Men and women equally are concerned about the abdominal shape! Sometimes this fullness may be due only to excess fat. Quite often this is a combination of excess skin, fat and loose abdominal muscles and usually caused by multiple pregnancies, significant loss of weight or distortion of the abdominal shape due to previous abdominal operations. Abdominoplasty (tummy tuck) aims to remove the excess skin with or without the fat deposits to leave a neater, flatter tummy.
If the abdominal fullness is only due to excess fat deposit, but the skin is still youthful, liposuction alone will address the problem. The skin elasticity would allow its re-draping after removal of the excess fat. In the majority of cases, however, the elasticity is lost because of pregnancy or weight loss resulting in an excess amount of loose skin. Continued exercises do not help to tighten the skin in this situation. This would then require an open abdominal operation to tidy up the contour.
A MINI ABDOMINOPLASTY is useful if the looseness of the skin is only in the lower abdomen below the umbilicus. This does not remove or re-position the umbilicus. A full abdominoplasty usually would result in the belly button/umbilicus re-positioned to its appropriate level. The excess skin is us freed up from the underlying muscle almost up to the ribcage. This also provides an opportunity to tighten the abdominal muscles if there is a significant gap between them.
People who have lost a significant amount of weight either due to weight loss surgery or continued exercise and dieting would have a more extensive amount of loose skin in the abdomen. A simple abdominoplasty may not be sufficient. ‘Fleur-de-lys abdominoplasty’ (a modification of a full abdominoplasty) eliminates this excess skin from the upper abdomen and leaves a better, defined waistline. This, however, will add a long scar in the midline of the abdomen in addition to a low scar from a standard abdominoplasty.
Abdominoplasty operation is a major procedure. Depending on the type of operation and the amount of tissue being removed this may take between 2-4 hours of operating time. The hips and knees are usually kept slightly bent in order to reduce the tension on the final suture line. It is a routine practice to use suction tubes in the abdomen to reduce any fluid collection. The hospital stay may depend on the amount of fluid drained through the drainage tubes and may take between 2-4 days.
This operation is designed to remove the excess skin in the abdomen. The wound and the abdominal area would therefore feel tighter for the first few weeks. The patient would be advised to adapt a stooping posture to minimise tension in the wound. Returning to work or exercises may take between 3-6 weeks based on individual circumstances. There is a higher risk of blood clots in the legs and appropriate measures like supportive TED stockings should be worn for 3 weeks after the operation. There may be additional risks of: watery fluid collecting within the abdomen (seroma) which may require further aspirations, minor delay in the wound healing, wound infection, some numbness in the lower part of the abdomen and rarely small bumps on the sides of the scars - so called ‘dog ears’ - needing further scar revision.