There are many reasons why the skin of the abdomen becomes stretched and then hangs more loosely than may be aesthetically pleased. Childbirth is a common cause, and any significant loss of weight means that the skin becomes lax and overhangs the pubic area. Once skin loses elasticity, even extreme dieting and exercise will be unlikely to help – especially where there are stretch marks. The proven solution is surgery with the procedure known as a “tummy tuck”.
Why do patients seek a “tummy tuck” (abdominoplasty) ?
Patients are embarrassed by their appearance when the skin is stretched and loose, overhanging the tops of trousers and skirts, bulging under fitted dresses and visible above and below bikini bottoms. Patients may also be disconcerted by stretch marks and a stretched bellybutton, which they find unappealing. They may tend to avoid swimwear, and will make excuses to avoid taking their children swimming or on the beach on holiday. These problems can be corrected by an abdominoplasty.
What does an abdominoplasty involve?
As with most elective surgical procedures, patients should not be on blood thinning medication such as aspirin or warfarin, and ideally should not take nicotine in any form for six weeks before surgery. The procedure is carried out under general anaesthetic, and usually involves two nights in hospital. Plastic tube drains are inserted under the abdominal skin to remove any excess blood or fluid for the first 24 to 48 hours. These drains are then removed, the patient is able to shower and have the dressings changed before being discharged home. An appointment is made for removal of sutures a week following surgery, and for a review two weeks after surgery.
What is the normal postoperative course?
The area affected feels tight for the first few days after the operation and patients are not able to stand fully upright. On the first day following the operation, an elasticated abdominal binder is applied for support and mobilisation is assessed. By the second day most patients are sufficiently mobile and discharged home.
It is not advisable to resume “normal” life as if nothing has happened immediately after any surgery. You should try to have help around the house and with young children for the first couple of weeks after surgery; at the end of two weeks most patients will be able to drive, carry light shopping and deal with “light household duties”. A return to a normal lifestyle is expected at the end of four weeks, when patients should be able to resume more strenuous activities such as gym, sport and aerobics – unless they have had more extensive repairs carried out with the abdominoplasty procedure, such as tightening of the abdominal muscles or repair of an abdominal hernia.
How much time do I need off work?
Most people can return to work which does not involve heavy lifting, two to three weeks after surgery. Individual cases will vary, and it may take up to six weeks for some patients to return to normal work and leisure activities.
What are the complications of this procedure?
A very small percentage of patients will have complications just like any other surgical procedure; these include bleedings, haematoma (blood clot under skin), seroma (fluid collection under skin) and infection. Although simply treated, these can delay healing, and there may be slight asymmetry in the size and shape of the scar or the position of the bellybutton, and a change in sensation over the abdomen.