Tummy Tuck (Abdominoplasty)

To improve the contour of your tummy by removing the excess lower skin and fat and by tightening the deep muscles for a flatter, more youthful look. It is common for the deep rectus muscles (sit up muscles) to move apart with age (divarication), especially after pregnancy, giving a lax and rounded appearance to the upper and central abdomen. These muscles are brought together and tightened with a permanent stitch during the surgery, for those that require it. I also frequently use ‘gentle’ liposuction as an adjunct to my abdominoplasties, especially to shape the flanks for a more hourglass appearance. On occasion however, more ‘formal’ liposuction is needed, especially to the upper part of the abdomen. This is called lipoabdominoplasty or Brazilian abdominoplasty. I always aim to place the scar as low as possible and the design partly depends on patient wishes. If you tend to wear low cut underwear/swimwear, it is important to try and design a relatively horizontal scar. If your underwear/swimwear curve upwards at the sides, then maybe a curvier scar would suit you better. Although there are no guarantees, I encourage everyone to wear their ‘typical’ underwear on the day of surgery, so we can design the scar within the boundaries of the garment. If the scar needs to be made longer to remove more fat on the sides, this is called an extended abdominoplasty. A mini abdominoplasty, may be considered when there is only small amounts of excess skin and fat at very bottom of the abdomen. It is usually suitable for thin women who mainly have overhanging lower abdominal skin with little excess fat, usually following pregnancy. The scar used, is usually shorter and the belly button does not need to be moved. There is however a variant of mini abdominoplasty, where the belly button needs to be disconnected as well to tighten the upper abdomen, but this needs very careful consideration.

The results can stand the test of time, but before considering any cosmetic abdominal procedure, it is imperative that you are at your desired and stable weight, as considerable post-operative weight fluctuations can affect the final aesthetic result. As part of the aging process the quality of tissues can also deteriorate over time, slightly altering the result of surgery. Although pregnancy following an abdominoplasty is not contraindicated, it is best to have completed your family before considering this procedure

Depending on the type of abdominoplasty performed, this surgery can take between two and four hours and requires general anaesthesia.

I use a special technique with internal nerve blocks, called TAP blocks, using a long-acting local anaesthetic agent for maximum comfort upon waking up. A surgical abdominal binder will also be used to support the internal muscle repair (divarication of recti), for comfort and to help minimise swelling and fluid collections. Some discomfort and abdominal tightness are to be excepted however and appropriate medication will be provided for you from the hospital to keep you comfortable.

For simple and mini abdominoplasties, I do not use drains. I use the technique of progressive tension sutures (PTS, internal support stitches), which allows me to perform drainless surgery. However, when considerable liposuction is also needed, such as in lipoabdominoplasty surgery, then the increased fluid production requires the use of a drain. This usually stays in for one or two nights, but sometimes you may be discharged home with the drain still in place. We will guide you through this process if this is needed.

Yes, a surgical compression garment or binder provides support and comfort and it is an integral part of the recovery process. Depending on where your surgery takes place, this will either be provided for you (Spire Clare Park), or one will be recommended to you for purchase. It is recommended that this is worn day and night for six weeks following surgery.

Recovery takes between two to three weeks and mainly has to do with comfort and wound healing. During this time, you can fully mobilise and are encouraged to do so with care. You are strongly advised against any heavy exercise or lifting for 6 weeks and no abdominal based exercises for 3 months following the surgery. A compression abdominal garment will have to be worn day and night for 6 weeks. Thromboembolic stockings will also have to be worn for at least 4 weeks post-surgery to reduce the risk of a DVT. The final results including scar appearance are usually evident once all the swelling has subsided and this can take up to 12 months. Using a single layer of the provided micropore tape on the scars for 6 – 12 weeks, will give the best results possible. If this is not tolerated, scar surgical massage is a good alternative, starting after the first 3 weeks when all the wounds have healed. Scars should not be exposed to direct sunlight without the application of a high SPF cream for about a year and products such as Cicaplast contain both silicone and SPF block. There are however other alternatives. As your abdomen will been tightened up, you will inevitably be hunched over for the first few days and your back will start to ache. This will be made slightly worse as you will have to sleep with a pillow under your knees for a few nights, keeping the hips flexed to take the tension off the wound. This improves once you stand up straight and although the timing varies between individuals, typically it is within the first few days. I perform a drainless abdominoplasty technique with internal progressive tension stitches (PTS), which again, makes the procedure more comfortable. I sometimes use drains when I perform a lipoabdominoplasty, as there is much more post-operative fluid accumulation with this technique.

This is a big procedure and risks include discomfort, possible areas of numbness below the new belly button, poor scarring, infection, risk of bleeding, seroma (collection of fluid, 2-5%), DVT (clot in the legs), PE (clot in the lung), swollen abdomen, degrees of asymmetry, back pain, dog-ear (bumps at the edges of the scar), belly button necrosis, recurrence of the muscle gap due to over activity in the healing phase, wound breakdown and delayed wound healing. Very often you can also feel abdominal tightness, acid reflux and bloating after the surgery and there can be a change in your bowel habit. This varies between patients and generally improves with time. I will generally not perform this surgery on active smokers. This is because the risks are far greater, including infections, poor wound healing, seroma formation and poor scarring. If you smoke, it is best advised that you stop at least for one month before and after the procedure. The final result in terms of resolution of swelling will be at approximately 4 to 6 months. This varies between patients and the final result and quality of the scar is evident at one year. Wound breakdown and delayed wound healing can occur especially at the place of maximum tension, which is normally the middle of the scar. This is rare and as mentioned, more common in smokers and patients with other medical conditions, such as diabetes. As with any surgery, there is always the risk of stretching of the scars and the development of poor-quality thick scars, such as hypertrophic or keloid scars. Lastly like in all surgery, there are no guarantees for a perfect outcome.