Tummytuck procedures

Removal of excess skin and fat to improve the shape of the torso

This procedure removes excess skin and fat from below the tummy button to create a flatter tummy. It can be combined with liposuction to fashion a narrower waist and enhance the overall result. It is particularly suited to women who have had children and have completed their family. Most patients are suitable for standard abdominoplasty which leaves a horizontal scar above the pubic area from hip to hip, a circular scar around the tummy button and occasionally a short vertical scar extending from the pubic area. However, if you only have a mild excess of skin and fat then you might be suitable for a mini-abdominoplasty which removes less tissue and therefore has a less dramatic effect but avoids a scar around the tummy button. Patients who have lost a lot of weight and as a result have a lot of excess skin may benefit from one of two variations (see diagrams) of the abdominoplasty which remove even more tissue than the standard procedure. The first is the Fleur-de-Lys abdominoplasty which adds a vertical scar down the middle of the abdomen and is very good at removing excess tissue from the front of the abdomen and narrowing the waist. The second is the body lift which carries the horizontal scar around the full circumference of the waist to the back and tightens the back and flanks as well as the front of the abdomen. 

Abdominoplasty surgery in most cases requires and overnight stay. You may need drains which are tubes that come out of the skin and remove excess blood and fluid. Usually they are removed the day after surgery before you go home. You will have some pain for the first week and you will need to take painkillers. You won’t be able to stand up fully straight at first but most patients can by the end of the first week. It’s important to get on your feet as soon as possible after surgery to minimise the risk of blood clots in your legs. I recommend wearing the stockings you’re given in hospital for the first week for this reason. You won’t be able to drive for the first week and you will need some help with your activities of daily living and domestic chores. If you have young children, you will need somebody to help with their care. You will need a minimum of 1 week off work. If you work from home you may manage to work at this point, but otherwise 2 weeks is preferable. Walking for exercise is acceptable from 4 weeks but wait until 8 weeks for anything more vigorous. 

The first dressing change is 1 week after surgery. Usually most of the wound is sealed and dry by this time but often there are areas that need longer to heal and further dressings. You will need to wear a pressure garment for 6 weeks to prevent fluid accumulation (the Spire Thames Valley and Princess Margaret Hospitals will provide one, you can purchase additional pressure garments at Macom.com – use ‘Baker’ for a 15% discount). Lymphatic massage from a qualified therapist can also help. 

Abdominoplasty scars are necessarily long and may widen or thicken or be otherwise unsightly. The risks of surgery are bleeding, drains, infection, delayed healing, seroma  (fluid collection under the skin), loss of blood supply to skin or tummy button (leading to tissue loss), distortion or malposition of the tummy button, asymmetry of the scar, bulges, recurrent laxity of the skin, numbness of the tummy and the thighs (usually temporary), persistent pain, blood clots in the calves and chest and sometimes the result is unsatisfactory and revision procedures are required. You should be aware that you do not have to have any surgery at all and that you may achieve fat reduction with weight loss although there will be no change in the excess skin.