Abdominoplasty Scotland | Tummy tuck questions and answers

Abdominoplasty Scotland | Tummy tuck questions and answers

This article hopes to provide answers to frequently asked abdominoplasty/ tummy tuck questions.

What is an abdominoplasty?

An abdominoplasty or tummy tuck is a surgical procedure that removes excess fat and skin from the abdomen and can also tighten your abdominal muscles. The result is a tighter looking abdominal area. Some patients require repositioning of their belly button (umbilicus) through a new opening in the skin. The procedure can also remove or reduce the appearance of stretch marks and unwanted scars on your abdomen.

How do I know if I need an abdominoplasty?

You may be a candidate for an abdominoplasty if you are close to your ideal weight but you still have excessive abdominal skin or bulging which you can’t get rid of. This commonly results from having had multiple pregnancies or as a result of significant, often rapid weight loss. A decision to undergo an abdominoplasty procedure will ultimately have to made after careful consultation with your plastic surgeon.

Will a tummy tuck remove stretch marks?

Yes and no. If the stretch marks are in the lower abdomen (below the belly button), then a tummy tuck will get rid of them. However any stretch marks above the belly button will be pulled down onto the lower abdomen and may be stretched further. They can, however, end up looking smoother and flatter.

What are the different types of tummy tuck procedures?

Broadly speaking there are three types of tummy tuck procedure:

  1. Standard
  2. Mini
  3. Extended

They all involve removing variable amounts of skin and fat (resulting in variable length scars) and all of them may or may not involve tightening of the abdominal muscles.

What is a standard abdominoplasty?

A standard or full abdominoplasty involves removing the excess skin and fat of the abdominal wall between the pubic area (bikini line in women) and the umbilicus. The umbilicus is left in its place but a cut is made around it to free the surrounding skin. The remaining skin of the abdominal wall at the level of the umbilicus is then pulled down to suture it at the pubic level. The umbilicus is brought out through a new incision made in the skin that has been pulled down over it. The patient is left with a long, usually curved scar across the lower part of the abdominal wall at the level of the pubic hair. There is also a scar around the umbilicus. Any weakness of the abdominal muscles or hernias are repaired before the skin is closed.

What is a mini abdomioplasty?

A mini abdominoplasty is performed when there is minimal excess of skin and fat affecting the lower part of the abdomen. The excess skin and fat from below the umbilicus is removed, leaving a long curved scar on your abdomen just above the pubic area. The umbilicus remains undisturbed. Again, any laxity or hernia of the abdominal wall is repaired at the same time. The scar from a mini abdominoplasty is usually shorter than that of a standard abdominoplasty.

An apronectomy is a modification of the mini abdominoplasty for patients who have a large overhang of skin and fat over the pubic area. In this procedure only the surplus skin and fat is removed. The scar is long and extends from one side of the apron to the other.

What is an extended abdominoplasty?

Extended abdominoplasty is usually required after massive weight loss. It involves removal of excess skin and fat from the abdomen and lower back. It will leave a scar around the umbilicus and a long curved scar on the abdomen above the pubic area, and around the lower back. Sometimes the scar extends the whole way around the body – circumferential abdominoplasty and this is a very major and involved procedure.

Is liposuction combined with abdominoplasty?

Liposuction is commonly combined with any of the different abdominoplasty procedures. Some surgeons prefer to perform liposuction at a later date.

Can I have liposuction alone instead of an abdominoplasty?

Sometimes liposuction alone can achieve a good result on the abdomen. A very important factor is the quality of the patient’s skin. Dramatic improvements can be achieved when the skin is of good quality and has not been overly stretched in the past. Skin quality often determines whether liposuction alone will suffice or whether a combined surgical procedure will be needed.

What are the side effects of a tummy tuck?

As with all surgical procedures, there are risks associated with abdominoplasty surgery. Some patients are at higher risk of complications than others (for example smokers and patients who are over weight). You surgeon will be able to point out particular risks that you may be more susceptible to depending on your personal history and circumstances.

All patients will experience:

A variable degree of pain and bruising for at least a few days. Pain is usually worse if there has been a requirement to tighten your abdominal muscles (rectus plication)

A variable degree of swelling – this can take several months to completely subside.

Permanent scarring – the quality of scarring cannot be guaranteed and usually depends on the way your body heals. Some patients can form thick, red, itchy scars but most scars usually fade over time (but won’t completely disappear).

A variable degree of numbness of the skin over your abdomen – the skin below your new belly button may be numb for several months (if you have had a standard or extended abdominoplasty), but this numbness will gradually disappear as the nerves regrow.

What are the possible complications of a tummy tuck?

Complications can occur during or after the operation.

Possible general complications include an unexpected reaction to the anaesthetic, excessive bleeding or developing a blood clot, usually in a vein in the leg (deep vein thrombosis, DVT). A DVT can be a serious condition and if the clot spreads to the lungs (pulmonary embolus) then the outcome can be fatal. Fortunately the incidence of pulmonary embolism after abdominoplasty is very rare (2 out of every 10,000 patients).

Complications specific to tummy tuck include:

Infection – this may need antibiotic treatment.

Bleeding (haematoma) – this may a return to theatre to stop the bleeding and drain the area.

Delayed wound healing – particularly in the tighter central part of the wound and sometimes dressings are needed for a few weeks. This is more common in patients who are overweight and who smoke.

Seroma –  is a persistent collection of serous fluid under your skin after the drains have been removed. The fluid can be drained with a needle during your post-operative visits. Such drainage generally stops eventually (but may last for more than a month) and usually does not affect the final results. The incidence of seroma has been reported as affecting between 2-8 out of every 100 patients.

Poor scarring – scars can sometimes be red, thickened and itchy (hypertrophic scars). These can take several months to settle and fade.

Permanent numbness – this is usually temporary, but can be permanent.

Asymmetry – perfect symmetry does not exist before or after abdominoplasty surgery. Scars will never be identical from side to side and the umbilicus will not be exactly in the midline.

Revisional surgery – secondary procedures are occasionally required to revise scars or to excise more skin (particularly on the sides).

How long does it take to recover from an abdominoplasty?

It usually takes about six weeks to make a full recovery from a tummy tuck, but this varies between individuals and the technique used. Over the counter pain killers such as paracetamol and ibuprofen are usually sufficient in the few days after your surgery. Patients can usually return to work about three to four weeks after their operation.

You will usually be able to do light activities at around 10 days after your surgery. Any vigorous activity should be avoided for at least six weeks. Your surgeon will give you specific instructions depending on the type of operation you have had.

What if I get pregnant after a tummy tuck?

Getting pregnant after a tummy tuck will not harm you or your baby, however it will undo (to some extent) the effects of your tummy tuck. If you are planning on getting pregnant it is best to wait until you have completed your family before undergoing a tummy tuck.