Abdominoplasty, commonly known as a “tummy tuck,” is a major plastic surgery procedure involving removal of excess skin and fat from the middle and lower abdomen and tightening of the muscles of the abdominal wall, so as to reshape body contour. Abdominoplasty is one of the most commonly performed aesthetic procedures, as it can positively impact self-concept and enhance self-confidence.
Most common causes of excess skin and fat in the abdomen are associated with pregnancy, aging, significant fluctuations in weight, heredity and/or prior surgery. There are different types of abdominoplasty depending on the individual case. The following parameters will influence the surgeon’s final decision: skin quality, amount of fat tissue, abdominal muscle tonicity and the overall patient’s morphology.
The standard abdominoplasty removes a large amount of redundant tissue (skin and fat) from the middle and lower abdominal wall, between the belly button (umbilicus) and the pubic region. The skin from the upper middle part of the abdomen is then re-draped downwards in order to replace the removed skin. The belly button is preserved and put in its normal position through a hole cut and contoured in the newly draped skin.
Liposuction has improved dramatically the outcome of abdominal aesthetic surgery, by reducing the amount and length of scars. Lipo-abdominoplasty (combination of liposuction and abdominoplasty) is the latest trend, combining, during the same procedure, liposuction to remove localized fat excess, with abdominoplasty, to remove excess of abdominal skin and to tighten the surrounding skin and abdominal wall muscles.
Abdominoplasty leaves a visible scar. Its length and position may vary according to the amount and location of skin to be removed. It usually extends from above the pubic hair to the groin region. Its length is determined in preoperative planning and the patient shall be fully aware of it.
Before the operation
A preoperative check-up is made according to the surgeon’s recommendations. The anesthesiologist will be seen in consultation, at latest, 48 hours prior to surgery.
No medication containing aspirin will be taken for 10 days before surgery.
Hospital stay and type of anesthesia
Type of anesthesia: Abdominoplasty is usually performed under general anesthesia. The patient is asleep throughout the entire operation.
Hospital stay: The duration of hospital stay is usually 1 to 2 days.
Techniques are adapted to each individual case, in order to obtain the best possible results. However, there are common principles:
The position of the skin incisions, which will correspond to the future scars, depends on the amount of skin to be removed. The more skin there is to remove, the longer the remaining scars. The excessive fat is aspirated with liposuction and the stretched abdominal wall muscles are tightened. Depending on the extent of fat and skin tissue necessary to remove, the operation normally ranges from 2 to 3 hours.
After the operation
For the first few days, your abdomen will probably be swollen and you’re likely to feel some pain and discomfort which can be controlled by medication. It is recommended to wear a compressive garment for 4 to 6 weeks. You should also refrain from work for about 1-2 weeks.
Your will be given instructions for showering and changing your dressings. And though you may not be able to stand straight at first, you should start walking as soon as possible. Sutures will be removed in 7-10 days.
The scars are often red during the first 2 or 3 months and progressively become paler starting from the third month onwards, during a period of 1 to 3 years. The scars should be protected from sunlight and UV for at least 3 months. Sporting activities can be progressively started after 6 weeks.
Concerning scars, you should know that they do fade away with time but never completely disappear. You should also bear in mind that scarring is a patient-related process.
The result can be best appreciated six months one year after the procedure: During this period, it is recommended to be patient while scars slowly fade and collaborate with the surgeon for a regular follow-up consultation every 3 months during the first year.
Abdominoplasty offers an amazingly noticeable aesthetic improvement. It enhances the patient’s comfort, quality of life and self-confidence, thus helping him or her to reach for a better weight-control.
Most of the time, a properly indicated abdominoplasty can offer a real improvement to patients in terms of satisfying results and conformity to their expectations. In some cases, localized imperfections can be observed, which must be distinguished from genuine complications:
- The scar can be a bit too visible, adherent or asymmetric. It can sometimes become widened, hypertrophic or bumpy (keloid).
- The belly button may look unnatural.
- In some case, when there is excessive tension on the scar, the pubic hair can be raised upwards.
These problems can be corrected secondarily under local anesthesia after 6 months.
Abdominoplasty, even if performed for aesthetic reasons, is a genuine surgical procedure, with the consequent risks related to all medical acts. Concerning anesthesia, the anesthesiologist will inform you about all the anesthetic risks. You must be aware that anesthesia can sometimes cause unpredictable body reactions that can be difficult to control. The presence of an experienced anesthesiologist, in a surgical environment, means that the risks are practically statistically negligible.
In fact, techniques, products and monitoring methods have progressed considerably over the last decade, offering optimal safety, especially when the operation is elective and the patient is in good general health. However, some complications can occur after abdominoplasty, which constitutes one of the heaviest procedures in Plastic and Aesthetic Surgery. Among possible complications are the following:
- Blood clots (hematomas) are quite rare but can occur. They can be evacuated to prevent an impairment of the final aesthetic result.
- Infection, though uncommon, can be treated with drainage and antibiotics.
- It is common to notice 8 days after surgery a lymph collection accumulating under the skin. Such a collection can be drained and will dry up rapidly without sequela.
- Localized skin necrosis. Large areas of necrosis is rare. It can be prevented by a proper preoperative examination and a cautious and well-executed operation, with moderate tension on sutures.
- Numbness of abdominal skin may be observed, frequently in the lower parts of the abdominal wall. It is usually transient and most patients recover normal feeling after 3 to 12 months.
- In some patients with highly damaged skin or skin with poor circulation, the healing process may be delayed.
Alternatives to Abdominoplasty – A Mini Tummy Tuck
Some individuals have fullness confined to the area below their belly button, rather than the entire abdomen. In this situation, a mini tummy tuck can often provide very pleasing results. In a mini tummy tuck or mini abdominoplasty, skin and fat are removed from this area in the lower part of the abdomen. The muscles beneath the skin are usually tightened to provide a tighter overall contour from within.
When compared with a standard or full tummy tuck, a mini tummy tuck has a shorter incision and shorter recovery time. The belly button does not have to be moved during a mini tummy tuck, though its appearance is often improved because the skin below it is pulled and this can work to make the belly button look better. The procedure is specific in the effects in can provide, and these are generally at the lower abdomen and to some extent the waist. During your consultation, your plastic surgeon will evaluate your current situation and goals and advise you which type of tummy tuck – the full or the mini – will create the best results for you.
My Way …. “Metron Ariston”
Although Abdominoplasty is one of the most commonly performed aesthetic procedures of Plastic Surgery, it has been associated with a significant complication rate, including flap necrosis, seroma, hematoma, infections, fat necrosis, wound dehiscence, and delayed healing.
For this purpose, I use the High Superior Tension technique, which dramatically decreases or eliminates most complications of abdominoplasty and achieves better aesthetic results.
High Superior Tension technique is aimed at reducing tension at the prepubic suture line and improving aesthetic results in the umbilical area. By transferring tension to the periumbilical area, along with following the basic principles of a) respecting large lymphatic trunks, b) closing all dead spaces and c) limiting undermining, the specific technique enables me to avoid the major complications of abdominoplasty and achieve a truly superior aesthetic result.
This webpage aims to provide some information about the subject. Individual patient circumstances may differ, which might alter both the advice and course of therapy given to you by your doctor.
American Society of Plastic Surgeons, British Association of Plastic, Reconstructive and Aesthetic Surgeons, French Society of Plastic, Reconstructive and Aesthetic Surgery