Tummy Tuck, abdominoplasty

Abdominoplasty surgery is becoming increasingly popular. The majority of  tummy tuck candidates are women of childbearing or middle-age with a history of one or more pregnancies. Childbearing takes its toll on the muscular support and integrity of the abdomen. Significant weight gain or obesity followed by weight loss will often result in sagging abdominal skin. Men occasionally request an abdominoplasty and the procedure can be successfully performed in males as well as females.

Age Group:

The peak age group is between thirty and fifty but it is not uncommon for older women to seek advice about abdominoplasty.

Pre Tummy Tuck Front view The Clinic Sandymount Green, Dublin 4

Pre Tummy Tuck Front  and Breast  Augmentation Front view The Clinic Sandymount Green, Dublin 4

Post Tummy Tuck  Front View The Clinic Sandymount Green, Dublin 4

Post Tummy Tuck  and Breast Augmentation Front View The Clinic Sandymount Green, Dublin 4

 

Pre  Tummy Tuck side view The Clinic Sandymount Green, Dublin 4

Pre Tummy Tuck side view The Clinic Sandymount Green, Dublin 4

Post Tummy Tuck  Side view The Clinic Sandymount Green, Dublin 4

Post Tummy Tuck  and Breast Augmentation The Clinic Sandymount Green, Dublin 4

Anaesthetic:

Abdominoplasty is carried out under general anaesthesia and takes approximately two to three hours. Most tummy tuck patients stay in hospital for two days following the operation.

Pre Tummy Tuck and Breast Implant  The Clinic Sandymount Green,

Pre Tummy Tuck and Breast Implant
The Clinic Sandymount Green,

Post  Tummy Tuck and Breast Implant  The Clinic Sandymount Green, Dublin 4

Post Tummy Tuck and Breast Implant
The Clinic Sandymount Green, Dublin 4

Pre Tummy Tuck and Breast Implant 1 The Clinic Sandymount Green, Dublin 4

Pre Tummy Tuck and Breast Implant 1
The Clinic Sandymount Green, Dublin 4

Post  Tummy Tuck and Breast Implant 1 The Clinic Sandymount Green, Dublin 4

Post Tummy Tuck and Breast Implant 1
The Clinic Sandymount Green, Dublin 4

Abdominoplasty Procedure:

A tummy tuck is performed through a lower abdominal incision. The skin of the abdomen is dissected off the underlying muscles from the lower abdomen (pubic area) to the upper abdomen (ribcage). The following steps are completed in turn:

  1. The lax abdominal muscles are tightened.
  2. The redundant abdominal skin is removed. Generally speaking all of the skin below the tummy button is excised.
  3. The remaining upper abdominal skin is stretched and advanced downwards to the supra-pubic region and sutured.
  4. A new ‘tummy button’ is fashioned by bringing the old ‘tummy button’ through a small opening in the overlying skin.

I prefer to use dissolving sutures as opposed to staples. Staples tend to be more uncomfortable, they must be removed after about one week and they may leave marks in the skin. For these reasons I tend not to use them. Dressings are applied over the incisions and finally an elasticated pressure garment is worn for approximately one month. Two small plastic drains are used to ensure that fluid does not collect under the abdominal skin.

Recovery / Aftercare:

Week 1:

During the first week  after your tummy tuck you will rest at home confined either to bed or the living room couch. Your abdomen will feel tight and you will therefore tend to bend forward slightly to take tension of the wound. Your medication will include antibiotics and pain relief. You may be uncomfortable particularly on movement but you should be reasonably comfortable when resting. Pain is uncommon but most patients will require regular pain relief during the first week post op. Your dressings as described earlier will remain untouched throughout the first week. Not having to change dressings will help to ease the discomfort.

Week 2:

During the second week you will become more mobile with a reduction in the level of discomfort. You will have completed your antibiotic medication and you will require less pain relief. You will be able to eat better by this stage. While getting into and sitting in a car may be uncomfortable most patients come back for review during the second week. The dressings will be removed and the abdomen including the scar will be examined and your progress will be discussed. Further dressings are not usually required thereafter apart from the elasticated body garment. The drains are removed at this stage provided there is no sign of fluid collection. If you live a long distance from the hospital it may be more appropriate to defer the first review to the third week by which stage you will be feeling well and you will be better able to tolerate the journey to the clinic. Communication by telephone may be all that is required at this stage to deal with any questions or concerns that you may have.

