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The phrase tummy tuck has been coined to describe abdominoplasty, a cosmetic surgery procedure aiming to slim and tone the lower abdomen. The procedure removes excess fatty tissues and skin and repairs damaged abdominal muscles.

Why do people choose a tummy tuck?

Quite simply, the idea is to create more tone and a flatter tummy.Many patients choosing abdominoplasty have had pregnancies which resulted in abdominal akin and muscle weakness. This creates unwanted tummy contours, little pouches of loose skin and/or belly fat which may not respond to exercise and/or dieting. Patients who have previously lost large amounts of excess weight may also choose a tummy tuck.  Another reason may be to lose stretch marks, scars from previous surgeries or as a weight reducing measure to achieve a flatter tummy. Patients typically hope to feel more confident, wear more revealing clothing without embarrassment and feel younger. There may also a multitude of other, personal motivations for choosing abdominoplasty, specific to each patient.

How is a tummy tuck done?

Patients may be advised to try to lose weight and exercise before the operation to optimise the results.  Risks from surgery and recovery should also be fully discussed with proper plans in place.

The operation itself generally takes around 2 hours. The patient undergoes full anaesthesia, followed by an incision to enable the surgeon to lift out the unwanted tissues. The incision is generally made from hip to hip, through the ‘bikini area’, although this can vary from patient to patient. Loose excess skin and fatty tissue are removed, and muscles which have become damaged (for example, herniated after multiple childbirths) are repaired. This is usually done with permanent sutures embedded into the abdominal wall. Medical tubing is inserted to allow the wound to drain hygienically and the incision is resealed with sutures. The patient recovers from anaesthesia and is given pain relief medication.

How long does it take to recover?

Many patients stay in hospital for 12-48 hrs following the operation. During the recovery phase, the wound is typically monitored at appointments with the surgeon to asses whether correct

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healing is occurring. The patient usually wears a type of medical corset, which promotes wound healing, day and night. This is generally worn for 2 to 3 weeks, after which time it may be advised to be worn during the day. During the first week, patients are generally advised to completely rest. After around 2 weeks (although again this will vary for each patient), the patient is advised to undertake light exercise to tone muscles and promote skin healing. Many patients return to work 14 days after the operation. Strenuous exercise is not generally advised for at least 6 weeks after the operation and patients also avoid placing strain on the lower abdominal area.

Weight loss without dieting?

Some sections of the media like to tag the surgery as a form of rapid weight loss without any ‘hard work’. However, in reality, plastic surgeons are commonly known to have advised patients to undertake dieting and excercise before surgery anyway, to maximise results and improve general health.

IMPORTANT DISCLAIMER:

Whilst every effort is made to give an accurate representation here, these pages CANNOT  be a substitute for professional medical advice and/or treatment under any circumstances.

Posted by: RS Brown

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2. http://www.sxc.hu/photo/958169

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In the USA, the number of tummy tuck surgeries (medical name ‘abdominoplasty’) increased by 137% from 2000 to 2007. The American Academy of Plastic Surgeons put the number  performed in 2001 at around 58,567, with women making up 97% of the patients. In the UK, the interestingly named British Association of Aesthetic Plastic Surgeons (BAAPS) reported a 31% increase, with 3,526 carried out in 2007, up from 2701 the year before.

One UK company, the Harley Medical group reported carrying out 2,000 post-natal tummy tuck operations  in 2008, reflecting a large group of patients looking to reduce and redefine tummy size following birth. The media seized on issues such as celebrity mothers regaining their figures with amazing speed, possibly influencing the trend in more women opting to have a tummy tuck after having had children.

Similarly, patient’s stories  often reflect lingering tummy fat and loose skin that would not go away with dieting and exercise. Although there will always be a minority of patients who have not tried either before paying for surgery, for many, conventional weight loss techniques did not give the results they sought. For some, the excess fat and skin became a very personal issue, restricting their choice of clothing and activities and presenting an obstacle to good self-esteem.

Financial implications

For patients in the USA and UK, the tummy tuck cost can be high compared to average earnings. A tummy tuck can cost from £4,500 in the UK, or $5,000- $10,000 or more in the USA. Healthcare insurance policies may not cover the cost of a tummy tuck, as it is not a physical medical necessity, or because the cause of the wanting the surgery is related to childbirth, a traditional exclusion on such policies.

Medical clinics around the world now offer ‘medical tourism’ or ‘medical retreat’ packages, offering cosemtic surgery including abdominoplasty at cheaper rates than their customers home countries.

Whilst for some patients, this can present a more cost-effective way to get the surgery done, the UK Dept of Health points out standards vary internationally and cautions against choosing plastic surgeons based solely on cost.

