is the medical name for a "tummy tuck". This operation aims
to flatten the abdomen by removing the excess skin and fat tissue and
also tightening the muscles underneath. It is most often used in female
patients who have had children and their tissues have been stretched by
the pregnancies. Often such patients cannot alter the shape of their abdomen
despite exercise or going to the gym regularly. This is due two factors.
Firstly, the skin has been overstretched and has lost its elastic recoil,
and secondly, the deep muscles have been pulled apart. Abdominoplasty
corrects both of these problems. In addition, it is possible to do some
liposuction to the flank areas at the same time, and improve any unsightly
Caesarian section scars. Patients are advised to finish having children
before embarking on the operation, as further pregnancies after the operation
are likely to undo its benefits!
The main aim of the operation is to improve the shape and contour of the
abdomen; it is not designed to remove weight. Ideal patients are relatively
thin with skin laxity and poor muscle tone. Such patients usually get
excellent results. Average-sized patients can also do very well from the
operation. However, very large patients whose main problem is excess fat
do not do as well with abdominoplasty and would do better with either
liposuction or a "bodylift" operation.
There is nothing
special or complicated to be done by the patient. If you are on the oral
contraceptive pill or HRT you should continue to keep taking it, and inform
the surgeon or anaesthetist in the hospital. If you smoke it would be
a good ideal to try to stop for a month before and two weeks after as
this will significantly improve wound healing and your post-operative
recovery. It would be advisable to stop any herbal medicines and avoid
aspirin or ibuprofen-like drugs for 2 weeks before the operation.
You will come
into the hospital on the morning of surgery. The operation is performed
under general anaesthetic and takes about two hours. Many patients find
that an overnight bladder catheter very helpful. This catheter is not
essential and you may opt before the operation not to have one. When you
wake up you will have a dressing over the abdomen and be wearing an abdominal
binder (this is a tight velcro dressing similar to a corset).
Post-operative follow-up and after care.
You need to
stay in hospital overnight. All being well, you will be discharged home
the following day with some painkillers. It is import to leave the dressing
alone and wear the abdominal binder 24 hours a day. At home you should
take life easy for the first few days, and if feeling tired during the
day resting in a chair rather than a bed. It is critical that during the
day that you walk around the room at least once per hour to improve the
circulation of blood in the legs and avoid a blood clot in the deep leg
veins. You wound be advised to take to 2 weeks off work and it is essential
to avoid all strenuous activity during this period. The binder needs to
be worn day and night for a month to give the best result possible, and
failure to wear it without doubt diminishes the final appearance. Vigorous
sport such as jogging or the gym should be avoided for 6 weeks.
Most of the post-operative pain is in the first 48 hours and is related
to the muscle tightening. This can be lessened by taking the painkillers
on a regular basis and avoiding bending down too much. At between 5 and
7 days you will be seen in the clinic and the dressings removed and the
wounds checked. A check up clinic appointment at 3 months after the surgery
will be arranged for you. The final result of the abdominoplasty is best
viewed at 3 months after the surgery.
carry a risk of complications, and abdominoplasty is no exception. The
risk of infection and significant bleeding are between 1 and 2 % and precautions
are taken to avoid this with antibiotics and careful operating. In virtually
all patients drains are inserted at the time of surgery. These drains
are removed on the ward the following day and their function is remove
any excess fluid that has accumulated under the skin. In a small group
of patients - less than 5 % - a collection of fluid persists and this
is called a "seroma". It is completely harmless and does not
affect the final outcome. This "seroma" is easily treated in
the clinic with a syringe.
It is impossible to perform any abdominoplasty operation with out a scar.
Such scars run from one side of the lower abdomen to the other. If any
attempt is made to shorten the scar more problems are actually created
due to lumpiness at the ends of the incisions, known as "dog ears".
Occasionally, scars may be red and thick for a few months but they usually
settle down by themselves without any treatment.
In order to get a flat appearance, the skin on the abdomen is pulled tight.
This does not usually cause problems in the fit, healthy patients. However,
in patients who are diabetic, or smoke heavily, or are obese, this skin
tension can cause problems with wound healing. Small areas of skin that
have not healed well can be treated with dressings in the clinic.
The most serious problem is a deep venous thrombosis (DVT) in the leg
and possible pulmonary embolus in the post-operative period. Great care
is taken to avoid this problem by using compression stockings and inflatable
calf pumps in theatre. In addition, these calf pumps are continued overnight
and early mobilization is encouraged.
is best suited to women who have finished their family and wish to improve
the contour of their lower abdomen. In carefully chosen patients who are
motivated, the complication rate is low and many are very happy with the
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