DR G DE AGUIAR

PLASTIC, RECONSTRUCTIVE & COSMETIC SURGEON

Procedures - ABDOMINOPLASTY


Introduction:
Abdominoplasty, also known as ‘tummy tuck’, is a major surgical body contouring procedure performed on both men and, more commonly, women. The procedure is designed to improve the appearance of the abdominal area, which may have been affected by pregnancy, significant weight loss or the ageing process. These factors can cause abdominal skin to become flaccid and protruding and in the case of pregnancy, can also cause the muscles within the abdominal wall to become weakened. These conditions cannot be corrected with diet and/or exercise alone, requiring surgical intervention to remove excess skin and fat. An abdominoplasty removes excess skin and fat (and stretch marks) from the middle and lower abdomen and tightens the muscles of the abdominal wall. The procedure can dramatically reduce the appearance of a protruding abdomen.

The Best Candidates For Abdominoplasty:
The best candidates for abdominoplasty are men or women who are in relatively good shape, are generally healthy, non-obese and non-smokers who are bothered by a large fat deposit or loose abdominal skin that won't respond to diet or exercise. The surgery is particularly helpful to women who, through multiple pregnancies, have stretched their abdominal muscles and skin beyond the point where they can return to normal. Loss of skin elasticity in older patients, which frequently occurs with slight obesity, can also be improved. Patients who intend to lose a lot of weight should postpone the surgery. Also, women who plan future pregnancies should wait, as vertical muscles in the abdomen that are tightened during surgery can separate again during pregnancy. If you have scarring from previous abdominal surgery, your doctor may recommend against abdominoplasty or may caution you that scars could be unusually prominent. Abdominoplasty can enhance your appearance and your self-confidence, but it won't necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.

The Procedure:
There are a variety of abdominoplasty procedures available, and operations can be tailored to suit the individual patient’s wishes and needs. There are many variations both to the design of the incisions and the technique itself. The duration of the procedure, type of anaesthesia, length of stay in hospital, extent of surgery and overall recovery depends on the type of procedure that will be required. This will be discussed in detail during the consultation.

When the amount of loose skin is minimal and excess fat deposits are located below the navel, a short horizontal incision above the pubic bone is all that is necessary. This procedure is called a partial or “mini” abdominoplasty. This is often combined with liposuction of the upper abdomen and no repositioning of the umbilicus (belly button) is required.

For patients who have significant skin laxity, excess fat and separation of the muscles, a classic tummy tuck or “full” abdominoplastyis the most common procedure. Performed under general anaesthetic, this operation can require patients to be in hospital for 1 to 2 days. During the operation, an incision is made from hip to hip and around the umbilicus. The excess skin and fat is excised from the umbilicus to just above the pubic hair and the muscles above and below the umbilicus are tightened. The skin is then stitched together resulting in a long scar across the lower abdomen, generally from hip to hip, and a new umbilicus is created. Surgical drains are usually placed underneath the skin and are removed within a few days.

Liposuction is often performed at the same time as an abdominoplasty. However, liposuction can be recommended instead of an abdominoplasty for younger patients who have good quality, elastic skin and whose area of concern is localised excess fat. During the procedure, small incisions are made, excess fat is removed and the wounds are then closed. Some degree of skin tightening or shrinkage can be expected, but the results of liposuction can sometimes be unpredictable. Liposuction alone will have less effect than an abdominoplasty.

Benefits:
  • Abdominoplasty, whether partial or complete, produces excellent results for patients with weakened abdominal muscles or excess skin / fatty deposits. In most cases, the results are long lasting, if you follow a balanced diet and exercise regularly.
  • An improved abdominal contour, the elimination of uncomfortable excess skin and fat and a reduction of the appearance of stretch marks.
  • Significant complications from abdominoplasty are infrequent
  • Unless there is significant weight gain or the patient becomes pregnant, the abdomen should remain firmer and flatter for many years.
  • Recovery time varies among individuals, but patients may be able to return to non-strenuous work 10 days to three weeks after surgery, and in many instances resume most normal activities, including some mild form of exercise, after a few weeks. Return to full activities is usual after approximately 6 weeks.
  • If you're realistic in your expectations and prepared for the consequences of a permanent scar and a lengthy recovery period, abdominoplasty may be just the answer for you


Risks and Considerations:
  • Every surgery carries some uncertainty and risk. Although an abdominoplasty is a commonly performed procedure with a generally high rate of patient satisfaction, potential complications do exist. They include bleeding, infection and reactions to anaesthesia. Tissue loss along portions of the horizontal incision is possible when the abdominoplasty is extensive. Loss, constriction or enlargement of the umbilicus is possible, as are minor asymmetries. There may complications related to the development of a deep vein thrombosis (leg clot or DVT) or pulmonary embolus (lung clot or PE) although active steps are taken to prevent this.
  • Some pain and discomfort at your wound site should be expected during your recovery period and some patients report a feeling of abdominal muscle tightness up to several months after the procedure.
  • While bruising will disappear over a period of weeks, it may be months before all swelling subsides.
  • Numbness over some portions of the abdominal area may persist for several months.
  • Patients undergoing this procedure should not be considering future pregnancies.
  • Incisions lines generally extend from hip to hip and around the umbilicus (full abdominoplasty) and may take months to fade and will be permanently visible. There is a risk of stretched, widened or thickened scars.
  • Usually, the continuous wearing of a post-operative compression garment will be required for several weeks following an abdominoplasty.
  • Poor healing, which results in conspicuous scars, may necessitate a second operation.
  • Smokers should be advised to stop, as smoking dramatically increases the risk of complications and delay healing.
  • You can reduce your risk of complications by closely following your surgeon's instructions before and after the surgery, especially with regard to when and how you should resume physical activity.

Procedures by Dr De Aguiar

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Commitment

Choosing to have plastic surgery requires thorough research and educated decision-making. This website is designed to help guide you get to know a little bit more about my practice and understanding of the procedures and treatments available to you. I look forward to meeting you which will allow you to make a better informed decision around treatments or surgery best suited to you.

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