Abdominoplasty

Pregnancy, ageing or weight loss can cause the skin of the abdomen to sag, creating the typical skin (fat) rolls. Sometimes, the abdominal muscles are also weakened and there is swelling of the abdomen in the midline. These changes to the abdominal are often exacerbated by exercise or weight loss.

An abdominoplasty or ‘tummy tuck’ corrects excess skin on the abdomen and sagging abdominal muscles, as well as removes any fat deposits. A tummy tuck improves the figure and gives the abdominal wall back its youthful tightness.

• Your abdomen shows excess skin after weight loss (through diet or gastric bypass surgery) and your weight has stabilised.
• Your abdomen shows excess skin or muscle weakness after pregnancy that does not improve with exercise. Your wish for a child has been fulfilled, and now you would like to have your abdominal wall firmed up again.
• If you only have stubborn fat deposits without excess skin, you are more likely to be a candidate for liposuction or a mini-abdominoplasty.

Abdominoplasties are performed under general anaesthesia. The procedure takes 2.5 hours. Through a horizontal incision below the bikini line and a small incision around the navel, the excess skin of the abdomen is separated from the muscles and tightened. The excess skin is removed, and the wound is closed to a fine line with absorbable sutures. Any fat deposits in the upper abdomen or flanks are treated with liposuction. The abdominal muscles are stretched to strengthen the abdominal wall and improve the waistline. Two drainage tubes are placed during surgery and are removed before you are discharged from hospital. After a tummy tuck, you usually stay in the hospital for two nights.

You should wear a firming corset or bellyband for about six weeks (day and night for four weeks, then during the day for another two weeks). Heavy lifting is prohibited for 4-6 weeks. Intensive exercise is possible after 6 weeks. Work incapacity usually lasts about 3 weeks. Showering is allowed immediately after surgery. The wound suture is usually protected with a waterproof shower patch for about 10 days. Standard painkillers are prescribed for the first 7-10 days after surgery. Follow-up appointments are scheduled for 2 week, 6 weeks and 3-6 months. The scar should be treated with specific scar ointments or silicone patches to minimise its visibility over time.

Post-operative bleeding and infection are rare complications of abdominoplasty.

Sometimes, fluid can accumulate between the skin and muscle layer (seroma). Wearing a bellyband helps to prevent these complications.

Tissue deterioration (skin necrosis) just above the wound suture may rarely occur in smokers or diabetics. Stopping smoking a few weeks before and after surgery is definitely recommended to prevent complications.

Thrombophlebitis of the calves or pulmonary embolism is prevented by using compression stockings during the surgery and administering a mild blood thinner the evening before the procedure.

A tummy tuck returns the abdominal wall to its former firmness and gets rid of skin rolls and excess fat. The waistline is also improved. The scar will eventually become a white line that is hidden behind the underwear. Weight fluctuations and new pregnancies can compromise the aesthetic result of the tummy tuck. If you stick to a healthy and sporty lifestyle, the results will be permanent.

If the slackening of the abdominal wall causes functional discomfort, such as back strain or irritation in the skin folds in hot weather, you may be eligible for partial reimbursement by health insurance.

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Latest publication date: 13/08/2024
Supervising author: Dr Vertriest Rudolf