This information is intended to help you understand the operation and the aftercare that will be necessary to achieve the best result possible.

What is an Abdominoplasty?

An abdominoplasty or tummy tuck is a procedure where excess skin and fat is removed. Abdominal curves and scars can be improved, and the muscles tightened. There are different types of abdominoplasty procedures with different resulting scars.

The standard abdominoplasty: The excess skin and fat is removed keeping the umbilicus (belly button) in place. The skin of the abdomen at the level of the umbilicus is then drawn down to suture it at the pubic level. You will be left with a long, usually curved scar across the lower part of the abdominal wall at the level of the pubic hair. There will also be a scar around the umbilicus. Any looseness of the muscles of the abdominal wall or hernia is repaired at the same time.

The Fleur-de-Lys abdominoplasty:  The procedure is similar to the standard abdominoplasty, but with this technique skin is also removed from the central aspect of the abdominal wall. This results in an additional long scar down the middle.

The mini abdominoplasty:  In the mini-abdominoplasty surplus skin below the umbilicus is removed leaving a low abdominal scar at the level of the pubic hair. The umbilicus is not disturbed liposuction may carried out at the same time to reduce the thickness of fat. Any looseness or hernia of the abdominal wall is repaired at the same time.

Apronectomy:  This is a modification of the mini-abdominoplasty for patients who have a large excess of skin and fat hanging down over the pubic area. In this procedure only the surplus skin and fat is removed. The scar is long, extending from one side of the tummy to the other.

The operation is carried out under a general anaesthetic. An information leaflet is available which will provide you with the details you require regarding your anaesthetic (The Trust Information Leaflet ‘You and Your Anaesthetic’).
For all of theses procedures tubes are placed beneath the abdominal skin to drain any collection of fluid. These are removed when fluid drainage stops.
 

After the operation you will return to the ward. For most patients the length of stay is for three to five days after the operation. The drains are removed and you are allowed home. An appointment will be given to you to have the stitches trimmed or removed at approximately 10 days in a plastic surgery dressing clinic with another for review in an outpatient clinic to see a doctor in approximately three months. Your wounds should be kept covered by dressings until the stitches are removed. An abdominal support is usually worn for several weeks following the operation to decrease a build up of fluid at the operation site. The pain-killing tablets you will be given on discharge should control any discomfort. You may need to attend for dressings after the stitches have been removed. After 2-3 weeks, you may start light exercise and may be able to return to work. Heavy lifting and strenuous exercise should be avoided for eight weeks. Initially you should refrain from driving.

Scars and wound healing:  You will have noticeable scars. Some patients make better scars than others depending on the individual’s skin type. All become red and raised initially and then begin to settle over a 12-month period. The scars may become red, raised permanently, and itchy. These are known as hypertrophic or keloid scars and is very difficult to treat. The scars may also stretch.

Wound healing can be slow, particularly in the tighter central part of the wound and sometimes dressings are needed until the wounds heal which may be a few weeks. This is more common in patients who are overweight and/or who smoke. This may leave more obvious scars that are tethered. These can be revised but this would require a further operation.

Infection:  Infection is a risk, which may require a course of antibiotics, or an abscess may develop within the scar requiring a second operation and hospital stay.

Bleeding:  Bleeding may occur requiring a second operation or the need for a blood transfusion.

Numbness and sensitivity:  There is numbness in the lower part of the abdominal after surgery this is usually temporary but could be permanent.

The sensitivity of the inner thigh may be affected. It can sometimes become numb due to nerve damage that may occur during the operation.

Swelling and Seromas:  Swelling above the scar is usually present following the operation and is due to a collection of tissue fluid (oedema) that normally drains to the groin. This swelling usually settles within a few months.

A collection of fluid may develop under the abdominal skin following removal of the drains. This is known as a seroma. If it is not causing problems it can be left alone and the body will absorb the fluid. However, on occasions it is necessary to remove the fluid using a needle and syringe this can be done in the outpatient department.

The abdominal wall may not be symmetrical following the procedure, one side being slightly more full than the other.  The tummy button may not be in its original position, it may move to one side. This complication has been over publicised and is rare. Very rarely there has been reports of the tummy button dying away leaving the patient with a scar where the tummy button was.

Secondary procedures are sometimes carried out and may involve scar revision and limited liposuction.

What are the limitations?

The skin is usually tightened downwards and this does not reduce the waistline. If this is desired then we can consider removing skin vertically (Fleur-de-Lys abdominoplasty), but you should bear in mind that vertical scars of the abdomen are more obvious. The beneficial effects of the operation are usually long term. The effects will be maintained better if you exercise the abdominal muscles and keep your weight steady. Pregnancy will of course stretch the skin again.  Your Consultant will advise you on this. For most patients this operation does not involve these complications and they are pleased with the results of surgery. This is not a complete list of all the possible complications, but it is provided to act as an additional source of information, following your discussion about the operation.

If you require any further information or advice please contact any of the following:

Sister or Nurse in Charge Plastic Surgery Out Patient Department, RVI
(Monday – Friday 8am – 5pm)
Telephone:  (0191) 282 4228

Sister or Nurse in Charge  - Ward 47 RVI
(at any time)
Telephone:  (0191) 282 5647