Tummy Tuck

Abdominoplasty or Tummy Tuck...

Abdominoplasty, probably better known as a tummy tuck and mini-abdominoplasty or mini-tuck are operations to remove excess skin and fat from the lower abdomen.

The majority of patients opting for this procedure will often be women who, following the birth of their child/children, dislike the effects childbirth has had on their body shape and appearance as it can leave stretched abdominal skin with a significant overhang, especially if it contains the scar from a caesarean operation. Unfortunately, no amount of moisturising cream or exercise will ever reduce stretch marks once they are established.

At the initial consultation, you will be asked a general medical history together with details of any previous abdominal surgery. I will then be able to show you where the incision runs. There may be a slight variation on these scars depending on the type of clothing the individual may wish to wear after surgery, but please bear in mind the scar cannot follow fashion.

Abdominoplasty after significant weight-loss can improve hugely the skin excess.This procedure can be combined with liposuction to the waistline to enhance the cosmetic effect. However, usually after the operation there is some relaxation of the abdominal tissues post-operatively which can lead to a fullness above the low abdominal scar. Whether this will occur is difficult to predict or quantify for individual patients. However, it is more often seen  when there has been significant weight loss, particularly after bariatric surgery or dieting producing weight loss of several stones. The abdominal scar may need a vertical as well as a transverse component, and if I feel this is likey in your case, I will discuss it thoroughly with you at the time of your initial consultation.

See the Before and After page:

Abdominoplasty - The Operation

Abdominoplasty is an operation carried out under general anaesthesia and requires one or two nights post-operative stay in hospital.

A n elliptical area of skin and underlying fat is removed from hip to hip above the pubic area and below the umbilicus (belly button). The umbilicus is left attached on a stalk.

A pocket is made underneath the skin of the upper abdomen as far as the ribs and this skin is then moved downwards to join the lower incision. Often (mainly post-pregnancy) it is also necessary to tighten the tummy muscles to improve abdominal contour. Having closed the skin edges, the umbilicus is then sewn back in its new position.

An mini-abdominoplasty is not quite as extensive as an full abdominoplasty and the umbilicus is commonly left in place. The position of the final position of the scar will depend to some extent on the elasticity of the abdominal skin once relocated.

Drainage tubes are placed under the skin to collect any excess fluid that may accumulate. Hidden stitches are used underneath the skin surface which are dissolvable and do not require removal. A special compression garment is provided routinely to help with healing and decrease post operative swelling.

Immediately after the operation, the abdominal skin feels tight and it may be not to stand up completely straight for the first few days, in order to take tension off the healing incision.

Abdominoplasty - After the operation

Two drainage tubes are usually removed at 48 hours. A light dressing may be required for one or two weeks and this should be kept dry. The pressure garment should be worn for 4-6 weeks.

You may feel mild discomfort after abdominoplasty and this is usually controlled by mild analgesia such as Paracetamol (do not take Aspirin).

Some temporary numbness of the lower abdomen skin is usual after this procedure but will gradually return to near normal although the process may take some months.

Any bruising is usually very mild and usually settles well within 2 weeks.

Occasionally some sterile fluid collects under the skin (seroma formation) but this always disperses naturally over the first 3-6 weeks.

As with all surgery there are risks involved but they are infrequent in occurrence. Blood clotting(Thrombosis/DVT) problems can in theory be a factor and as a precaution you will wear elasticated compression (TED) stockings before, during and after (1 week) the operation and gentle early mobilisation will be encouraged.

Wound infection is prevented with antibiotics at the time of the surgery and for one week after. Patients who Smoke or who are Diabetic have an increased risk of delayed wound healing and wound problems.

Scars are normal after any surgery and are part of the natural healing process. In the early stages, there can be build up of excess scar tissue which is firm, red, raised and itchy. Once the skin strength is restored the scars mature, becoming softer, flatter and more natural skin colour and texture. This process takes on average12-18 months to completion and during this period, daily massage with moisturising cream is advised. Some distortion of the skin, particularly around the hip area often occurs after abdominoplasty and it may occasionally be necessary to carry out a liposuction procedure in order to reduce this should it persist once the initial scarring has subsided.

Abdominoplasty - Summary

Abdominoplasty is an operation with high patient satisfaction and are good option for people with excess skin after weight loss or childbirth. Certain patients may be suitable for liposculpture without tummy tucks, or indeed may benefit from both procedures, but this would be determined at consultation.

We recommend at least two weeks away from work and, of course, this may be increased should you have a very physical occupation.

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I chose Mr Armstrong to carry out my facelift surgery after a lot of extensive and careful research. I was impressed with his academic credentials and his professional experience, noting that he had worked in some of the most prestigious medical institutions.

At my first consultation with Mr Armstrong I felt totally reassured that I would be in a safe pair of hands by the clarity with which he described all aspects of the facelift procedure I was requesting.  He explained everything to me in a clear and precise manner and in an unrushed and very thorough way. Together we agreed the best procedure for me, a 63 year old woman, would be a facelift plus an upper eyelid reduction and fat transfers to my cheeks, nasolabial lines and marionette lines.

I am now three weeks post-operation and the results have far exceeded my expectations.  I am absolutely thrilled with the results. I still look like me but a younger fresher version.  My droopy eyelids and hanging jowls have gone and my face and eyes look energised and revitalised.  My friends have been amazed at the transformation with one describing me as looking "sensational"!

Mr Armstrong's care before, during and after the procedure has been exemplary, and, along with his nursing staff,  I was thoroughly well looked after in a most kind, caring and professional manner.

I highly recommend Mr Armstrong to anybody considering surgery.  He is a highly skilled surgeon with a  safe and competent pair of hands.  My only regret is that I didn't do it five years earlier.

TD


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