Abdominoplasty

The goals of abdominoplasty are to improve the contour and external appearance of the abdominal wall while leaving insignificant scars and a natural looking umbilicus. The following elements are seen to variable degrees in all patients seeking abdominoplasty:

• Redundant, flaccid skin
• Excessive fatty tissue
• Muscular weakness
• Scar deformities including striae
• Fatty deformities of the abdominal wall may be concentrated around the umbilicus, below the umbilicus, or at the waistline.

The Goals of a Tummy Tuck

Generalised obesity is typical of male patients, while women usually present with a lower abdominal apron of skin and fat. Depending on the degree of skin laxity, excess fat and muscle wall laxity will dictate the type of abdominoplasty that is required. In category 1 where there is mild skin laxity, minimal excess of subcutaneous fat and mild lower abdominal wall muscle laxity then a mini abdominoplasty is appropriate. In category 2 where there is moderate skin laxity, moderate subcutaneous fat excess and moderate lower abdominal wall laxity then a standard abdominoplasty procedure is appropriate. In category 3 cases, where there is severe skin laxity, significant subcutaneous fat excess and significant lower and upper abdominal wall laxity then an extended abdominoplasty procedure is required in association with liposuction.

The basic steps of abdominoplasty

The basic steps of an abdominoplasty involve:

• Pre-operative markings whilst the patient is standing upright. The incision line lies on the upper border of the pubic hair line. The incision line is extended to stay within the pelvic region enabling the scar able to be covered by the patient's underpants.
• The lower abdominal skin/fat flap is elevated up to the rib cage.
• Lower abdominal skin/fat flap is elevated up to the rib cage.
• Sutures are placed in the fascia overlying the erectus muscles to tighten the abdominal wall.
• The redundant skin/fat having been pulled downwards is removed.
• The umbilicus is relocated into its normal position in the midline of the abdominal wall.
• Liposuction may be added to improve the final contour of the waistline and flanks.
• Drains are inserted to remove any fluid or blood that may accumulate beneath the skin flap.
• An abdominal girdle is worn. It is placed on the patient in the operating room.

Tummy Tuck Operation

The procedure is performed under general anaesthetic. The patient stays in hospital usually two to three nights. Patients can shower the following day after surgery. On discharge patients are usually sent home with one drain still in place. A district nurse reviews the patient on a daily basis and the drains are usually removed day 7 post-op at home. All stitches used in surgery are dissolvable saving the patient the need for stitch removal.

Most patients require a period of two up to three weeks leave from work. Patients are required to avoid lifting objects heavier than 10kg during the first three weeks. Patients can usually return to exercise and gym activities six weeks post-operatively.

Scar lines are designed to stay hidden within the underpants line of the patient. Scars are usually taped with a skin coloured Micropore tape for a period of three weeks to aid with scar maturation. Most scars take between six and 12 months to fade.