Are you a candidate for Abdominoplasty?
Posted on October 13, 2009
MyBreast founding surgeon Norman Waterhouse talks you through whether abdominoplasty is right for you.
Abdominoplasty or a ‘tummy tuck’ is a popular and much requested procedure. Actually, there are several different variations to the operation, selected to meet individual needs.
This is ideally suited to address the changes of a woman’s body after pregnancy, otherwise called the ‘mummy tummy’. Multiple pregnancies cause stretching of the skin and separation of the long paired abdominal muscles (the rectus abdominis). Fat can also be deposited in the central area of the abdomen and in the flank areas. Even when all the baby weight is lost, and no matter how many sit ups are done, the abdomen may still have a bulge with loose excess skin and loss of the waistline. Add in a Cesarean scar and some stretch marks and the picture is complete. Some women may only exhibit one or some of these problems.
The appearance of the abdomen can be very distressing and wearing lingerie, tight fitting dresses and swimwear is problematic. There is often a sense of loss that a once cherished figure is gone for ever and reduced confidence and self esteem may result. Surgery may be the only available option to restore a flat belly and a waistline.
Anyone considering surgery should be in good health and not overweight. If the patient’s BMI (Body Mass Index) is over 30, the complication rate of the operation increases and should not be performed until a weight reduction program has been completed.
The risks of complications are also higher for women with diabetes (particularly if poorly controlled) and smoking is known to increase the risks of poor wound healing.
Careful assessment and examination is essential to determine whether surgery is suitable and which procedure will work best. On rare occasions, liposuction alone to the flanks and front of the abdomen is enough, but only if the problem is just stubborn fat deposits. This may be the case for younger women. In most cases though, some formal procedure will be needed to remove excess skin and to repair the underlying muscles.
Modern plastic surgery has refined the concepts of abdominoplasty with an emphasis on improving shape and form, rather than just removing excess skin. The pattern of the scar has also evolved so that the incision now follows a natural crease line just above the pubis and follows this crease out to just inside the hips. This design heals well and the scars are well hidden inside underwear and swimwear.
Some procedures, often called mini abdominoplasty, do not involve a scar around the umbilicus (tummy button). Most full abdominoplasty operations do need a scar to allow the umbilicus to be kept in a normal attractive position. When the muscles are repaired, it is similar to a hernia repair and needs a period of rest and recovery before returning to the gym!
An overnight stay in hospital is always required and sometimes an extra night is helpful.
Anyone with young children at home will need some help for a few days. Grandparents are very useful!
It will be ten days before driving is possible and at least four weeks before active exercise is resumed.
The abdomen can be swollen for some time and the full benefit of the operation may not be seen for a month or two.
Abdominoplasty has a number of complications which can be involved, but most of them are very minor. They can largely been prevented by thorough assessment by the surgeon, to establish risk factors such as a history of thrombosis, management of diabetes and cessation of smoking.
With careful planning and the right choice of procedure, abdominoplasty can be extremely rewarding and women often say how delighted they are to ‘have their body back’.
The other large groups of patients who are suitable for abdominoplasty are those who have lost large amounts of weight. They sometimes require a larger procedure, the body lift.