Week 3:

You should be able to go out on a limited basis by this stage. You may have a shower but not a bath – you must not immerse the abdomen in bath water until the wound is fully healed i.e. sealed. You may be able to drive a short distance, do limited shopping and cook a light meal.

Over the following few weeks you gradually return to normal and regular activities, however if a muscle repair was carried out as part of the abdominoplasty you will not be able to return to full activities in the gym or other exertional activities for about eight weeks. Repairing and tightening the abdominal muscles is the same as repairing a hernia. The repair must be protected until the muscles have knitted tightly. If not bulging of the abdomen may recur. If a muscle repair was not required as part of the abdominoplasty your recovery will be quicker and you should be able to return to the gym and resume similar exertional activities in four to six weeks.

Irrespective of the type of abdominoplasty carried out I advise patients to wear the elastic support for about six weeks. Many patients become ‘attached’ to their elastic garment. It gives them a feeling of security when up and about, particularly when they resume exertional activities.

Expectations:

As with most cosmetic procedures very good abdominoplasty results can be achieved if the patients are carefully selected. Indeed careful selection virtually ensures that results are rarely disappointing. Factors which may lead to a less than satisfactory outcome are:

  1. Smoking
  2. Overweight
  3. Chronic illness such as diabetes or cardiovascular / respiratory disease
  4. Poor patient selection
  5. Poor surgical technique

Risks and Complications:

These are uncommon provided patients are carefully selected and provided the operation is performed to a technically high standard. The quality of the scar may sometimes be unsatisfactory and therefore may require revision. This is a relatively straightforward procedure, carried out as a day case and recovery takes approximately one to two weeks. If the scar is unsatisfactory it is worth carrying out revision. Supplementary liposuction is sometimes carried out as a secondary procedure to improve the general abdominal shape particularly of the waist and hips.

After giving birth to twins in 2010, I decided to research surgery options to improve the look of my tummy which had been left very saggy. After having two consultations with Mr Small I made the decision to go ahead with the abdominoplasty. The pregnancies had also left my breasts saggy. I wanted to have them done also but due to work pressure, I would have to get both procedures done together. Mr Small told me that as I was young, fit and healthy, the abdominoplasty and breast augmentation could be safely carried out in one operation. Mr Small explained all the risks and benefits of the surgery very clearly and I felt confident that I would get a result that I would be very happy with.

I was able to talk to Mr Small as often as I needed if I had any queries or concerns beforehand. Although I was nervous about the surgery I felt very reassured by him that this would give me a great result.The surgery went smoothly and I could see even with all the bandages that my tummy was totally flat, which was a great feeling. I stayed in hospital one night and was allowed home the following day. Mr Small and I were in contact a few times over the first week or so, to ensure my healing was on track and if I had any queries, I could just give him a call for reassurance. Within two weeks I was back at work, albeit taking it easy.

Mr Small was very reassuring and understood exactly what it was I wanted to achieve with my surgery. I can honestly say this surgery was the best decision I ever made – although very daunting, it has restored my confidence and there’s nothing better than feeling good about yourself !

Regards S.J.

 

Shown is a forty two year old professional and mother of three children, deeply unhappy about the shape of her abdomen. She is shown before surgery and five months following abdominoplasty and muscle tightening.

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I am a 42 year old lady, have 3 children and post pregnancies was left with an area of loose, sagging abdominal muscle and skin. I was very self conscious of my body shape, which led me to always wear loose fitting clothes. I go to the gym frequently but realised that sit-ups etc. were not going to improve the problem.

I researched what surgery was available and where I could access it.I chose James Small. I checked that Mr. Small had the appropriate qualifications on the required registers for practicing as a  specialist plastic surgeon.

The first consultation was excellent. I was left fully informed about the abdominoplasty I required, what the surgery entailed, possible complications and the aftercare. I had a further two consultations before deciding to have the surgery.

Abdominoplasty is major surgery and, having a young family, I required a lot of help and support in the early weeks after discharge. I returned home with two drains in-situ, a large wound and wearing a support garment. The first four to five weeks were the most difficult, waiting to get drains out, the wound healing and, most of all, being able to stand up straight again. I also had a minor complication which required me to wear the support garment for a longer period. The aftercare by Mr. Small has been excellent.

I am now six months post surgery, I have made a full recovery and am delighted with the result.

Regards

M. C.

 

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