Abdominoplasty

This is also called a tummy tuck.

In this procedure excess skin and fat can be removed, abdominal contours and scars improved, and the stomach muscles tightened.

Different combinations are combined in the various procedures.


The Standard Abdominoplasty

The excess skin and fat of the abdominal wall between the pubic area and the umbilicus (navel) is removed leaving the umbilicus on a stalk. The skin of the abdominal wall at the level of the umbilicus is then drawn down to suture it to the pubic level. The patient is left with a long, usually curved scar across the lower part of the abdominal wall at the level of the pubic hair. There is also a scar around the umbilicus. Any looseness of the muscles of the abdominal wall or hernia is repaired at the same time. Liposuction may be carried out during this procedure to thin the abdominal wall or the flanks.

The Mini-Abdominoplastry

In the mini-abdominoplasty surplus skin below the umbilicus is removed leaving a low abdominal scar at the level of the pubic hair. The umbilicus is not disturbed but liposuction is usually carried out at the same time as the procedure to reduce the thickness of fat in the abdominal wall and any laxity or hernia of the abdominal wall is repaired at the same time. The position of the umbilicus may be lowered significantly.

The Extended Abdominoplastry

In the extended abdominoplasty surplus skin and fat of the loins and back are also removed so that the scar extends around the flanks onto the lower back.

An apronectomy is a modification of the mini-abdominoplasty for patients who have a large excess of skin and fat hanging down over the pubic area. In this procedure only the surplus skin and fat is removed. The scar is long and transverse extending from one side of the apron to the other. Modifications to the abdominoplasty skin excision are made when the patient has particular problems associated with scars from previous operations.
An alternative procedure which should always be considered instead of many of the above is liposuction on its own. This reduces fat and causes just a little retraction of the skin.

Who is a candidate?
Anyone who has excess abdominal skin and fat may be a candidate. With women the problem is usually caused by pregnancy, but is greatly aggravated by weight loss. The muscles of the abdominal wall may be weakened by pregnancy and actually pulled apart in the middle (divarication).

Men are similarly affected by weight loss. Stretch marks (striae) are simply the scars which are left after extreme stretching of the skin. They are usually most apparent on the lower part of the abdominal wall. There is no specific treatment for these stretch marks, but many of them are excised in an abdominal reduction and those that are left are tightened making them look less obvious.

Patients who are unable to tighten the abdominal wall skin with exercise or wish to achieve a smoother flatter abdomen will also benefit.

What are the consequences?
The patient is left with scars. The main scar runs across the lower part of the abdomen (see illustrations) and in a standard abdominal reduction there will also be a thin scar around the umbilicus. Other scars may be left where the patient has particular individual problems. Some patients make better scars than others but in all cases scars are red initially. It is essential that the patient understands where these scars will be and should discuss them with the surgeon. Although we try and hide them beneath underwear and swim wear, fashions can change making previously covered scars visible.

There is numbness of the skin in the lower part of the abdominal wall after surgery - this is usually temporary but could be permanent. Swelling above the scar is usually present due to a collection of tissue fluid which normally drains to the groin. This swelling (oedema) settles within a few months.