Surgical Procedures - Body Sculpting

Tummy Tuck

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Susie Victoria
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Surgery that removes excess fat and skin from around the waist and tightens the underlying muscle to give a flatter, younger-looking abdomen.

Abdominoplasty is a major surgical procedure that removes excess fat and skin from the middle and lower abdomen and tightens the muscles of the abdominal wall underneath. A protruding abdomen can be reduced dramatically but the permanent scar left behind can be extensive. What can and should be done in your case will depend on a Consultation with your surgeon. However the following introductory paragraphs will, we hope, be helpful.

RIGHT FOR YOU?

If you are in relatively good shape but are bothered by a large fat deposit or loose abdominal skin that won't respond to diet or exercise, a tummy tuck could be right for you. The surgery is particularly helpful to women whose pregnancies have stretched their abdominal muscles and skin beyond the point where they can return to normal. In older patients a loss of skin elasticity often comes with slight obesity. This can also be improved. Patients who intend to lose a lot of weight should clearly do so before the surgery. Women who plan further pregnancies should also wait, as vertical abdominal muscles tightened during surgery can separate again during pregnancy. If you have bad scarring from previous abdominal surgery, your surgeon may also recommend against abdominoplasty since your scars could be unusually prominent.

Abdominoplasty can enhance your appearance and so increase your self-confidence, but it won't necessarily achieve your ideal. So, before you decide on surgery, discuss everything frankly with your surgeon to make sure you are being realistic.

SOME RISK

Every year thousands of abdominoplasties are performed successfully. When carried out by a qualified plastic surgeon trained in body contouring the operation normally works well. Nevertheless, there are always risks with surgery and there are specific complications associated with this procedure. Rare though they are, infections and blood clots can occur. Infection can, of course, be treated with antibiotics and,if necessary, drainage both of which may prolong your hospital stay. You can minimise the risk of blood clots simply by moving around as soon after surgery as possible. It is also possible that poor healing, which is likely to leave conspicuous scars, may make a second operation necessary. Smokers should stop, since smoking may increase the risk of complications and delays healing. Follow your surgeon's directions carefully, especially with regard to resuming physical activity.

Hurlingham Clinic Tummy Tuck

PLANNING

Initially your surgeon will evaluate your health and assess both your abdominal fat deposits and your skin tone. Tell him if you smoke, and if you're taking any medications, vitamins, or other drugs. Discuss your expectations frankly and he, in turn, will describe your alternatives and the risks and limitations of each. If, for example, the fat is all below the navel, a partial abdominoplasty or mini-tummy tuck may be enough. This can often be performed on an outpatient basis. You may, on the other hand, benefit more from partial or complete abdominoplasty done in conjunction with liposuction to remove fat deposits from the hips, for a better body shape. Sometimes liposuction alone will create the best result. Your surgeon will work with you to come as close as possible to achieving your desired body contour. He will also cover anaesthesia, the location for your surgery, the recovery schedule and the costs.

PREPARATION

You will be given specific instructions on preparing for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins, and medications. If you smoke stop at least two weeks before your surgery and do not to resume for at least two weeks afterwards. Avoid overexposure to the sun before surgery, especially to your abdomen, and do not diet excessively. Both can inhibit your ability to heal. If you develop a cold or infection of any kind, your surgery will probably be postponed. Whether your surgery is done on an outpatient or inpatient basis, arrange for someone to drive you home afterwards, and be available to help you out for a day or two if needed.

WHERE?

Our surgeons perform tummy tucks in an operating theatre in one of the London private hospitals where they serve as a Consultant. The surgery takes from one to three hours depending on the procedure chosen. Many patients are able to go home on the day of the surgery; some remain in the hospital for one or two days.

ANAESTHESIA

Relatively simple abdominoplasties may be performed under local anaesthetic with a sedative to make you drowsy. You will be awake but relaxed. You will feel no pain but some tugging and occasional discomfort. Many patients elect to have their abdominoplasties performed with an epidural anaesthetic - the same type often used during childbirth. With this approach you will remain pain-free below the waist and a sedative will be also be given to make you very sleepy. Alternatively, under a general anaesthestic, you sleep through the whole operation. Agree the most suitable technique with your surgeon.

Hurlingham Clinic Tummy Tuck

WHAT HAPPENS?

Complete abdominoplasty usually takes two to three hours. Mini tummy tucks need take only an hour or two. Most commonly, the surgeon will make a long incision from hipbone to hipbone, just above the pubic area. A second incision is then made to free the navel from surrounding tissue. With partial abdominoplasty, the incision is much shorter and the navel may not need to be moved, although it may be pulled into a lower position as the skin is tightened and stitched. Next, your surgeon separates the skin from the abdominal wall and lifts a large skin flap to reveal the vertical muscles in your abdomen. These muscles are then pulled together and stitched into a new position so that they are tighter. This provides a firmer abdominal wall and narrows the waistline. The skin flap is then pulled down and surplus skin is removed. A new hole is cut for your navel, which is then stitched in place. Finally, the incisions are stitched and dressings applied. A temporary drainage tube may be inserted to drain excess fluid. In partial abdominoplasty, the skin is separated only between the incision line and the navel. This skin flap is pulled down, the excess is removed and the flap is stitched back into place.

AFTER SURGERY

Your abdomen will naturally be swollen for the first few days, but medication will control the pain. Depending on the extent of your surgery, you may be released within a few hours or you may have to remain hospitalised for a couple of days. Your surgeon will give you instructions for showering and caring for your dressings and any temporary drains that may be in place. Though you may not be able to stand up straight immediately, you should start walking about as soon as possible. All stitches are usually the dissolving type so no sutures will need to be removed. A temporary support garment may replace the dressing on your incision.

Hurlingham Clinic Tummy Tuck

RECOVERY

It may be weeks or months before you feel like yourself again. Those who start out in top physical condition with strong abdominal muscles will recover much faster. Some return to work after only two weeks, while others take three or four weeks to recuperate. Exercise will help you heal more quickly. Even people who never normally exercise should begin an exercise programme to reduce swelling, tone muscles and lower the chance of blood clots. Vigorous exercise, however, should be avoided until you can do it comfortably. Your scars may actually appear to worsen during the first two to three months. This is normal. Expect it to take from nine months to a year before the scars flatten out and lighten in colour. They will never disappear completely but abdominal scars will not show under most clothing, even under bathing suits.

HAPPY?

Abdominoplasty produces excellent slimming and shaping results. You must, however, be realistic in your expectations, accept the permanent scar and take some time off to recover. The results are normally long lasting, provided you follow a balanced diet and exercise regularly.