An Abdominoplasty is an operation to surgically address the concerns or symptoms associated with an overstretched stomach skin and stretch marks as well as address the appearance and contour of the abdomen. Abdominoplasty is more commonly known as a tummy tuck. The procedure removes excess skin and fat from the middle and lower abdomen in order to tighten and improve the abdomens muscle wall and function as well as appearance and comfort of the abdomen.
Best candidates for abdominoplasty
The best candidates for abdominoplasty are patients who are concerned by abdominal loose skin and fat deposits that have not improved after diet or exercise. This procedure is particularly helpful for women that have stretched and excess abdominal skin after childbirth. Health problems associated with stretched abdominal muscle wall and skin include back pain, rashes under skin folds of the lower tummy, exercise intolerance and urinary incontinence.
It is better to perform an abdominoplasty after you have lost excess weight and after you have had children with no plans to further expand your family.
Abdominoplasty aims to mobilise and remove excess skin and fat from the umbilicus (belly button) down to the pubic area through an incision of the lower abdomen. The skin of the upper abdomen is then stretched down to the suprapubic area (the level where a caesarian scar would normally sit) and stitched closed. The umbilicus or belly button is then brought out again through a new hole. Dr Drielsma places extra tension in the midline of the upper tummy to give a muscular look.
Dr Drielsma also makes the abdominal muscles tighter by stitching stretched muscles together to give a flatter tummy and waistline. This aims to address abdominal muscular (or core) tone and can help to improve urinary incontinance when this is a problem. Abdominoplasty may also be combined with liposuction to the hips, outer and inner thighs.
Abdominoplasty takes around 3 hours of surgery (or 4.5 hours with liposuction) under general aneasthetic.
Recover: 2-3 days in hospital
Return to work: Around 3 weeks
How is the procedure performed?
Dr Drielsma makes an incision across the lower abdomen, extending out to the hips. He then elevates skin and fat up to the rib cage. He removes excess skin and fat before stretching down the upper abdominal skin to the lower abdomen. Dr Drielsma makes a new opening for the navel.
Abdominoplasty surgery is performed under general anaesthetic and takes approximately three hours. A device called a pain buster helps minimise discomfort along the abdominal wound line during the hospital stay. Abdominoplasty usually requires two nights/days stay in the hospital.
After the surgery, you will wear a garment to provide support to the abdomen. We order and fit this prior to the operation. You will wear this for 6 weeks following surgery. We encourage early mobilisation with walking etc. Stitches are all absorbable.
When can I return to normal activities?
Are there any risks?
As with any surgical procedure, there is a risk of complication. Surgery and anaesthesia are safe and it is unlikely you will experience any difficulty. However, there are areas of potential problems you need to understand before proceeding with your surgery. You can reduce your risk of complications by closely following instructions before and after surgery.
Bleeding can be problematical in about 2% of cases. It’s possible in cases of bleeding that return to the operating theatre will be necessary and may require a blood transfusion.
If infection occurs it will usually become evident within one week of surgery and may delay the healing process or result in the development of scar tissue. This may require treatment with antibiotics. In the unlikely event of infection, this may adversely affect the ultimate result of the surgery.
The surgery is done under a general anaesthetic. Your anaesthetist will discuss the possible discomforts following anaesthesia. Your anaesthetist will answer any questions you have regarding your anaesthetic at the time of surgery.
All surgery carries risks and every incision leaves a scar. Scars do however fade well over a one to two year period and become much less noticeable. The scar of abdominoplasty is never invisible but Dr Drielsma places it in a position that is inconspicuous when wearing most clothing or swimming costumes.
The scars will often look red and lumpy at about three months after surgery as they heal but this is normal and will settle over the following 3-6 months. It takes 12-18 months before the scars mature completely, flatten out and lighten in colour.
Areas of your lower abdomen may be numb for up to six months as bruised nerves are recovering. Some minor residual permanent alteration in sensation may occur.
A seroma is a collection of fluid under the skin and fat. If this occurs it may take several weeks to absorb. Wearing the pressure garment will help reduce this risk.
Although rare, there is a risk of clotting in the veins of the legs. Pulmonary embolism (a clot going to the lung may rarely complicate such a thrombosis. The risk of this is about one in 500 and the contraceptive pill increases this risk. All possible precautions are taken to minimise the risks of thrombosis including the use of leg compression devices during surgery, use of TED stockings and blood thinning injections while in hospital.
Important points to remember before proceeding with surgery:
There can be no absolute guarantee with any surgery. In the hands of an experienced surgeon, a secondary operation to correct a minor irregularity may be needed. Should there be any questions regarding abdominoplasty, be sure they are answered in advance by Dr Drielsma. Well-meaning friends are not a good source of information. Find out everything before the operation – a well-informed patient is a happy one.
It is important that you make the decision to proceed with surgery for yourself, not anyone else.