Abdominoplasty is a common cosmetic surgery that is not well known by this name. Commonly referred to as an “tummy tuck”, this is a major procedure that is done by a plastic surgeon in order to remove excess skin and fat and to tighten the abdominal muscles in order to flatten the stomach in order to improve the way that it looks. Because this is a major surgery, it is only recommended as a last resort after all other options have been exhausted. This procedure should not be used as an alternative to weight loss but can be combined with liposuction. The outcomes which one may expect from abdominoplasty include:
- Tightening of the abdominal muscles following multiple pregnancies
- Reduction of excess skin
- Good option for people who were once obese and have excess fat deposits or loose skin that needs to be removed
- Can be used to correct hernias
- Increases self-confidence and helps to boost self-esteem
Before deciding whether you would like to have a tummy tuck procedure, it is important to understand the composition of the abdomen and how it is affected by age and how the procedure is carried out.
What is the abdominal wall made of?
The abdominal wall is made of many layers and is needed to protect the organs that lie in the abdominal cavity. The abdominal wall is made of skin, subcutaneous fat and a host of different muscles. When gaining weight, the most common place for fat to be deposited is in the abdominal wall, known as central fat distribution. This fat is also very difficult to get rid of. It stretches the overlying skin, causing it to lose its elasticity and ability to recoil. When there is excessive loss of this adipose tissue, via exercise, dieting or other means, there is often over-stretched skin which remains. This is one of the targets of abdominoplasty surgery.
Additionally, other processes can contribute to the loss of compliance of the abdominal wall. Women who get pregnant experience the stretching of all the layers of the abdominal wall. This includes the vertical muscles in the front of the abdomen. It also causes the stretching of the skin. After pregnancy, women might find that their skin is flabby, and they are more prone to developing hernias. The stretching of the abdominal muscles makes it difficult to achieve a flat stomach despite rigorous exercise. This is the ideal situation in which to perform an abdominoplasty procedure.
Who is eligible to have abdominoplasty?
Typically, abdominoplasty is designed to help people just removed excess tissue in order to make the abdomen look flatter. There is no real age limit when an abdominoplasty can be done, but it is usually done on people above the age of 30. It is important to understand that this is not a weight loss procedure, and being overweight or obese and having surgery is very dangerous. Therefore, it is recommended that patients who get this procedure be normal or near normal weight for their age and height. As with any cosmetic surgery, it is important to make sure that the decision to get the surgery is done out of your own will and desire to change your appearance, rather than at the request of someone else. Having said this, there may be some patients who do NOT qualify to receive the surgery, for one or other reason. The following would make one a good candidate for abdominoplasty surgery:
- Being physically fit and healthy to undergo surgery
- Dissatisfaction with the shape or look of the abdomen
- Having exhausted other options for flattening the stomach
- Not planning on having any more pregnancies
- Not planning on losing excessive amounts of weight in the future
- If there are any hernias that may need to be repaired
- If there is excess skin or fat around the abdomen
Before having the surgery, it is imperative to have a conversation with your surgeon regarding all your medical conditions and relevant medical history because certain health conditions may affect the type of anesthetic or your eligibility to have the surgery.
Details of the abdominoplasty procedure
After speaking to your surgeon about the concerns you have regarding your abdomen and where you would like changes to be made, the surgeon will decide how best to achieve the result you are looking for. Once this has been decided, you will be given anesthetics for the procedure to ensure that you are comfortable and do not feel pain. Because of the area being operated on and the scale of this type of surgery, general anesthetic (where the person is completely asleep and unaware) is the anesthetic of choice. Depending on the outcome of the abdominoplasty, it can be either an inpatient or an outpatient procedure. If it is an outpatient procedure, you will not require an overnight stay at the hospital.
There are two types of abdominoplasties that can be done, and either on can have additional liposuction. The two options are a standard complete abdominoplasty or a mini abdominoplasty. The complete abdominoplasty is done on patients who require a lot of work done. For this procedure, a horizontal incision is made from one hipbone to the other at the level of the pubic hair. The excess skin and fat from the umbilicus to the incision is removed. The muscles of the abdominal wall are tightened with stitches and hernias are repaired. The belly button is circumscribed, which means that it will remain in the original position after the procedure. It can take anywhere from 2 to 5 hours long.
The mini-abdominoplasty or mini tummy tuck is a procedure for people who require less or minimal work done on their abdomen. The incision is much smaller and there is no scar around the umbilicus. This type of procedure may also be performed with an endoscope and typically takes approximately 2 hours.
Once this is all done, the incisions are closed with sutures, which will need to be removed at a time after the surgery. On some occasions, a drain may be placed under the skin for approximately two days in order to drain any excess blood and other fluids from building up under the skin. The incisions are covered with sterile bandages.
After the abdominoplasty surgery
As expected from most surgeries, you will experience pain and swelling following an abdominoplasty procedure. Your surgeon will prescribe medication for you to combat any pain that you may experience. The pain may last for several weeks or months even. You may express numbness around the region and overall tiredness.
For the first few days following your abdominoplasty, it is advisable to do the following:
- Use cold compresses to minimize the swelling
- Avoid wearing tight clothing
- Limit moving, exercise or other strenuous activity
- Avoid exposing the incisions to pressure
- Follow your surgeon’s instructions following the positions you should sleep and sit in
Your surgeon will give you instructions regarding the continuation of daily activities, such as bathing and other physical activities. You will return to your surgeon after a few days. Here they will assess the healing of the wound and the level of swelling and bruising.
Like all surgeries, there are risks that are involved. Most cosmetic procedures are low-risk when they are performed in a sterile environment. Some of the complication that can occur from an abdominoplasty procedure includes:
- Infection after surgery
- Bruising and swelling
- Hematoma or seroma
- Unsatisfied with the outcome
- Delayed wound healing
- Extensive scars
- Deep vein thrombosis which can lead to a pulmonary embolism
If you are interested in feeling more comfortable with your body and having improved self-esteem, contact your plastic surgeon in order to discuss whether you are eligible for abdominoplasty surgery and which option would best suit what you are looking for.