Abdominoplasty or Tummy tuck

Also known as – tummy tuck

Procedures
Face
Breast
Body
Hair
Non Surgical

Indications

- Any post-partum female with loose sagging abdominal skin with or without stretch marks or with a protruding abdomen due to muscle wall weakness or gap in the midline rectus muscles

- Any male or female with massive weight loss causing laxity and overhanging of the skin-fat envelope of the abdomen.

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What does the procedure achieve

An abdominoplasty aims to improve the overall contour of the tummy and lower back regions. It removes loose hanging skin (often with stretch marks) from the tummy region, removes excess fat from lower back, flanks and tummy regions resulting in a flatter, firmer and improved shape of the tummy. In addition, the procedure improves the way the navel appears and corrects any muscle weakness or hernia.

Depending on the amount and extent of skin laxity, you may be suggested a standard lipo-abdominoplasty, a mini-abdominoplasty, an extended abdominoplasty or a circumferential abdominoplasty.

Contraindication

Any patient above 18 years of age who is physically and mentally healthy and wants to improve the shape and appearance of their tummy and lower back region is an eligible candidate.

Consultation

The purpose of a detailed consultation would be to:

- Discuss your surgical goals and expectations

- Evaluate your general health status and risk factors

- Elicit History of previous surgeries and medical conditions

- Elicit History of all current medications

- Ask about Allergies (including drug allergies), addictions if any

- Take Preop photographs and plan for your procedure

- Discuss all treatment options

- Explain the possible outcomes

- Potential risks and complications of the surgery

Anaesthesia

Abdominoplasty may be performed under spinal anaesthesia with or without epidural anaesthesia or general anaesthesia.

Time For Procedure

The duration of surgery may range from 3 to 5 hours depending on the extent of surgery.
  • Detailed medical evaluation by Blood tests, Xrays, ECG, Stress Test etc
  • Control of any co-morbid medical conditions such as Diabetes, High Blood pressure, Heart disease, Chronic Asthma
  • Stop smoking at least 48-72 hours prior to surgery, preferably 2 weeksearlier
  • Stop all blood thinners, Aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding during surgery
  • Evaluation by physician and anaesthesiologist, as necessary

The first step of the surgery is usually liposuction of the lower back and flanks followed by that of the upper abdomen and the flanks. This not only removes the excess fat in the deep player over the muscle wall but it also performs a  discontinuous dissection in the plane in which the skin-fat apron will be raised, thus helping with the surgery. An incision is then taken just above the pubic hairline in a natural crease if possible (similar to a caesarean section incision) and deepened to the muscle wall. The skin-fat apron is then raised in this plane above the muscle wall to the level of the belly button. The belly button is then skeletonized all around but left attached to the muscle. Further dissection is done above the belly button only on either side of the midline upto the junction of the chest and abdomen.

If there is a gap in the rectus muscles, this is then repaired. If there is a hernia in and around the belly button, that too can be repaired. The raised skin-fat flap is then pulled down and excess removed, after anchoring it in the midline. The position of the belly button on the surface is once again marked and an incision made full thickness through the flap. The belly button underneath is now located and brought to the surface, fixed and stitched. Before closure, a closed suction drain is generallyput.

The incision is then meticulously closed in multiple layers with strong sutures. Dressings and an abdominal binder or compression garment are applied.

  • IV fluids and antibiotics are given for 24 hours.
  • Pts are nursed in a flexed position at the hips
  • Intermittent compression devices on the calves are placed to prevent venous thrombosis till the patient is ambulant.
  • Liquid diet is started within 6 hours and then progressive diet as tolerated
  • Ambulation is started on the same evening or next morning
  • Pt discharged at day 2-3 following surgery, depending on the drainage from the suction drains.
  • Compression garment is put post op and continued 24/7 till dressings are completed. They are to be worn for 4-6 weeks, removed only for a bath.
  • Light exercises allowed after 4wks
  •  abdominal wall exercises are deferred till 3-6 months.

FAQs

It varies from patient to patient. Usually 3 weeks is the time needed for entire wound healing.Routine morning walking can be started by 2 weeks. Weight trainings and lifting weights are not allowed for at least2-3 months.