A tummy tuck is also known as an abdominoplasty. This is an operation normally aimed to remove the excess skin and tissue from the lower part of the abdomen. There are a variety of abdominoplasty procedures available, and operations are tailored to suit a patient’s wishes and needs. Generally speaking, tummy tucks are most commonly carried out to remove excess skin after substantial weight loss, to remove unwanted scars, stretch marks or excess fat. Abdominoplasty is not an operation for people who are overweight, or as a weight loss tool. However, in appropriate patients who have already lost some weight, an abdominoplasty can have a very marked effect and is, in our experience, associated with high patient satisfaction, enabling a healthier lifestyle.

Summary

  • General anaesthetic
  • Operating time about 2-3 hours
  • Hospital stay 3-4 days
  • Back to work in 3 weeks
  • Compression garment for 6 weeks
  • Full exercise after 6 weeks

Am I a good candidate for abdominoplasty?

The abdominoplasty is best performed when a patient is fit and healthy. The ideal patient is someone whose weight is close to normal, particularly those who have been overweight and have lost the excess weight. You may be a good candidate for abdominoplasty if you have one or more of the following conditions:

  • excess or sagging abdominal skin
  • an abdomen that protrudes and is out of proportion to the rest of your body
  • abdominal muscles that have been separated and weakened (rectus diastasis)
  • excess fatty tissue that is concentrated around your abdomen

During the consultation, you will be asked about the results you would like to achieve from abdominoplasty. This will help your surgeon understand your expectations and determine whether they can be realistically achieved. If you plan to become pregnant or lose weight in the future, you should discuss this with us. Scarring from previous abdominal surgery may limit the results of your abdominoplasty.

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Tummy Tuck – Before and After

Abdominoplasty – the operation

The type of tummy tuck best suited to you depends on the appearance of your abdomen:
A mini tummy tuck is suitable if you have minimum excess of skin below the belly button.
A full tummy tuck is most often used if you have more excess skin and tissue between the belly button and your pubic skin region, but also if excess tissue exists above your belly button (umbilicus).

Mini abdominoplasty

For patients with only a small amount of excess skin a lesser abdominoplasty might be appropriate. During the operation, a wedge of skin and fat is excised from the lower tummy leaving a horizontal scar above the pubic hair. Sometimes the muscles will also be tightened. No scar is left around the umbilicus, which may be stretched slightly into a different shape.

Full abdominoplasty

For patients who have significant skin laxity, excess fat and separation of the muscles, a classic tummy tuck is the most common procedure. During the operation, an incision is made from hip to hip and around the umbilicus. The excess skin and fat is excised from above the umbilicus to just above the pubic hair. The muscles above and below the umbilicus are tightened. The skin is then brought down and the skin that was above your belly button is sewn to that above your pubic skin area

This will give you a circular scar around the umbilicus and a long scar across the lower abdomen. Although this operation leaves a large scar, it does provide the greatest improvement in abdominal shape. If you do have a scar from a caesarean or hysterectomy, this can be removed at the same time.

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Abdominal muscles:

In both mini and full tummy tucks, the muscles of the abdomen will usually be repaired. These are called rectus-abdominus muscles (the 6-pack muscles), which are stretched and may stay apart after pregnancy or weight loss (the opening is then called a rectus diastasis). During surgery, these muscles can be stitched back together into their correct position. At the same time, hernias can be repaired. This will improve the shape of your tummy, prevent future hernias and improve your posture.

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After the procedure – Your recovery

  • You will be admitted on the day of surgery, and your length of stay depends on which procedure is done. Usually, you will stay in the hospital for about 3-4 days.
  • With a full abdominoplasty you will have tape dressings over your wounds, and tight tape dressings on your tummy. At least two drains (plastic tubes attached to suction bottles) will have been placed to drain excess wound fluid and blood. The drains will usually be removed before you go home, and you will be given instructions about your dressings and stitches. On the day following surgery, we will encourage you to mobilise gently. You will also be fitted with a surgical compression garment to gently support your tummy. You will be encouraged to wear this for 6 weeks following the operation.
  • Post-operative pain in these procedures is easily controlled.
  • You will be mobile from day one and should be back to full exercise within six weeks. Stitches will need to be removed after 2 weeks. Most people have approximately 3 weeks off work following a tummy tuck procedure, depending on the type of work you do. The recovery is slightly slower if you have had your muscles repaired as there will be more tenderness. Important to point out is the fact that some people recover quicker than others.

We will keep a close eye on you after your surgery and would normally see you for your follow-up appointments at regular dressing clinics every 2-3 days and then 6 weeks following surgery, at which point your post-operative photographs will be taken.

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Tummy Tuck – Before and After

Results after an abdominoplasty

Abdominoplasty will enhance your body contour by making your abdomen firmer and flatter. You may find that you feel more comfortable in your clothing and are more confident about your appearance.

All abdominoplasties result in some scarring although the nature of the scars will depend on the technique that has been used. We will aim to locate the horizontal scar within the area covered by usual underwear or swimwear. Scars tend to be quite red and raised in the first six weeks, changing over six months or so and then should start to fade. Most patients will form good quality scars over time, but occasionally and unpredictably some patients will get lumpy scars that do not improve unless treated. Especially in black skin, hypertrophic or keloid scarring can occur, in which case appropriate treatment will be initiated.

 Tummy Tuck - Before and After Gallery-04

Tummy Tuck – Before and After

How long will the results last?

When the excess skin and fat are removed from your tummy and your muscles repaired you are unlikely to develop excess skin or splitting of the muscles unless you have further pregnancies or you put on a significant amount of weight – your abdomen should remain firmer and flatter for many years. However, gravity and the effects of aging will eventually take their toll. If, after a period of years, you again become dissatisfied with the appearance of your abdomen, you may choose to undergo a second procedure to restore a more youthful body contour.

Generally we advise you that tummy tuck procedures should be performed after you have completed your family. It is possible to get pregnant and have children following your abdominoplasty but this will undo some of the corrective surgery that was involved in the procedure.

What complications can occur?

Whilst these operations are generally safe in the hands of a qualified and experienced plastic surgeon and regarded to be highly successful, there are, as with any operation, risks involved and the possibility of complications that patients need to consider.

A full abdominoplasty is a major operation and you must be prepared for the process and recovery period. Most patients are delighted with the physical and cosmetic improvements that abdominoplasty brings. However, it is impossible to guarantee that every patient will be completely satisfied with the result. There will be minor asymmetries with respect to the scars, and possible residual bulges (dog ears on the sides). Occasionally patients will bleed immediately after the operation and need to go back to the operating room for this to be dealt with. Wound healing problems may occur.

Most wound problems are minor and can be managed with simple dressings; however more major wound problems can arise such as infections, skin loss, wound separation and delayed healing. Wound problems, if they occur, can delay your recovery and result in worse scarring. In some patients fluid will collect in the abdomen in the region of the operation (seroma formation). If this occurs it needs to be removed using a needle, this is done in the outpatient clinic.

All patients can expect alteration in the feeling of the lower abdomen which is usually permanent. This operation carries a risk of blood clots in the legs and possibly the lungs. Various precautions are taken to limit this risk but if a blood clot occurs, treatment with blood thinning medication will be needed for several months. Blood clots in the lungs can be serious.

For further information about what is involved in this type of procedure, please contact Valentis Clinic on +254 725 045 705 or contact Dr Tilman Stasch at info@valentisclinic.com  if you have any questions regarding your forthcoming surgery.