skin)
  Drainage tubes will be inserted into the wounds to remove blood and excess fluids but sometimes not all the blood will be removed. If this happens then a blood clot can form. This blood clot (haematoma) will have to be drained in order to stop any bleeding.
  
• Scarring
  There are always scars following surgery although these will fade over time. The surgeon will always try and ensure that these scars are hidden by your underwear or swimwear. Scars can be healed by micropore tape, steroid injections, silicone gel sheeting, massage and scar revision surgery.
  
• Skin or fat necrosis (skin/fat death)
  The tissue along the incision can be lost or ‘dies’ as a result of tummy tuck especially in the extensive procedures. This can delay healing and is very noticeable in those patients who smoke.
  
• Infection
  Wound infection is a risk with any form of surgery. If this does happen then you will be given antibiotics to deal with this.
  
• Nerve damage
  This shows itself as a loss of sensation below the belly button. Nerves can be damaged during surgery and this can be temporary or even permanent in a few unlucky cases.

These complications will be discussed between you and the surgeon during your initial consultation.