Abdominoplasty (Tummy Tuck)

Abdominoplasty (Tummy Tuck)

The aesthetic appearance of the abdomen can be affected by excessive fat deposit, redundant skin with multiple stretched marks, and budging of the abdomen. These conditions are usually caused by weight changes, pregnancy and aging process.

Excessive fat makes the abdomen looks full and round and affect the slim contour of the abdomen. Redundant skin in the abdomen hangs down like an apron, varying in length and size and can cause physical discomfort and unsightly appearance. In normal situation, the abdomen muscles are able to hold the internal viscera and maintain the flatness of the tummy. Weakened abdomen muscles are unable to hold and retain internal viscera in their normal position. The viscera bulge out under the weakened muscles and skin and cause a protuberant abdomen.

Liposuction, and to a certain extent diet and exercise, can remove fat deposit in the abdomen. However, these measures are unable to deal with redundant skin and muscle weakening and laxity.

Abdominoplasty (also known as tummy tuck) is a surgery that remove redundant skin and fat, and to repair and tighten the muscles in the abdomen. The objective is to create an abdomen that is flat, tight and slim. In tummy tuck, the abdomen skin is separated from the underlying structures and removed. The weakened abdominal muscle is repaired and tightened. Tummy tuck is usually combined with liposuction to remove excess abdominal fat.

The scar from a tummy tuck is located very low on the abdomen and is hidden by the panty. If present, scar from a previous Caesarean section surgery will be removed together with the excess skin.

There are different types of abdominoplasty surgery (see Surgical Technique). Which type of abdominoplasty to use depends on the severity of the redundant skin, the amount of excess fat and the extent of the laxity of the abdominal muscles.

Preparation

1. Inform the doctor of any pre-existing medical conditions and drug allergy. All medical conditions must be treated and stabilized before surgery.

2. Stop smoking and vaping at least one week before surgery. Smoking and vaping is harmful to wound healing and increases the risks of other post-operation complications.

3. Stop the following medications and supplements starting from one week before surgery until one week after surgery.

   1. All supplements containing vitamin E, ginseng, ginkgo, garlic, fish oil, and other ingredients that increase bleeding during the surgery. Other supplements, traditional medicine, and herbs, in which ingredients are unknown, have to stop as well.

   2. Medicine that increases bleeding during the procedure such as aspirin, NSAIDs, and warfarin. However, you may need to consult your physician who prescribed the medication before you stop the medicine.

4. On the day of surgery, wear simple and comfortable clothing. Do not wear any makeup. Do not wear any jewelry and metal objects on the face and body.

5. Be mentally preparedfor the surgery. Stay relaxed and have a good night sleep on the night before surgery.

Surgery

Duration: 3-4 hours

Anaesthesia: General anaesthesia

Hospitalization: Daycare for mini-abdominoplasty. At least one-night stay for a standard abdominoplasty. 2-5 days for an extended abdominoplasty.

Recovery*: Back to work in 7 days, light exercise after 2 weeks, heavy exercise after 4 weeks.

* The actual recovery speed depends on the types of abdominoplasty and may vary from person to person.

Surgery Technique:

Skin markings are done before surgery. The skin in the lower abdomen is incised according to plan. The skin is separated from the underlying muscles and fascia. Repair and tightening of the abdomen muscles is performed. Excess skin is removed and the remaining skin is pulled down to closure the wound. The umbilicus will remain in its normal position in the abdomen. Abdominoplasty is frequently combined with a liposuction to remove excess fat.

There are different types of abdominoplasty and the decision to use which type of abdominoplasty depends on the amount of loose skin and the severity of weakened abdominal muscles.

1. Mini Abdominoplasty: This procedure is suitable for a patient with mild to moderate severity where the excess skin and fat are limited to the lower part of the tummy and there is no significant weakening of . The incision is short and confined on the central part of the lower abdomen. Recovery is much faster than other types of abdominoplasty.

2. Standard Abdominoplasty: Standard abdominoplasty is the most common type of abdominoplasty performed. This technique is recommended for patients with moderate to severe abdominal skin excess and laxity and there a significant weakening of abdominal muscle. The incision extends from hip to hip, in a curve line just above the pubic hairline. A standard tummy tuck allows removal of a good amount of abdomen skin, and allows a full repair and tightening of the abdomen muscle from the top to the bottom of the abdomen.

3. Extended Abdominoplasty: This procedure is for patients with severe excess skin in the whole torso, including the entire tummy and the flanks. The incision covers the lower abdomen, the hips, and extend to the sides of the abdomen.

Post-operative Care**

1. What to expect:

   1. Swelling usually peaks on the second to third day after surgery and will gradually subside in 1-2 weeks

   2. Suction drains may be inserted for the first few days to remove fluid and blood from the wound.

   3. Tight sensation in the abdomen may be present for 1 to 2 weeks. The patient may need to bend the body while standing and walking to reduce tension on the wound. The tightness will gradually improve and the patient will be able to stand and walk upright after about 2-3 weeks.

2. General care:

   1. Use a supportive garment to support the tummy for the first 1-2 months.

   2. Avoid smoking and vaping for at least one month. Smoking increases the risk of wound complications.

   3. Sleep on the back and avoid sleeping on one side.

   4. Be relaxed and calm. Adequate rest and sleep are helpful for a speedy recovery. Contact the clinic for help and information if there are any worries or queries.

   5. Early ambulation is encouraged to speed up recovery.

3. Medicine: Finish the oral antibiotics as prescribed. Take the painkiller as prescribed when necessary.

4. Wound care: After removal of the wound dressing, clean the wound with a clean cotton tip soaked with sterile water/saline. Apply antibiotic ointment. Avoid pressure on the wound. During wound healing, it is normal for the wound to  feel itchy. Do not scratch the wound. The use of scar gel, if needed, should only start after one month from the surgery.

5. Physical activity: Avoid heavy physical activity and exercise for at least one month.

6. Follow-up: Come back one week after surgery for review.

7. Emergency: If there is heavy bleeding, a rapid increase in swelling or severe pain, immediately contact the clinic/doctor for advice.

** The instructions in this list are only for general guidance. If you have any specific queries or concerns during the post-operative recovery, please contact the clinic for further advice.