ABDOMINOPLASTY - TUMMY TUCK
Abdominoplasty also called tummy tuck is a major surgical procedure that tightens abdominal muscles and gets rid of excess skin and fat. This intervention has partly medical partly aesthetic reasons and will be performed often after losing weight or after a pregnancy. Because of the longlasting and forceful stretching of the abdominal wall the abdominal muscles slacken, especially the separation of the vertical abdominal muscles (the vertical abdominal muscles beside the navel or belly button) remain even if doing intensive physical exercise. With tummy tuck surgery abdominal excess skin can be removed, and abdominal muscles can be tightened, so the body shape can be enhanced. Abdominoplasty can be performed together at the same time with waist and thigh liposuction.
Instructions before the operation
- Your general practitioner has to issue a medical certificate to release you to the operation.
- A routine laboratory test must be made (blood cell count, ions, liver and kidney function, Prothrombin, blood sugar, blood group).
- Smoking and drinking alcohol is forbidden.
- Do not take aspirin and any medicine containing aspirin for 2 weeks before surgery.
- If you are regularly taking medicines, you have to discuss with your surgeon which must be taken or left off.
- Do not eat or drink or smoke 6 hours before surgery. Chewing-gums and drops are not permitted either.
- Before surgery you have to take off your rings, jewellery, piercing and take out your dentures, contact lenses and remove your make-up.
- The surgery of women can be performed outside the menstruation period.
Abdominoplasty is usually performed under general anesthesia. Time in surgery is about one and ahalf to three hours depending on the extent of surgery. It begins with a long incision across the abdomen, immediately above the pubic area, from hip bone to hip bone. A second incision is made to free the navel from the abdominal tissue. The skin is separated from the abdominal wall, up to the ribs, exposing the vertical abdominal muscles (rectus muscles). The rectus muscles are then stitched into a new position, tightening the muscles and reducing the waistline. After the muscles have been repositioned and tightened, the excess skin is stretched and removed. The remaining skin is redraped over the abdominal area and sutured in place. The hole created by the incision around the belly button is normally removed when the excess skin is cut away, and a new hole is formed to place the navel proportionally. Finally, the cut is stitched and a couple of draintubes will be left on the spot for several days. Hospital stay: 1 night
After the operation
This is a major surgical procedure and you can expect a considerable recovery time. Your abdomen will be swollen and sore for the first few days. The first two days your surgeon will prescribe pain medication, anti-thrombotic medication and antibiotics. If fever occurs, you have to take the antibiotics for further 6 days. Right after the day of the operation the patient will be encouraged to exercise comfortably in order to avoid thrombo-embolical complications. On the second day, the surgeon removes the draintube. Stitches will be removed 2 weeks after surgery. The patient must wear a girdle (a pair of special compression trousers) for 4 to 6 weeks night and day. Taking a shower is allowed only after the stitches have been removed. Light physical exercise is recommended in order to strengthen the abdomen muscles but only in 4 weeks, but please avoid sports like tennis, jogging, swimming for 6 weeks. The scars can be treated with a proper cream only after 3 weeks. The abdominal scars will appear to worsen during the first three to six months, and may take nine months before they flatten and lighten in color. They never completely disappear, but they are located to be easily hidden by clothing. Avoid sun exposure at least 2-3 months after the surgery.
Complications and risks
As abdominoplasty is a large-scale operation, you should discuss the risks in detail with the surgeon and the anaesthesiologist before the surgery. Besides the risks of general anaesthesia abdominoplasty may involve infections, haematoma, embolic conditions or bad looking scars may crop up. One of the most probable complications is bleeding that generally occurs in the first 24-48 hours. Another serious problem may be skin necrosis because the stretching of the skin may hinder the circulation. Most commonly it occurs under the navel on a small area, but in serious cases it can be more than palm-sized. Normally it recovers spontaneously, but the healing may take months. The area involved will differ in its colour and condition from the surrounding healthy skin. In the first weeks increased production of mucus and serum can cause problems. These must be drained off. Thrombus-embolism is the most dangerous life threatening complication. The reasons may be the large wound surface, obesity, smoking, lack of exercise and varicose veins. A blood clot in smaller veins may get into the main circulation and possibly cause severe occlusion in the lungs. In the first weeks the possibility of inflammation also endangers the health of the patient. This may lead to intense suppuration and development of abdominal abscesses. The quality of wound healing is significantly affected by the long line of incision. The wound may often widen and abnormal scar formation, keloid may sometimes occur.