Tummy tuck

Tummy tuck is a major surgical procedure that involves the removal of skin and fat from the lower 2/3 of the abdominal wall and allows tightening of the abdominal muscles.

Aim of the tummy tuck

Tummy tuck allows the dramatic reduction in size of a prominent belly and may significantly improve the shape of the body. The procedure does not aim at reducing body weight and in no case should it be considered as a slimming method.

Ideal tummy tuck candidates

The ideal candidates for a tummy tuck are women and men who have good health but are concerned about the size and shape of their abdominal wall, excess fat and loose skin that can no longer be treated with diet and exercise.

Tummy tuck is also advisable for patients who have undergone bariatric surgery (weight-loss surgery) and have since developed abdominal lipodystrophy.

Women who have had multiple pregnancies are also good candidates for this procedure. These women experience muscle and skin laxity that cannot be corrected with exercise.

Patients who are planning to follow a diet regimen must first complete the diet and then undergo a tummy tuck. Also, women who are planning to become pregnant in the future should postpone their tummy tuck, since the abdominal muscles on which the tummy tuck is performed will become flaccid again during pregnancy.

Patients previously submitted to specific surgical procedures on the abdomen that have left behind scars on specific areas, may not be eligible for a tummy tuck.

It must be noted that this operation can be combined with other surgical procedures such as liposuction and breast reduction or augmentation.

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BENEFITS

Tummy tuck may significantly improve the appearance of the outer abdominal wall and therefore the patient’s spirit and self-esteem. However, the patient must know that his/her expectations must be realistic.

PRE-OPERATIVE ADVICE – PRE-OPERATIVE CHECK-UP FOR TUMMY TUCK

During the initial consultation, the plastic surgeon will perform a clinical examination of the patient and will provide him/her with detailed information regarding the procedure (indications, contra-indications, risks, benefits, complications, post-operative course). Pictures will also be taken.

Further to usual pre-operative tests (full blood count, complete urinalysis, electrolytes, urea, creatinine, blood sugar, ECG and chest X-ray), an abdominal CT scan and examination by a general surgeon may also be required in specific cases where an abdominal hernia is suspected. Patients who smoke should ideally refrain from smoking for two months before surgery in order to achieve optimum results.

Prior to the tummy tuck you shall be given a handout with specific advice on the diet you should follow, medication and vitamins that you must avoid or take, smoking and sunbathing habits before and after surgery. In case you catch a cold, (runny nose, cough) or have an infection, surgery may be postponed for a few days.

POST-OPERATIVE OUT-OF-HOSPITAL PROGRESS

After surgery, you will be taken to your room. Patients are advised to stay at the hospital for one or two days; however, most patients are discharged the day after surgery.

The afternoon following the surgery you shall be put on a liquid diet and eventually on a normal diet if you are not feeling sick. Post-operative pain is average and usually treated with analgesic tablets or injections. It usually lasts for a few days. With the help of a nurse, the patient gets out of bed on the same day to avoid blood clots in the legs. The patient wears special anti-embolism stockings while at the hospital. After surgery, the patient wears a special compression garment for approximately four to six weeks.

The patient is discharged if able to follow a regular diet, walk with or without help, is self-supported and feeling well, in general. The first visit to the doctor follows one week after surgery.

POST-OPERATIVE OUT-OF-HOSPITAL PROGRESS

During the first days the patient will experience oedema (swelling) and bruising which will, however, gradually disappear (most of the oedema subsides within two to three weeks). Pain will become lighter and can be treated with painkillers. Gauzes must remain intact for two days. They are then removed, and the patient may take a bath as usual (if drains are left in position for more than two days then bathing is only allowed after the drains are removed).

The patient must walk around and must not spend much time in bed in order to avoid blood clots. The patient must wear the compression garment for at least four weeks. Work out and lifting weight (suitcases etc) is allowed after four weeks. However, fast walking is allowed with moderation. Driving is allowed two weeks after surgery. The patient is usually able to return to work one week after surgery (depending on the nature of work). Scars will improve with time and will settle after about nine months. However, scars will never disappear completely.

POSSIBLE COMPLICATIONS OF A TUMMY TUCK

As in any surgical procedure, even if all rules are followed, a tummy tuck may have complications of which the patient must be informed. These are rare and may include:

Wound infection treated with antibiotics and possible removal of purulent tissues. Lower limb vein thrombosis, that usually develops in patients who do not move a lot after surgery and are obese.
Heavy smokers may develop problems during wound healing. This is why candidate patients are advised to quit smoking two months before surgery.
Diabetic patients may also face healing difficulties.
The final appearance of the scars cannot be estimated. Bad scars (hypertrophy, keloids, pigmented scars, atrophic scars, wide scars) are rare but if they occur they may be treated with surgical or non-surgical methods.
1. Fluid concentration. This fluid is usually self-absorbed but in some cases the use of syringes may be necessary.