Tummy Tuck or Abdominoplasty

My dearest patient,    

A tummy tuck is a procedure by which the tummy is rejuvenated to give a more attractive appearance. During this procedure excess fat and skin is removed and the inner lining of the tummy is tightened. The process of body contouring may also involve limited liposuction to give a more attractive appearance to the tummy.

During the aging process and pregnancy the tummy skin and inner support stretches. Stretch marks, fat, midline stretching and hanging skin are all addressed during a tummy tuck.

During the preoperative consultation I will discuss the surgical incisions, scars, necessary to perform the procedure. I would recommend that you bring your favourite swimsuit or underwear to the second consultation and the morning of the operation. This will assist us in placing the cuts in the most aesthetically pleasing position, hidden as much as possible.

There are largely two major types of tummy tucks. Both these procedures are modified to address particular concerns in each patient. Generally a complete abdominoplasty involves a cut from one hip bone to the other. The skin, tissue and muscle will then be contoured as needed. The surgery would involve moving your belly button and you will need drainage tubes. The skin at the cut will have a puckered or purse string appearance which will completely settle by one year.

The partial or mini-abdominoplasty is most often performed in patients that have a small amount of fat and skin below the navel. The procedure is a smaller procedure and often times it may not be necessary to reposition the belly button.

For the rest the long scar is hidden as much as possible in one of the natural lines of the body.

In order to perform the procedure correctly it will be necessary to recreate a new belly button to accommodate the removal of the excess skin and fat. Thus a completely new belly button will be created. It is important that we discuss preoperatively the size of the new belly button most suitable for you.

In the mini- tummy tuck it may not be necessary to reposition the belly button.

The tummy skin will be lifted and pulled down to create a flatter tummy. In addition the inner layer or fascia deep in the tummy will be tightened to give a flatter appearance to the tummy and to bring the six pack muscles closer in the midline.

We may also choose to perform some liposuction to improve the general appearance of the tummy. During liposuction you may experience extensive bruising and some leaking of fluid from the tiny incisions.

You will have 2 drains after the procedure that remain for about 10 to 14 days.

You may need an addition procedure to correct small deformities like asymmetries or dog ears which may arise. This would be excess skin at the ends of the long cuts, most often seen in patients not at their ideal body weight.

Tummy tucks are indicated in the following patients:

Patients with:

-Excess skin, fat and laxity of the lower abdomen

-Men and women who are in good health

-After pregnancy to tighten the abdominal muscles and remove excess skin

-Men and women who have lost a lot of weight and are suffering from loose skin or excess fat deposits.

A tummy tuck should not be performed on the following patients:

Patient who have had

-Multiple previous abdominal surgeries

-Wanting to have another pregnancy

-Not at your ideal body weight

-Excess intra-abdominal fat, thus fat inside the tummy and not on the outer layers. A tummy tuck can only address the outside layers and not the inside fat. Inside fat will adversely affect a tummy tuck as the pressure from inside adversely affects the outside surgery and results.

-Chronic illnesses such as sugar diabetes, heart or lung disease, connective tissue diseases, wound healing disorders or any other medication or conditions that suppress the immune system e.g. Steroids


-A personal or family history of bleeding and clotting abnormalities.

-Men and women that are planning to lose a lot of weight and not currently at their ideal weight. Should you gain or lose a lot of weight after a tummy tuck the fat will accumulate below and above the scar as the scar creates a fixed point. A large change in weight after a tummy tuck results in a very poor result.

-Patients suffering from depression, anxiety or any psychiatric conditions.

Below follows a brief description of what you can expect during your tummy tuck procedure

One month prior to surgery you should…..

-Avoid aspirin, blood thinning agents, green tea, herbal preparations and garlic.

-Please stop smoking. Smoking results in poor wound healing, infections and skin death.

Before the operation…..

You should not eat or drink for 12 hours prior to surgery.

Please arrive at the hospital at 6 am unless otherwise instructed. From the admissions desk you will be directed to the ward for admission and preparation.

The anaesthetist will visit you prior to the procedure to ensure that you are comfortable and safe during the procedure. The Anaesthetist may provide you with a tablet pre-operatively to calm you should you be nervous.I will meet you prior to the surgery for any necessary drawings, settle any nerves and answer any final questions.

The procedure will take approximately 2 – 4 hours. During the procedure a cut will be made from one hip bone to the next unless we’ve discussed differently.

The tummy skin will be lifted and pulled down, the belly button will be placed in a new position, the inner layer will be tightened and some liposuction will be performed. Two drains will be placed and the wounds closed. A protective dressing will be applied.

You will be woken in recovery where I will be waiting for you. From there you will be taken to the ward where you will spend the night unless we performed a mini-abdominoplasty. I would recommend that you stay 2 nights although additional nights may be beneficial in selected patients. You will find yourself to be positioned in a beach chair position after the surgery. This position facilitates the procedure in that it prevents you from pulling the cuts apart. It is very important that you maintain the bent-over position and gradually resume straight position after the surgery. It should take a few days before you can walk up straight completely if you had a major abdominoplasty.

You will be given pain tablets and sleeping tablets to start the recovery process. I will check on you in the evening to make sure you are comfortable. Most patients will go home one or two days after the surgery. You will go home with the drains. I will see you on a weekly basis to change the dressing and check the drainage. The drains will be removed when they drains less than 60 ml in 2 days. I recommend that you stay off work for 2 – 3 weeks after the surgery. During this time you are not allowed to drive or pick up any heavy objects. Exercise may only be resumed about 6 – 8 months after the surgery once you are completely pain free. Should you need any revision surgeries to correct the small areas of concern I will not charge you a surgical fee only hospital and anaesthetic fees.

Below follows a list of possible complications that may arise during the abdominoplasty procedure.

  • Wound dehiscence, opening up of the wound due poor blood supply of the newly approximated fat layers
  • Pain
  • Bleeding
  • Bruising
  • Scarring
  • Infection
  • Malposition or loss of the navel
  • Asymmetries of scars left and right half not completely the same
  • Seroma or fluid collections
  • Bruising from the liposuction
  • Skin flap necrosis, parts of the skin dies off
  • Opening of the wound
  • Puckering of the scar
  • Irregular or asymmetrical scars
  • Often times a need for second procedure, especially in the standard abdominoplasty.
  • Pain
  • A clot in the legs
  • Possible pulmonary or fat embolus, (clot to the lungs)
  • Possible ICU admissions
  • Possible need for further correctional surgery
  • Death, due to fluid distribution-pulmonary oedema or any of the above
      • Long permanent scar from one hip bone to the other hip bone
      • Asymmetrical scar
      • Asymmetrical fat distribution below and above the scar
      • Dog ears, excess skin and fat projecting as triangles on the side
      • Hypertrophic or keloid scar
      • Skin discolouration
      • Loss of sensation at, above and below the scar

In general it is important to understand that an abdominoplasty is a major procedure with risks and complications.

These complications can be as severe as death. It is important that you understand and accept these complications before you embark on the surgery. It is also important that you and your family are sure that you absolutely need the surgery.

Often patients experience a brief episode of depression, caused by the ugly surgical scars, pain and the anaesthetic. It is important that you understand that the final cosmetic result can only be appreciated fully a year after the procedure. The puckering will settle and straighten out and the scars will lighten with time.

Patients are happy with their decision and comfortable with their new appearance.



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