Abdominoplasty after weight loss FAQs

Revered consultant plastic and reconstructive surgeon Mr Jonathan Duncan offers expert guidance on abdominoplasty procedures for patients who have undergone weight loss in this informative article, including the potential risks associated with the procedure and what to expect from the recovery period to follow. The highly experienced specialist also shares detailed insight on how abdominoplasty surgery can affect the appearance of stretch marks.

What are the risks and potential complications of abdominoplasty for post-weight loss patients?

The risks are generally the same for any patient undergoing an abdominoplasty. The general risks of any surgery include:

• infection
• bleeding · the nature and distribution of scarring
• the potential need for further surgery
• delayed wound healing
• fluid build-up underneath the scar (seroma)
• the potential need for revisional procedures

In my own practice, I have found that weight loss surgery patients specifically have a significantly increased risk of developing a seroma, a fluid build-up behind the scar, following abdominoplasty surgery. This is not always the case however, and should it occur, it does not affect the patient’s final result. Nonetheless, it can slightly delay recovery and you may need to meet with your surgeon more frequently to ensure it is effectively resolved.

Post-weight loss surgery patients may also have a slightly increased risk of wound break down. Unfortunately, this can sometimes create a perfect storm where a seroma develops as well as an opening up of the wound. This can be very difficult for patients to manage and can cause a lot of leakage of fluid, which is tricky to deal with.

Ensuring that you are in the best possible health before your abdominoplasty can help to minimise these risks. Patients who are smokers, for instance, should aim to give up before undergoing their procedure. Many patients who wish to undergo an abdominoplasty are either pre-diabetic or coming out of diabetes and it’s important to ensure their levels are well controlled before surgery.

The other important area to consider is maintaining a steady weight. It’s important that patients are not continually losing weight while preparing for surgery and those who have gone through significant weight loss should aim to maintain a stable weight for at least three months before surgery. This is key because as when we lose weight, the body is in a catabolic, meaning we lose protein and other nutrients which are essential for wound healing. As such if surgery is carried out while weight loss is ongoing, wound break down is a significant risk factor.

How long is the recovery period after post-weight loss abdominoplasty surgery?

Although there is a generic recovery period, people have different perceptions of what it means to be fully healed and recovered. I see my patients one week post-operatively and I always advise them that they won’t feel amazing at that stage, as the wound will still be tight and they will require plenty more rest to heal.

Usually, patients will start to feel their energy coming back after around ten to fourteen days. At this stage, they will still be in recovery and shouldn’t be doing a lot of heavy exercise. I recommend taking two weeks off work and if you do return to work after this, you will likely still feel tired but you should be able to manage your usual day to day activities.

At around six weeks post-op, patients should expect to be returning too, or at least be close too feeling normal. They should start to appreciate that they are feeling generally recovered, with more normal energy levels and less feelings of tightness and swelling of the abdomen.

From the patient’s perspective, however, they may feel that they are still in ‘recovery’ as they may continue to experience some tightness, numbness or twinges of discomfort as they move. This is a normal part of the healing process as the body readjusts to its new shape and size. After three months, any swelling should have died down and sensation should be returning to normal.

Can a post-weight loss abdominoplasty improve the appearance of stretch marks?

In the bigger picture, essentially the answer is no - the procedure won’t get rid of the appearance of stretch marks. However, this ultimately depends on the distribution of the stretch marks. Some people can get stretch marks that are quite red and are still active. If that’s the case, I would say you probably shouldn’t be going in for surgery at that stage. More often than not, however, when losing weight, the tension on the skin is reduced so any stretch marks should be fairly mature.

In around ninety per cent of patients, you will get rid of the majority of the stretch marks because the skin that is stretched out is the skin will be removed by the surgery. Some patients have quite problematic stretch marks over their flanks and hips which can be difficult to deal with because they won’t be removed in surgery. However, they will be less obvious following the procedure because the skin will appear tighter and firmer, changing how the marks are perceived because the canvas they are on is slightly different.

While at university, I conducted research which looked into scars and their management as well as anti-scarring drug trials. One of the greatest areas of difficulty was in assessing scars as they can differ greatly, as can people’s appreciation of them. My thesis was based on this topic and in many ways, I would say a stretch mark is quite similar in terms of the factors at play. While the surgery won’t change the qualities of the stretchmark itself or remove it, it will alter how the patient perceives it.

You can read more of Mr Duncan’s expert insight on tummy tuck procedures for post-weight loss patients in his other detailed article on the topic.

If you are considering an abdominoplasty and wish to schedule a consultation with Mr Duncan, you can do so by visiting his Top Doctors profile.