Surgery to the skin and/or fatty tissue of the tummy is most often performed for women who have either lost a lot of weight or who have experienced ‘collapse’ of their tummy skin after one or more pregnancies. Often a Caesarean section has been involved. Sometimes problems arise after a hysterectomy. Men who have lost a lot of weight can also be helped.
Women may have had their tummy muscles severely stretched in pregnancy causing bulging or even herniation of the intestines (ventral hernia) and Mr Matthews would carefully assess for that at consultation.
A greater or lesser operation may be indicated to ‘put things right’. A minor tummy tuck or mini-abdominoplasty just involves removing skin and fatty tissue low on the tummy leaving a low scar of limited length. This can be done as a day case under local anaesthetic and sedation or a general anaesthetic (asleep). It can be combined with lioposuction to the upper tummy and other areas.
More extensive surgery (full abdominoplasty) is needed to deal with bigger problems and may include tightening of the tummy muscles and repair of a ventral hernia. The scar from full abdominoplasty is also usually low but extends round onto the flanks. In cases where loose tissues extend right round the back, this can be removed too (trunk reduction) and the scar then extends all the way round as well.
Full abdominoplasty is done under general anaesthesia and involves a stay in hospital of 3 – 4 nights afterwards. You should expect to be off work for 4 – 6 weeks (2 – 3 weeks for a mini-abdominoplasty) and not to be exercising energetically before 8 weeks. Full abdominoplasty often requires freeing of the tummy button which is then brought through the tightened tummy skin at the right level: there is therefore a scar round it as well as the lower scar and these will take 9 – 12 months to gradually fade. Sometimes the scars remain more obvious than hoped for by not fading so well or because they thicken up to some extent. Mr Matthews would advise about this if it happened but scars often improve anyway with time.
Full abdominoplasty can take up to 3 ½ – 4 hours. Safety of general anaesthetic is therefore considered carefully in each case. Being overweight and/or smoking represent serious risk factors.
Sometimes the operation can leave a slight fullness (‘dog-ear’) on one or both flanks which may require treatment under local anaesthetic as a day case if it is still a problem after about 6 months.
Finally, full abdominoplasty is quite a big operation and takes quite a while to fully recover from. However, it can produce excellent results and greatly enhance quality of life.