Removal of excess abdominal skin and fat is known as an abdominoplsty or ‘tummy tuck’. Others need removal of unwanted skin after major weight loss or for abdominal scars. Whilst different to liposuction (removal of fat alone), a combination may be used in some cases.
There are a variety of abdominoplasty operations:
- Full – removes skin and fat beneath the navel in exchange for an horizontal scar, ideally low to allow concealment by underwear. The umbilicus remains attached to the underlying tissue, but is re-sited through the upper abdominal skin with a second, circular scar.
- Mini – where there is no skin/fat excess above or around the umbilicus or insufficient skin to close a ‘full’ abdominoplasty. The horizontal scar is shorter and there is no navel scar, but muscle repair is not performed.
- Fleur-de-Lys – the largest procedure and so named because of the tissue excision. An additional vertical scar extends from the ribcage into the pubic region and is used only for significant lateral excess, generally after massive weight loss.
- Floating – the least common in which the umbilicus is detached from the underlying abdominal wall to avoid distortion.
Because full abdominoplasty takes around 3 hours in theatre patients must be in good physical health. Smoking risks wound healing problems and skin necrosis (tissue death) therefore must be ceased weeks before any surgery. Aspirin, or aspirin-like, medications should also be avoided to reduce the risk of bleeding.
More questions about abdominoplasty surgery?
General anaesthetic (GA) is required. The lower incision incorporates any scars (eg., Caesarian) and the skin is lifted to allow repair to any separation of the muscles. Excess skin is removed and a new incision made for the umbilicus. Drains are used to collect any excess fluid, absorbable stitches inserted and dressings applied beneath your pressure garment. This should all be left in place for the first week until review at the clinic.
Although you must rest it is important to mobilise gently as soon as practicable to reduce the risk of developing clots in the veins. You will need to sleep propped up with several pillows beneath the knees to reduce wound tension.
The garment must be worn constantly for the first week. You may then shower daily and wear the garment at all other times for the next 5 weeks.
You will be healed in a few weeks, but full scar maturation takes 12–18 months and is worst (being red, raised and unsightly) during the early stages. You should also limit sun exposure for the first year.
Whilst any operation has the potential for complications, these are rare with modern techniques. You must ensure you are happy with these aspects during consultation with your surgeon. Particularly, important are your own expectations as to whether the operation is likely to achieve the result you desire from it and at what cost in terms of the scar and any risks.
