Tummy

Operation to remove the excess skin and fat from the lower abdomen in order to achieve a firm and flat youthful appearance.

All loose skin and fatty tissue are removed through a large incision extending across the abdomen, usually from hip to hip. The muscles may also be tightened to give a firmer result. There is usually a scar around the navel if it is re-sited. The Surgeon will inform you of the exact nature of the scars at consultation.

This operation will be carried out under General Anaesthetic and will take approximately 3 hours. You are likely to have suction drains in place, which will be removed prior to your discharge from hospital. There may be sutures or clips in your wounds and these will be removed approximately 7-14 days later. You will wear a support corset for 6 week.

Why have a Tummy Tuck?

• Remove excess fat and skin of the lower abdomen that does not reduce following exercise and dietReduce the bulging of the lower abdomen following pregnancy
• Improve the shape of the lower abdomen and boost self-esteem.
• As we age, loss of skin elasticity and muscle strength combined with fatty deposits in the lower abdomen cause this area to bulge.
• Pregnancy, especially multiple and twins, clearly accelerate these changes as well as weaken the abdominal muscles
• A Tummy Tuck operation can remove the excess skin and fat and tighten the muscles to achieve a more youthful, flat and firm abdomen
• The operation can also produce a lifting of the groin and perineal region to provide some rejuvenation
• Remember surgery will not change you and solve any life crises, but should boost your self-confidence and enjoyment of life
• The type of operation required to achieve the best result for you will depend on the amount of excess skin and fat and will be discussed at the time of your Consultation.

What are the alternatives?

For some people, an alternative is liposuction (or liposculpture), where fat is sucked out through small holes in the skin. Many creams, diet supplements and beauty treatments claim to reduce stubborn areas of fat and even cellulite. However, there is no scientific proof that they work.

Before Surgery

Weight:

Smoking:

Essential to stop at least 3 weeks prior to surgery, and until Wounds are fully healed or at least 2 weeks after.

Other Scars:

Some may prevent full abdominoplasty and the technique will be modified accordingly.

Drugs:

Avoid aspirin and similar drugs for 2 weeks pre-operatively.

Contraception:

Stop taking the contraceptive pill six weeks before surgery and use an alternative method of contraception as this reduces the risk of blood clotting (thrombosis) after the operation.

• You may also be measured for an elastic garment to wear around your tummy for the first month after the operation, to reduce swelling
• Ask your G.P. if they would kindly perform a blood test for FBC & U&E and also record your blood pressure and post the results to the Surgery Abroad International please before your surgery
• Your surgeon and anaesthetist will consult you before the operation. This is a good time to ask any questions about the operation. Your surgeon may draw on your tummy to mark the operation site

After Surgery

Operation

• You may return from theatre with an I/V (intra-venous) drip, which is replacing any lost body fluids to prevent dehydration. This is to be expected after surgery.
• There will be a drainage tube in each side of your lower tummy to drain any blood or watery liquid that collects from the operation site. These drains are usually removed a few days after surgery.
• You are encouraged to mobilise gently for the first few days. We encourage you to be as comfortably active as possible. Movements of the limbs “on the spot” and walking are perfect initial activities.
• You may also be wearing anti-thrombosis compression stockings to help the circulation in your legs and help prevent blood clots forming (deep vein thrombosis or DVT).
• Most people stay in hospital for one to three days.
• Wound must be kept dry until the dressings are removed (usually at your first pre operative visit). After your stitches are removed we prefer for you to shower only for one week as we do not want your stitches to sit in bath water.
• We want you to drink liquids as much as you can (water is always best). This will replenish your fluids preventing dehydration and shock and flush out the surgically injected fluids.
• Moderate discomfort is to be expected during this time. Should you have pain not relieved by your prescribed medications, please call. Your doctor or nurse will give you painkilling tablets or injections to reduce any pain that you have after the operation.
• It is important to do deep breathing exercises to help to reduce the risk of developing a chest infection. Your doctor or nurse can show you how to do these.

Scar

• Bikini line just above the hair line.
• Umbilical.
• May occasionally need a vertical incision.
• Muscle tightening may be required especially following pregnancies.
• You will be left with a scar around the tummy button (which will often be moved to a higher position) and a long scar along the bikini line, which can usually be hidden within your underwear.

A diagram showing the Adominoplasty incisions and scar lines

Sutures

Drains

Dressings

Supportive bandaging, girdle supplied.

Posture

The abdominal skin will feel tight and you are usually unable to stand up straight for several days.

Skin support

Firm cycling shorts or girdle type pants should be worn for 6 weeks post-operatively in order to support the abdominal skin. Your support garment should be worn 24 hours per day for the first 2 weeks after surgery. After the first 2 weeks your garment must be worn during your waking hours. You may take it off at bedtime ONLY. You need to wear your garment for 6 weeks post operatively. This garment is to help your skin adhere to the muscle wall. Remember that you want the best result possible.

Exercise

Avoid vigorous exercise, including lifting of heavy shopping bags etc, for 6 weeks. Moderate exercise such as walking or swimming is recommended until this time. You are advised to limit your activities.
- Do not drive a car during the first week.
- Most people are able to return to work between two to four weeks after the operation, but vigorous exercise is not recommended for at least six weeks.

Care of scars

Apply Micropore tape (1 inch) along the scar for 3 months to prevent stretching and accelerate scar softening. Vit. E creams may be used after this period. If you experience any unusual swelling or bleeding at the incision site, call Surgery Abroad International representative immediately. After two weeks, women and men who are in physically undemanding occupations can normally return to work. You should gradually be returning to a normal routine with the exception of heavy lifting, stretching and athletic endeavours. At the end of 6 weeks, you can usually resume a normal life.

Potential Problems

A tummy tuck is a commonly performed and generally safe surgical procedure. For most people, the benefits in terms of improved appearance are greater than any disadvantages. However, in order to give informed consent, you need to be aware of the possible side effects and the risk of complications.

Side-effects are the unwanted but mostly temporary effects of a successful procedure. For example, feeling sick as a result of the general anaesthetic. Anyone having a tummy tuck can also expect that:

• there will be swelling, which may not completely settle for a few months
• the incisions will leave scars, which will be pink and noticeable at first, but should become finer and less noticeable after a few weeks
• Complications are unexpected problems that can occur during or after the procedure. Most people are not affected.

Specific complications of a tummy tuck are uncommon but can include those listed below:

• Final position of the tummy button may be off-centre.
• Bleeding can occur under the skin, causing the area to swell and become painful. This is called a haematoma. Sometimes it is necessary to return to theatre to stop the bleeding, remove the blood and help avoid infection.
• Other serious complications of tummy tuck operations are rare. They include the formation of fat or blood clots in the blood vessels. These can break off and move to the lungs. This is called a pulmonary embolism and can be life-threatening
• The chance of complications depends on the exact type of procedure that is being performed and other factors such as your general health. Your surgeon will be able to explain how the risks apply to you.

Pain

- Moderate discomfort can be expected. Avoid aspirin/ibuprofen type analgesics.

Bruising

post-operative swelling

may last for several months.

Wound

Numbness

This is expected in the lower abdominal skin. Invariably lasts for 3-6 months but may be permanent.

DVT

- Leg vein thrombosis is rare. Measures will be taken to keep risk