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What Actually Happens During Tummy-Tuck Surgery?

by Ursula Dewey ,
What Actually Happens During Tummy-Tuck Surgery?© Getty

If you've ever considered a tummy tuck to tighten up loose skin on your stomach, there's probably a few questions whizzing around your head. This is your essential guide to everything that happens during a tummy tuck procedure.

A tummy tuck is an ever more popular operation - we all know someone who knows someone who's had this seemingly simple nip and tuck. But what does the tummy tuck operation really involve? How intrusive is it? What kind of pain would you experience and is it suitable for everyone?

We wanted to find out more so we spoke to Mr Jag Chana, Consultant Plastic Surgeon at Spire Bushey Hospital to discover what to expect at every stage, step by step.

Before The Operation

What happens at the consultation stage?
General health and suitability for the procedure is assessed:
The consultant will discuss your concerns in relation to the appearance of the tummy and a full medical history will be taken to decide on the suitability for the procedure. At the same time a full examination will be carried out. Importantly, medical fitness for the surgery is assessed and in particular if you are overweight or a smoker then these factors significantly increase the risks of surgery.

The exact type of procedure is discussed:
There are different types of tummy-tucks such as mini-abdominoplasties (mini-tuck) or a full abdominoplasty, each of which can be combined with liposuction in order to tailor the procedure to provide the most optimal result. An assessment is made to decide which procedure is most suitable and what this procedure entails in terms of the scarring, the expected results and the recovery.

The risks of the procedure are discussed
All surgery has risks and these are discussed so that you can make an informed choice.

What steps happen between the consultation and deciding to have the surgical procedure?
There should be a two week cooling off period before going ahead with surgery, which is important so that there is no pressure to proceed with surgery. Once a decision is made, a pre-assessment is carried out and this may involve some medical tests although this is not always necessary. You should receive some written information about the procedure and receive details about the arrangements for admission to hospital and the anaesthetic.

What preparation do you have to go through before the operation? In the days/weeks before?
The most important factor is to completely stop smoking since this greatly increases the risks of the surgery. Also all non–steroidal or aspirin like medication can increase the risk of bleeding so this should be stopped at least two weeks before the surgery.

On The Day

What happens before the surgery?
There will be a further check by the nursing team and the anaesthetist to ensure you are medically fit and ready for the surgery. You will need to have had nothing to eat and drink from midnight the night before. The consultant will also see you and a consent form for the procedure will need to be signed.

What should you bring with you on the day?
You need to bring only personal items to help with up to a two night stay in hospital

Where is the anesthesia administered? How long does it take to work?
A general anaesthetic is needed. This means you are completely asleep for the whole procedure and this will be discussed with you by the Consultant anaesthetist in the morning for the procedure

How long does the operation last for?
Depending on the complexity and exact type of abdominoplasty the operation can take between two and three hours

What happens during the operation?

This involves removal of an elliptical amount of skin just above the pubic hairline without touching the belly button. This is most suitable for patients who have just a small amount of loose skin only at the lower part of the tummy. The skin is closed leaving a scar in the bikini line.

This involves removing all the skin from the belly-button down to the pubic hairline. The muscles underneath are repaired and tightened to provide a flatter appearance. The skin is closed by pulling down to the pubic hairline leaving a scar in the bikini line from hip to hip. The belly-button is the positioned in the same place but will have a small scar around the inside edge.

With either type of abdominoplasty a small amount of liposuction may be carried out to refine the overall result.

How are the incisions closed?
The incisions are closed with layers of stitches. The deep stitches are buried and dissolvable. Surgeons may have different preferences of whether they use removable skin stitches or dissolvable skin stitches.

How is the area bandaged?
The area is dressed with skin tape and light dressings. Also a compression garment is used.

How is infection prevented?
Usually antibiotics are given to cover the surgery.

What pain killers are used post op?
Some local anaesthetic is given at the time of surgery as a form of block to prevent pain in the immediate post-operative period. Also, a self-administered patient controlled pump is provided so that pain relief is easily administered by yourself after surgery while in hospital. On discharge only mild pain killers are required for a few days. You must not take aspirin based tablets since these can precipitate bleeding.

Post Surgery

How long do you stay in the hospital/clinic for?
Depending on the type of abdominoplasty the stay is usually for one or two nights.

When can you remove the dressings?
The specialist nurses will check the wound at one week and remove and replace the dressings.

How often do you have to change the dressings?
Usually with abdominoplasty some type of dressing is required for one to two weeks. If the wound is dry after this time no dressings are required. If there is a situation of slow healing in one or two areas which can occur then dressings may be needed more frequently and for a longer period.

What sort of pain can you expect post op?
The pain is mild to moderate and is easily controlled with pain killers. Most patients explain that it is not as severe as a cesaerian section and it is usually described like a muscular type of discomfort.

How long is the downtime after abdominoplasty?
Although you will be mobile and walking from the next day, two weeks off work are needed in general, providing the job is not too strenuous and does not involve heavy lifting.

What activities should you avoid post op?
Heavy exercise should be avoided for six weeks although gentle walking is allowable after two weeks. Strenuous abdominal exercises should be avoided for three months.

What can you wear to support the area post operation?
A compression garment will be provided and this needs to be worn for six weeks.

What advice would you give about the procedure to anyone considering abdominoplasty?
This is a very successful procedure in correcting post pregnancy changes or skin laxity in weight loss patients. However, the success of the procedure depends on being within a reasonable weight range and therefore this procedure is not suitable for grossly overweight patients.

For more information about cosmetic surgery visit Spire Healthcare

The content of this article is provided for general information only, and should not be treated as a substitute for the professional medical advice of your doctor or other health care professional

Ursula Dewey
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