This type of surgery is known as abdominoplasty or a tummy tuck. This procedure can help patients who have been left with loose layers of fat and skin after pregnancy, significant weight loss or successful weight loss surgery.
The aim of abdominoplasty is to sculpt the body to its natural contours resulting in a flatter tummy and more youthful form. A beneficial side effect to tummy tuck surgery is the reduction in visibility of stretch marks and existing scars, as the skin bearing the blemishes is removed.
In female patients an incision is made just below the bikini line and in male patients this is in a natural crease of skin where any scarring is hidden. The skin is then lifted, freeing the tissue and fat from muscle allowing the manipulation and removal of the required amount of skin and fat, and also the tightening of the muscles should this be needed. The incision is closed with stitching and bandages applied – these will need to be worn for about three weeks.
Sometimes liposuction may be recommended in conjunction with abdominoplasty to achieve the best results. The tummy tuck operation will take place under general anaesthetic, which means the patient will need to stay in hospital overnight. Following the operation the patient will need to plan to take up to two weeks off work and to spend the time resting at home. Strenuous activity of any sort will need to be avoided for several weeks after that.
There will be some discomfort in the first few days, and swelling and bruising may occur, however any pain can be eased with prescribed painkillers. The patient should expect to see the full results of the abdominoplasty procedure in about three weeks. There will be an unavoidable scar, but this should be hidden and will fade significantly with time.
This type of surgery is very successful in removing skin excess and tightening the tummy muscles. Only those stretch marks in the area of skin which is taken away will be removed, though the remainder will tend to be lower on the abdomen. In patients who are generally overweight, it is better to lose weight before surgery to improve the end result. However, even these overweight patients with significant skin excess hanging over the groin region find removal of that tissue highly beneficial.
Preparing for Surgery
Smoking can increase the likelihood of wound problems in this type of surgery and abstaining from smoking for at least two weeks preoperatively and postoperatively is a sensible precaution.
The patient is admitted to hospital on the day of surgery and Miss Patel will again explain the procedure to the patient and will plan and mark the exact extent of the surgery. The patient will be seen by a consultant anaesthetist who will discuss the anaesthetic with the patient and will answer any questions the patient may have.
Recovery following abdominoplasty
The patient will be able to go home the following day. It is usually recommend that the patient use an abdominal support (binder) or a fitted girdle to give extra support to the abdomen as the swelling settles which normally takes for four to six weeks.
Miss Patel will normally see the patient between five to seven days following surgery to check that all is well and to reduce the dressing. The patient is then seen again a week later at which stage dressings can usually be dispensed with. Occasionally, small amounts of tissue fluid can collect under the scar ( this is known as seroma) which is removed painlessly in the consultation room. A final follow up visit is planned three months after surgery.
Abdominoplasty can result in some abdominal discomfort immediately after surgery, particularly if the muscles have been tightened. The patient will be provided with appropriate painkillers after surgery and when they go home. It is recommended for the comfort of the patient to keep their knees flexed up when in bed on a pillow or two in the first few days immediately after surgery. It may also be more comfortable for the patient to bend over slightly while walking in the initial stages of recovery. Gradually patients return to a normal walking position after the first week or so following surgery.
Normal day to day activities can be resumed after approximately two weeks following surgery and patients are able to return to work by the second or third week. After six weeks patients should be able to resume activities such as aerobics and sport. Some minor swelling in the lower tummy and around the scar is normal and the area of the scar can become a little lumpy and hard in the short term. This usually settles with time. The area above the middle of the scar is numb after the operation and whilst this will improve greatly after the operation, a continued degree of numbness in this area is normal.
Safety and Potential Risks of Abdominoplasty
The majority of patients undergoing abdominoplasty performed by an experienced surgeon achieve good results with a rapid recovery. However, in a small proportion of cases, complications do occur and can include the following:
- Scars – Scars usually heal nicely in a thin white line; however, in some patients, they can be thicker than expected and may require scar management therapy.
- Infection – Infection is rare in this type of surgery and the risk is minimised by careful surgical technique and the use of a dose of antibiotic during surgery.
- Haematoma – This is a rare complication where the small blood vessels in the wound bleed after the surgery leading to a collection of blood under the wound (a haematoma) which needs to be released and washed out before re-suturing the wound. When this problem arises, it is typically on the day of surgery and does not affect the final result.
This is not a definitive list and symptoms will vary with each patient. Please ask Miss Patel for more information.
For further information please contact Miss Patel to arrange a consultation.
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