Excess abdominal skin, stretch marks, fat rolls, weak abdominal wall, and bulging of the tummy are common consequences of pregnancy and weight loss. Abdominoplasty or tummy tuck is a procedure in which we remove excess skin and fat and tighten the muscles to improve abdominal contour. We flatten the belly and create a slimmer silhouette. Abdominoplasty permanently removes stretch marks located below the belly button. Liposuction can be added to the procedure to remove excess fat deposits in the surrounding areas.
Good candidates for abdominoplasty are healthy individuals in good physical shape, and with stable body weight. Typical abdominoplasty patients are women with excess abdominal skin after pregnancy; women or men with weak abdominal muscles and protruding belly. Patients unable to tighten the abdominal wall skin with exercise to achieve a smooth and flat abdomen will also benefit. Patients after massive weight loss are candidates for a special type of vertical abdominoplasty or lower body lift if needed.
In the standard abdominoplasty, the excess skin and fat of the abdominal wall between the pubic area and the belly button is removed. The abdominal musles are tightened and skin sutured. The scar is positioned in the lower abdomen above the level of the pubic hair and around the belly button
With the mini-abdominoplasty we remove a small excess of skin below the belly button, leaving a short scar above the pubic hair line. The belly button is left in place. A laxity or hernia of the abdominal wall can be repaired at the same time.
In the extended abdominoplasty, excess skin and fat of the flanks and back are also removed so that the scar extends around the flanks onto the lower back.
In vertical abdominoplasty also called fleur-de-lis abdominoplasty (for its lily shape) a vertical incision is added to standard abdominoplasty to reduce the skin excess around the abdominal circumference. An additional vertical scar, extending upward from the lower horizontal incision to above the belly button is required.
Proper planning allows us to hide the scar transversing the lower abdomen beneath the underwear and two piece bathing suits.
Recovery usually depends on the extent of the procedure. You might need to stay in the clinic for one night. You can expect some moderate pain, which is alleviated with pain killing tablets. Light activities are comfortable in a week or two. Sports will not be possible for about five weeks, particularly when the muscles have been strengthened with sutures. A compression garment is usually helpful to reduce the swelling and improve comfort in the first month.
Blood collection (haematoma) or bacterial infection are rare complications. Healing can be slow especially 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. This tends to leave more noticeable scars, which can be revised later. There is numbness in the lower part of the abdominal wall after surgery that is usually temporary. The swelling settles within a few months. Deep vein thrombosis and pulmonary embolus are rare complications of any operation including this one.
The beneficial effects of the operation will remain, however, the effects will be maintained better if the patient keeps exercising the muscles and keeps the weight steady. A further pregnancy will stretch the skin again, although probably not to the same degree.