Tummy Tuck
A Tummy Tuck is formally known as an Abdominoplasty is. It is an operation to remove the excess fat & skin from the lower part of the abdomen & tighten the abdominal muscles.
Indications (reasons for having an abdominoplasty): The reasons why some people may choose to have a tummy tuck include:
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Excess skin & fat & weakness of the abdominal wall muscles following pregnancy.
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Skin excess following weight loss.
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Some kinds of abnormal scarring.
Pre-Op Care: It is important to get to the person’s desired weight before having the operation. Someone on the oral contraceptive pill may be advised to stop six weeks before the operation to reduce their chances of developing a clot in the legs & take other precautions against unwanted pregnancy.
Smoking is not good for wound healing as smokers tend to have more problems including chest infections & wound healing problems so it is advisable to stop or at least cut down some weeks before the operation. Aspirin should be stopped for 7 – 14 days before the operation to reduce the likelihood of bleeding as they reduce the natural blood clotting ability of the person. If you are taking any herbal remedies it is good to inform the Surgeon as some of them also reduce the natural blood clotting abilities of the body.
Anaesthetic: The operation is usually carried out under general anaesthetic.
Technique: The excess fat & skin is lifted off the abdominal muscles. Then the muscles are tightened with strong sutures (stitches) & excess skin & fat are then cut off. The wound is sutured, leaving a scar along the bikini line. The scar is on the bikini line above the pubic hair extending to both hips. Occasionally there is an added vertical midline scar to help improve the definition of the waist. (If this is planned, this will be discussed with the patient during the consultation.) Tummy tuck does not deal with stretch marks. Only the marks within the excised excess tissues are gotten rid of. This may be combined with liposuction especially on the hips & flanks to reduce bulges. The liposuction may also be done as a separate procedure some months after the tummy tuck. Two drains are usually used, one on each side.
Duration of admission: The hospital stay is usually for about 2 - 4 days.
Post-Op Care: Following the operation the person is usually propped up with hips & knees bent in bed to reduce strain on the wound & make him/her more comfortable. This posture is gradually straightened as the days pass.
The patient usually gets out of bed the following day or the next two days by the physiotherapist. The physiotherapist will be able to take you through this during admission. The physiotherapist will also administer chest exercise sessions to make sure that breathing is improved to reduce the chances of a chest infection.
Injections that reduce the chances of developing a blood clot in the legs as well as compressive stockings are used. Usually an intravenous drip is administered for the first day or two. The drains are usually removed after 2 - 3 days as the drainage reduces.
Painkillers to achieve adequate pain relief are administered & the patient is also given prophylactic antibiotics.
The lower part of the new tummy may feel numb because the skin & tissues have been lifted off the muscle. The feeling will gradually return as weeks & months pass.
Time off work: 4 – 6 weeks.
Complications:
General: Risks exist as with any operation including bruising, swelling, clots in the legs (which can be dangerous), bad scarring.
Specific: Due to the large raw area underneath the skin & fat of the tummy there may be oozing following the operation & haematoma (collection of blood) that will require drainage. This may require another visit to the theatre.
When any oozing stops there may be some collection of yellowish fluid substance called serum which may need to be drained in clinic using a needle. This is only a nuisance for some people.
The wound may become infected. The chances of this happening is reduced by administration of antibiotics. Rarely there may be a severe infection causing sloughing of the skin of that of the tissues. This will require a trip back to theatre for debridement & drainage of any abscess. It is more likely to occur in people who are immuno-compromised.
There may be small areas of superficial wound breakdown which will require dressings until they fully heal.
Occasionally there may also be some sloughing of skin of part or all of the ‘new’ umbilicus.
In the long term the scars may become raised, stretched or lumpy.
There may also be puckering at the ends of the scars, called dog ears, which may require revision at a later stage.These things will also be discussed during the consultation with your surgeon.