Abdominoplasty (Tummy Tuck)

What is Abdominoplasty?

Abdominoplasty is an operation in which the excess skin and fat below the umbilicus is removed to give the abdomen a better shape and make it look nicer.

Who will benefit from an abdominoplasty?

When people gain and lose weight as following pregnancy and significant weight loss, the lower abdomen is stretched and refuses to go back. No amount of diet and exercise can overcome the laxity of the skin especially if it has stretch marks. In this situation, the excess skin and fat have to be removed by surgery. So those who would benefit from abdominoplasty are

• a. If you have got excess abdominal tissue which doesn’t go with exercise
• b. If you can hold a pannus of tissue with both your hands below the belly button and feel it unwanted
• c. If you are embarrassed with the abundant stretch marks below the umbilicus which you find it unappealing.
• d. If you are embarrassed as the abdomen overhangs the top of the trouser, skirt or saree and causes a bulge under fitted dresses.

Where will the scar be after an abdominoplasty?

The scar will be a transverse scar over the lower abdomen extending from one hip to the other hip. This will be hidden while you wear a pant, skirt or a saree and we will try to hide it under the bikini line.

What is done during the operation abdominoplasty?

The operation abdominoplasty is done under general anaesthesia. It lasts for 2 to 3 hours depending on each patient. During this operation the skin and fat over the abdomen are lifted from the underlying abdominal musculature, redraped and the excess skin and fat are removed. If there is an underlying weakness of the abdominal wall causing divarication of recti, we will repair it and strengthen the abdominal wall musculature. To ensure that there is no excess collection of serous fluid or blood collecting under the flap we will place three surgical drains to drain them. The umbilicus or the belly button is sited at the right place, and the wound is closed.

Will Liposuction be done along with abdominoplasty?

Some patients are bothered about excess fat around the hips or at the waistline popularly called as the saddlebags and lovehandles respectively. During the operation fat from these areas can be sucked out to give them a good shape to the body. This is done when the skin tone is good. However when the skin tone is not good it will be better to excise it. This will be done by having a longer transverse scar which goes around the side of the body to the back. The scar will still be hidden by the panty line

Liposuction over the Lovehandle area

Liposuction of Fat over the Saddlebag area

Will I be able to lose a lot of weight with this procedure?

This operation is primarily a body contouring operation and not a weight reducing operation. After the operation, you can expect a decrease of about 1-2 kg weight. Some patients may not reduce weight at all. So if reducing weight is your primary goal, this operation is not for you.

What is the normal post-operative course?

Soon after the operation, the patient may feel slightly tight over the abdomen as the abdominal musculature has been repaired and the excess skin has been removed. This will go away in 2 to 3 weeks. We will give adequate painkillers to control the pain. We will monitor the amount of fluid in the drains daily and will remove them as soon as the amount of fluid in the drain is very less. Depending on how comfortable the patient is we will try to mobilise the patient from the first or second day after surgery. We will discharge the patient as soon as the patient feels comfortable walking to and from the toilet and after the drains have been pulled out. This amounts to approximately 4 to 5 days of hospital stay. Patients who stay near and are happy to monitor the drains may be discharged earlier around the third or fourth day from surgery.

What are the complications associated with this procedure?

• a. Delayed wound healing and skin necrosis :
  A small subgroup of patients may have delayed wound healing and may have minimal skin necrosis ( skin becomes black due to reduced blood supply). If the amount of necrosis is very less, it can be managed with regular dressings. If the amount of skin necrosis is more, then we may take the patient back to the operation theatre, trim it and resuture the area.


• b. Seroma:-
  Seroma is excess serous fluid in the cavity below the abdominal flap. This usually occurs later than 3 weeks and is usually aspirated out. When it comes repeatedly, we may take the patient to the operation theatre and remove the excess fluid.


• c. Mild asymmetry or some excess fat over the sides :
  In spite of all our efforts there maybe some mild asymmetry or excess fat over the sides of the abdomen which can be revised by a minor procedure.


• d. Decreased sensation over the lower abdomen :
  The sensations can be reduced or feel different over the lower abdomen for a while as the abdominal flaps have been raised. This is expected, and the sensations will return in a few months.


• d. Hypertrophic scarring :
  Each person heals differently and some patients may develop raised large scars called hypertrophic scars. They will get better with techniques like scar massage, silicone sheets and compression.


• d. Deep Vein Thrombosis (DVT) and Pulmonary Embolism :
  DVT is formation of blood clots in the veins of the legs. This can happen as the surgery is a prolonged surgery. This clot may go on to the lungs causing difficulty in breathing. Fortunately this complication is not common and rare as we will take a lot of efforts to prevent this. We will be giving blood clot thinners before surgery and after surgery. We will also have sequential compression devices which will keep pressing the legs so that the legs are not static and this will help prevent DVT.

Facts about the surgery at a glance :

( Each patient can be different. Please consult your doctor regrading the same )

Surgery time	: 2 - 3 hours
Hospital stay	: 4 - 5 nights
Walk to the Toilet	: Next day
Take a shower	: 2 days
Reasonably mobile	: 2 weeks
Driving	: 3 weeks
Sport & exercise including gym	: 8 weeks
Full recovery	: 8 weeks
Time off work	: 2 - 3 weeks
Bras and garments	: Yes Abdominal binder
Long-term issues	: May require scar management