Definition and Overview
Also referred to as tummy tuck, abdominoplasty is an invasive cosmetic surgical procedure that aims to achieve a firmer, smoother abdomen by removing excess fat and skin and tightening the abdominal muscles. It can also be performed to improve weakened muscles that may have been damaged due to multiple pregnancies, aging, fluctuating weight loss, and heredity.
Who Should Undergo and Expected Results
The best candidates for abdominoplasty are men and women who:
- Have substantial fat and excess skin around the abdomen and, to a certain extent, the back region
- Do not like the appearance of their abdomen
- Want to achieve a firmer, smoother, and well-toned abdomen
Women who have multiple pregnancies are more likely to have sagging abdominal skin, making them good candidates for the procedure as well.
It is also possible to perform a tummy tuck alongside or after major gynecological surgery like the removal of the uterus (hysterectomy) as taking out excess fat and skin can improve the surgeon’s visuals and speed up the healing process.
On the other hand, abdominoplasty may not be considered or should be delayed for people who are heavy smokers, as the habit can significantly hamper recovery and even increase the risk of complications. Women who are planning to have more children may also have to wait until they’re done with childbirth since delivery can result in the separation of the muscles tightened by a tummy tuck.
While tummy tuck helps remove excess fat and skin, it is usually not advisable for people who are overweight or obese due to an increased risk of anesthesia-related complications.
Overall, the success and satisfaction rate of abdominoplasty is very high. In one study, at least 95 percent of the respondents said their abdomen’s appearance had improved while 86 percent said they were satisfied with the outcome. The same study showed that only about 1.4 percent of the cases resulted in hospitalization due to complications.
With regard to stretch marks, a tummy tuck doesn’t eliminate their appearance unless these marks are found in the excised skin.
How Does the Procedure Work?
There are three types of abdominoplasty:
Complete – This involves creating a hip-to-hip incision, contouring of many elements of the abdomen such as the muscles, fats, and tissues, and repositioning of the belly button.
Partial – This is more ideal for men and women whose excess skin and fat are found or limited below the belly button. Thus, it does not require a large incision, navel repositioning, and prolonged surgical time.
Circumferential – This may be performed when there’s also a significant accumulation of excess fat and skin in the back.
Before an abdominoplasty is performed, the patient undergoes intensive consultations with the surgeon, covering different points such as:
- Procedures to be done during surgery
- Surgical preparations
- Wound management and other post-operative care
- Expectations and possible outcomes
- Risks and complications
- Costs and insurance
Patients are also expected to go through different physical and imaging exams, blood tests, and sometimes nutritional and mental counseling to ensure they are completely prepared for the surgery and recovery.
In the actual procedure, the patient is administered with general anesthesia to make the procedure comfortable and pain-free. Depending on the type of approach to be used, an incision is made either below the belly button or from one hip to another. The skin is then lifted all the way to the ribs to expose the abdominal muscles, which are then tightened. The skin is redraped to the abdomen and the excess fat and skin are removed. Another incision will be made if the belly button needs to be repositioned. All the incisions are then sutured and the entire area is bandaged. A drainage tube may be attached to the abdomen to avoid the accumulation of fluid in the surgical site.
The entire surgery may last between one and four hours, depending on how much fat and skin is removed, the overall health of the patient, complications arising during the procedure, and other related factors.
The first assessment post surgery is typically scheduled within two weeks while complete recovery can take up to six months.
Possible Risks and Complications
As an invasive surgical procedure, abdominoplasty carries the following risks:
- Infection at the wound site
Other possible risks and complications include:
- Injury to the nearby tissues or organs
- Death of skin and fat (necrosis)
- Seroma (accumulation of fluid in the operated tissue)
- Damage to the nerves that may result in numbness
- Poor healing of the wound, which may be influenced by underlying conditions like diabetes or habits like smoking
- Embolism, which occurs when a blood clot dislodges itself from its source and moves to the lungs
- Visible scarring, which may or may not fade over time
Although the results of a tummy tuck are generally permanent, skin and fat can still become loose usually due to fluctuating weight loss. Thus, surgeons encourage patients to maintain a healthy lifestyle including proper diet and exercise after surgery. They also stress that the procedure should not be an alternative to conventional but effective and long-term weight loss approaches.
- The American Society for Aesthetic Plastic Surgery