A Tummy Tuck, or Abdominoplasty, is a surgical procedure that involves the removal of skin and fat, and tightening of the abdominal muscles. For this reason, it is more extensive than Liposuction. The actual extent of surgery will depend on the amount of excess skin and the laxity of the abdominal muscles.

At your initial consultation, your surgeon will evaluate your health, determine the extent of fat deposits in your abdominal region, and carefully assess your skin tone. Be frank in discussing your expectations with your surgeon. They should be equally frank with you, describing your alternatives and the risks and limitations of each. If, for example, your fat deposits are limited to the area below the navel, you may require a less complex procedure called a partial Abdominoplasty, also know as a mini-Tummy Tuck. You may, on the other hand, benefit more from partial or complete Abdominoplasty done in conjunction with liposuction to remove fat deposits from the hips, for a better body contour. Or maybe liposuction alone would create the best result. Your surgeon should work with you to recommend the procedure that is right for you and will come closest to producing the desired body contour. Prior to Tummy Tuck surgery, the amount of skin that is to be removed is carefully marked. The operation is carried out under general anaesthesia. An incision is made in the bikini line and the excess skin is pulled down and inward, and is removed along with underlying fatty tissue. The muscles are tightened as required, the skin is carefully redraped and the incision closed with several layers of sutures (stitches). Complete Abdominoplasty usually takes 2 -5 hours, depending on the extent of work required. Partial Abdominoplasty may take 1 – 2 hours. Most commonly, the surgeon will make a long incision from hipbone to hipbone, just above the pubic area. A second incision is made to free the navel from surrounding tissue. With partial Abdominoplasty, the incision is much shorter and the navel may not be moved, although it may be pulled into an unnatural shape as the skin is tightened and stitched. Next, the surgeon separates the skin from the abdominal wall all the way up to your ribs and lifts a large skin flap to reveal the vertical muscles in your abdomen. These muscles are tightened by pulling them close together and stitching them into their new position. This provides a firmer abdominal wall and narrows the waistline. The skin flap is then stretched down and the extra skin is removed. A new hole is cut for your navel, which is then stitched in place. Finally, the incisions will be stitched, dressings will be applied, and a temporary tube may be inserted to drain excess fluid from the surgical site. In partial Abdominoplasty, the skin is separated only between the incision line and the navel. This skin flap is stretched down, the excess is removed, and the flap is stitched back into place.

The best candidates for Abdominoplasty are men or women who are in relatively good shape but are bothered by a large fat deposit or loose abdominal skin that won’t respond to diet or exercise. The surgery is particularly helpful to women who, through multiple pregnancies, have stretched their abdominal muscles and skin beyond the point where they can return to normal. Loss of skin elasticity in older patients, which frequently occurs with slight obesity, can also be improved. Patients who intend to lose a lot of weight should postpone the surgery. Also, women who plan future pregnancies should wait, as vertical muscles in the abdomen that are tightened during surgery can separate again during pregnancy. Abdominoplasty can enhance your appearance and your self-confidence, but it won’t necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.

For the first few days, your abdomen will be swollen and you’re likely to feel some pain and discomfort which can be controlled by medication. Depending on the extent of the surgery, you may have to remain hospitalised for a few days. Your doctor will give you 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. Surface stitches will be removed in five to seven days, and deeper sutures, with ends that protrude through the skin, will come out in two to three weeks. The dressing on your incision may be replaced by a support garment.

If you start out in top physical condition with strong abdominal muscles, recovery from Tummy Tuck surgery will be much faster. Some people return to work after two weeks, while others take three or four weeks to rest and recuperate. Exercise will help you heal better. Even people who have never exercised before should begin an exercise program to reduce swelling, lower the chance of blood clots, and tone muscles. Vigorous exercise, however, should be avoided until you can do it comfortably. Your scars may actually appear to worsen during the first three to six months as they heal, but this is normal. Expect it to take nine months to a year before your scars flatten out and lighten in colour. While they’ll never disappear completely, abdominal scars will not show under most clothing, even under bathing suits.

Post-operative complications such as infection and blood clots are rare, but can occur. Infection can be treated with drainage and antibiotics, but will prolong your hospital stay. You can minimize the risk of blood clots by moving around as soon after the surgery as possible. Poor healing, which results in conspicuous scars, may necessitate a second operation. Smokers should be advised to stop, as smoking may increase the risk of complications and delay healing. You can reduce your risk of complications by closely following your surgeon’s instructions before and after the surgery, especially with regard to when and how you should resume physical activity.

Dr. Choy operates out of Sydney & Coffs Harbour. Please contact Cosmos Clinic for more details.