Abdominoplasty

Abdominoplasty (“Tummy Tuck”)

Procedure: Flattening of the abdomen by removing excess fat and skin, and by tightening the abdominal wall muscles.
Duration of procedure: About 3 hours.
Anaesthesia: General.
In/Out patient: Can be either, depending on individual circumstances and the amount of surgery.
Postoperative: Temporary bruising, discomfort and soreness.
Recovery: Return to work after 4 weeks, and more strenuous activity after 6-8 weeks or longer. Fading and flattening of scars can take from 3 months to 2 years, depending on skin type and elasticity.
Results: Firmer muscle definition and improved abdominal contours. The procedure is often combined with liposuction of the hip region. The results are permanent, unless you gain weight.
Before/after illustrations: Owing to recent legislation, these photo’s have had to be removed until the situation has been clarified. For example images, please contact:ingrid@plasticsurgerysa.co.za.

General

Abdominoplasty is a surgical procedure for improving abdominal appearance. Pregnancy can cause abdominal skin and muscles to become flabby and loose. Excessive weight gain followed by weight loss often leads to loose excess skin and thinned stretched musculature – in both men and women. Abdominoplasty was developed to correct these conditions, by removing excess fatty and skin tissue and tightening the muscles. It is also done to eliminate or improve the appearance of existing scars and to correct hernias.

Abdominoplasty (commonly known as a tummy tuck) is not primarily a weight-loss technique. The procedure does involve removal of some fat, but is not a substitute for a sound diet and exercise. Prior to surgery, patients should be at their normal or near-normal mass.

There are two kinds of abdominoplasty: complete abdominoplasty and mini-abdominoplasty. The former is done on patients who need maximum correction. A horizontal incision is made on the lower abdomen, at the level of the pubic hair, that extends from left hip to right. Abdominal musculature is tightened by means of stitches, and any hernias or weaknesses repaired. The umbilicus (belly button) is usually separated from its surrounding tissue during the operation and repositioned on the abdominal wall via a new skin opening to retain normal aesthetic appearance.

A mini- or modified abdominoplasty is done on patients requiring less correction. This avoids a scar around the umbilicus, and the horizontal scar is shorter than a full abdominoplasty’s hip-to-hip.

Abdominoplasty can be performed at the same time as another intra-abdominal procedure such as tubal ligation, although I prefer to perform abdominoplasty as a separate procedure. It can also be done at the same time as other cosmetic procedures such as breast or facial surgery. Liposuction of the hips and other areas is often done concurrently with abdominoplasty.

During consultation, I’ll assess whether a complete or mini-abdominoplasty is the appropriate procedure. I take clinical photographs before surgery (these are an important aid in planning and performing the surgery) and after recovery as part of the clinical record. The photographs are only of the abdominal area and thus exclude one’s face.

The following questions about abdominoplasty are frequently asked:

Is the operation done under general anaesthetic and how long will it last?

For complete abdominoplasty, general anaesthetic is given. Mini-abdominoplasty can be done with local anaesthetic & sedation.. The procedure takes from one to three hours, depending on the area involved.

Will I have to stay in hospital?

After a complete abdominoplasty, it’s necessary to stay in Dr. Jedeikin’s Recovery Retreat for 4-5 days. For a mini-abdominoplasty, you’ll be discharged on the same day, once fully awake. If you live more than an hour’s drive away from the hospital, however, you must stay in the recovery retreat overnight.

A reliable adult should accompany you when you leave, spend the night with you, and accompany you when returning to my rooms the day after surgery. If someone suitable is not available, we can recommend a nurse.

What care is necessary post-op?

After a complete abdominoplasty, a patient remains in bed till the next morning. A urinary catheter is inserted during the operation and remains in place until you are discharged to the Recovery Retreat. Patients who’ve had a limited abdominoplasty do not need a urinary catheter. You’ll experience some pain, for which medication is given, and this gradually subsides as you begin to walk. The narrow bandage is removed two days after surgery, and you can then shower. Stitches are internal and self-dissolving.

When can I return to work and to normal physical activity?

Most people return to everyday activities and to work after four weeks post-op. However, strenuous sport may not be undertaken for two months.

Will there be scars?

After a complete and a mini-abdominoplasty, there’ll be a horizontal scar just above the pubic hairline. After complete abdominoplasty, there’ll be an additional circular scar surrounding the umbilicus. A different shape or location of scar may sometimes result from individual anatomical variations; this would be clarified preoperatively. On occasion, intraoperative findings dictate that the scar be somewhat longer or in a different position than planned beforehand. I make every effort to keep the scar as short and inconspicuous as possible.

Will I be able to have more children?

Yes, you’ll be able to have more children, but it’s inadvisable to have an abdominoplasty until your family is complete because subsequent pregnancy will stretch the entire abdomen considerably.

How will I feel after the operation?

As with any surgical procedure, small sensory nerves to the skin are cut during an abdominoplasty. Parts of the abdomen will feel numb or not have a full spectrum of feeling. Sensation returns over a number of months, but some diminished feeling may persist indefinitely.(especially around the scar)

Swelling of the abdomen is normal after surgery. For the first couple of weeks, clothes may fit more tightly and your weight may increase. Bodily swelling will subside from the third week after surgery but some degree of lower abdominal fullness persists. You should see about half of your total contour improvement at four to six weeks and about three-quarters after a three months. It usually takes another two months for the last of the swelling to recede. Some patients may experience continued improvement up to six months after surgery, but changes beyond six months tend to be slight. Bear in mind that it takes from six months to a year for the scars to fully mature. Massage with Surgeons Choice tissue oil helps enormously

Is there a chance of complications?

As with all surgery, one needs to be aware of possible side-effects and undesirable or serious complications, no matter how remote the possibility. All surgery holds potentially serious risks. It’s important to be aware of possible complications so that your decisions include an understanding of them. I discuss these risks pre-operatively; they include blood collection under the skin (haematoma); serious fluid effusion under the abdominal skin (this can be aspirated with a syringe if it collects postoperatively); infection; wound healing problems; and, rarely, DVT (deep vein thrombosis) –a blood clot in the lower limbs that can lodge in a lung. A full consent form detailing most of the common complications will be given to you at your preoperative consultation.