Tummy Tuck - Abdominoplasty

About

I have done over 850 abdominoplasty or ‘tummy tuck’ operations. The operation makes the abdomen flat by removing the excess skin and fat between the umbilicus and the pubic bone and tightening the abdominal muscles. The scar is as low as possible in the bikini line from one hip to the other. Liposuction is frequently done to reduce fullness at the sides. Recovery is three weeks but it takes three months until you see the final result. There is a ‘full’ and a ‘mini’ version of the procedure and the operation which is most appropriate is determined at the consultation. This surgery is most commonly to correct the looseness after pregnancy, the ‘overhang’ after a caesarean section, the skin remaining after significant weight loss and by those who simply never had a good body shape. Typical results are shown in the Gallery.

Consultation

You must be a healthy non-smoker with a BMI (body mass index) of less than 30. In the assessment I pull down on the skin of the lower abdomen to show how much excess can be removed and what scar line will be needed. Then I look at the contour of the abdominal muscles to assess if they need to be tightened. This information determines whether a ‘full’ operation is needed or if a ‘mini’ procedure will suffice. I also look at the curve of your back and your posture.

The ‘mini’ operation only corrects skin and fat excess below the belly button. It works well when the skin on the upper abdomen is tight, when the tummy muscles are flat and the problem is only lower down. A good example of this is the overhang or ‘ledge’ above a caesarean section scar on a slim person with otherwise tight skin. 

The ‘full’ operation deals with skin and fat excess above and below the belly button as well as loose muscles. This is the more common scenario. It is very effective and can produce a completely flat abdomen. 

Other factors can obscure a ‘perfect’ result. The potential ‘flatness’ of your tummy is also determined by the curve of your back (‘lordosis’), the fullness of your rib cage at the front and your ‘posture’. Posture is whether you normally hold your tummy flat. Any fullness to the side in the flank area (‘love handle’) above the hip is also examined. Liposuction can be added to the procedure to address this. 

Operation

Surgery is under general anaesthetic and takes 3 hours. A saline solution containing adrenalin is injected into the area of surgery to reduce bleeding. Liposuction at the sides is done first if needed.

The incision is low in the bikini line. The skin and fat of the tummy is separated from the muscles up to the rib cage. An oval incision around the belly button leaves it attached to the muscle layer until later. The rectus muscle is tightened with a permanent stitch from the breastbone to the pubic area and long acting local anaesthetic injected to control pain. The skin and fat layer is thinned, pulled tightly down and joined to the muscle layer underneath with many dissolving stitches holding it in position and closing any spaces to prevent fluid collections. The belly button is relocated in the correct position and stitched to create a natural shape. Then the excess skin and fat lower down is removed and the stitch line in the bikini line is closed. The vertical length of the skin and it’s weight is recorded. It’s not uncommon for the measurement to be 30cm (12 inches). A tiny drain in placed under the stitch line and local anaesthetic is injected as well. 

The “mini tuck” goes up to but not beyond the belly button, there’s no scar around it and the muscles are not tightened. Only a limited amount of skin and fat is removed.

Recovery

When you wake up you will be not be in much pain. Local anaesthetic is in place, knees and upper body are raised to reduce tension and a bladder catheter means you don’t need to get up.

Next morning you will be helped to get up and shower. Then you rest but remain mobile every few hours and wear anti-embolism stockings for 10 days to avoid the risk of a leg thrombosis. The hospital stay is 1-2 nights and 3 weeks is needed for the first part of the recovery. There is a check at 2 weeks, you can start gentle exercise at 6 weeks and there will be a follow up appointment at 8 weeks. The last of the swelling goes at 12 weeks. 

Gallery

Look at photographs of typical results for this procedure