An expert’s insight into abdominoplasty

There are various reasons why the skin on the abdomen becomes stretched and looser than desired. Childbirth is a common factor, and significant weight loss can cause the skin to sag and hang over the pubic area. Once the skin loses its elasticity, even rigorous dieting and exercise often have little effect, particularly when stretch marks are present. The most effective solution for this issue is a surgical procedure known as a "tummy tuck" (abdominoplasty).

Revered consultant plastic surgeon Mr Makarand Tare shares his expert insight into the procedure.

Why do patients seek a tummy tuck (abdominoplasty)?

Patients often feel self-conscious when their abdominal skin becomes stretched and loose, causing it to hang over the waistline of trousers or skirts, bulge beneath fitted clothing, or be noticeable above and below bikini bottoms. Stretch marks and a distorted bellybutton can also be a source of discomfort. Many individuals avoid wearing swimwear and may even avoid activities like swimming with their children or going to the beach on holiday. These concerns can be addressed through abdominoplasty.

Some women choose to undergo abdominoplasty following pregnancy. It is not uncommon to suffer with separation of muscles in the midline following multiple pregnancies. The separation of muscles (divarication) can cause a distinct bulge over the umbilicus which can change the contour of the abdomen. Additionally, the muscles and the ligaments stretch during pregnancy and obesity. The abdominoplasty procedure involves plication (tightening) of the fascial sheath which improves the contour of abdomen.

What is the difference between liposuction and abdominoplasty?

Liposuction addresses the issue of excess fat but not the issue of excess skin, hence invariably you are left with a loose skin after liposuction which may or may not contract fully over the period of 12 months. On the other hand, abdominoplasty addresses the issue of excess skin and excess skin fat, simultaneously offering a superior contour. 

It should be noted that both liposuction and abdominoplasty offer body contouring, but are not a means to achieve weight loss. 

What does an abdominoplasty involve?

Like most elective surgeries, patients should avoid taking blood thinners such as aspirin or warfarin, and it’s recommended to refrain from nicotine use for six weeks prior to the procedure. Abdominoplasty is performed under general anaesthesia and typically requires a two-night hospital stay.

Plastic drains are placed beneath the abdominal skin to remove excess blood or fluid for the first 24-48 hours. Once the drains are removed, patients can shower and have their dressings changed before being discharged. Sutures are usually removed a week after surgery, with a follow-up review scheduled two weeks post-operation.

What is the typical postoperative recovery?

Sutures are usually removed two weeks after surgery, with a post-operative follow-up review scheduled at weekly intervals. After three weeks, most patients can drive, carry light bags, and handle light chores. A full return to normal activities, including more strenuous tasks like going to the gym or playing sports, is expected after six to eight weeks unless the procedure involves additional repairs such as hernia repair with mesh.

How much time off work will I need?

Most people can return to non-physical work within two to three weeks of surgery. However, recovery times vary, and some patients may need up to six weeks before resuming normal work and leisure activities.

What are the potential complications of this procedure?

As is the case with any surgery, there is a small risk of complications. These may include bleeding, haematoma (a blood clot under the skin), seroma (fluid collection under the skin), and infection. Although these complications are treatable, they can slow down recovery. There may also be slight differences in the size or shape of the scar, the position of the bellybutton, or changes in sensation over the abdomen.

If you are contemplating a tummy tuck and would like to book a consultation with Mr Tare, do not hesitate to do so by visiting his Top Doctors profile today.