IMPORTANT DISCLAIMER:

Whilst every effort is made to give an accurate representation here, these pages CANNOT be a substitute for professional medical advice and/or treatment under any circumstances. Prices will vary from location to location and are intended here for illustrative purposes only – these figures CANNOT be taken as actual costs or as a recommendation of a reasonable or advisable price to pay.

Posted by: Media Whirl

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1. http://www.sxc.hu/profile/Blinc

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In recent years, the mini tummy tuck has gained as much popularity as a full abdominoplasty. The main differences are the mini tummy tuck uses a shorter incision (generally  lateral incisions across the bikini line) and does not involve repositioning of the navel.

The mini tummy tuck is particularly suited to patients wishing to remove excessive fatty tissue between the navel and the pubic bone. Candidates include women who have had natural childbirth or Caesarean sections; older patients and people who have mild weight fluctuations.

The procedure aims to result in a firmer, flatter tummy with greater elasticity. It may also improve stretch marks in the lower abdomen below the navel and above the pubic bone. The procedure ultimately aims to improve self confidence and self-esteem by creating a better abdominal contour.

Generally, an incision of approximately 10-15 cm is made horizontally just above the bikini line area. Excess skin is removed, along with excess fatty tissue, sometimes in combination with liposuction. If they have become damaged prior to surgery, the muscles of the abdominal wall can also be strengthened during the procedure. Abdominal muscles which have become stretched, for example through childbirth, can be repaired by suturing gaps in the muscle layers.

Although the navel is not usually repositioned as in full abdominoplasty, the surgeon generally still inserts drainage tubes to drain away blood and serum. Generally, dissolving sutures are used around the abdomen and naval to resolve the wound caused by the surgery. As in full abdominoplasty, the abdomen is bandaged and a medical corset is worn following the procedure.

The operating time is generally less than the full abdominoplasty, generally an hour or more compared to 2 hours or more.

Patients electing for a  mini tummy tuck should have a detailed discussion about whether this is the procedure most suited to them individually. Sometimes it is possible to have this procedure under local anaesthetic, although general anaesthesia may be preferable for patient comfort.

As with all cosmetic surgery:

- results will vary from patient to patient

- there are some risks of complication which are reduced (but not eliminated) by choosing qualified, specialised, ethical and experienced plastic surgeons

- risks may be increased in patients who smoke

- aftercare is key and is quite an involved process

- although surgery time and incision length are reduced compared to full abdominoplasty, the procedure remains a serious operation

IMPORTANT DISCLAIMER:

Whilst every effort is made to give an accurate representation here, these pages CANNOT be a substitute for professional medical advice and/or treatment under any circumstances.

Posted by: RS Brown

Photo Credit

1. http://www.sxc.hu/profile/Blinc

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There have been some media reports recently concerning cosmetic surgery outside the UK or USA resulting in complications and/or poor results. The British Association of Cosmetic and Reconstructive Surgeons told Sky News in 2008 they had seen 208 cases of complications from overseas cosmetic surgery, three quarters of which required treatment. Tummy tuck patients were included in those 208 cases. The new trend of plastic surgery abroad is often referred to as medical tourism. The UK Department of Health cautions patients against choosing plastic surgeons abroad solely based on cost considerations, highlighting the need to choose qualified, specialised, experienced and ethical surgical teams.

Media reports in August 2009 refered to surgeries in India and Pakistan which have been blamed for the introduction of a strain of ‘superbug’, New Delhi Metallo-1 to the UK. However, of 22 known cases by summer 2009, ten were not from overseas surgeries. The bug is of concern as it is resistant to antibiotics.

The safest advice is to repeat the need to find a qualified, experienced surgical team and be fully informed as to potential risks before committing. There may be risks of blood clotting in some cases which air travel could exacerbate.  The British Association of Plastic and Reconstructive Surgeons states patients should wait a minimum of 7 to 10 days after tummy tuck surgery before flying and be aware that tummy tuck surgery is quite a major procedure incompatible with normal holiday activities such as sunbathing on beaches, swimming, drinking alcohol, etc (1). Their advice for patients considering surgery abroad, whether they are UK, European or USA citizens provides some excellent guidelines (1).

Some more considerations

Is it possible to meet with the surgeon in the patient’s home country to discuss the procedures before committing? It could feel more pressurised and difficult to decline an operation if the patient is unhappy with the clinic abroad once they have paid for travel, time off work and any contracts have been signed.

Are the surgeon and their team specialised and experienced in this type of surgery? What professional bodies do they belong to? How many years have the team been practicing? How many procedures of this nature have they previous undertaken?

What aftercare arrangements are in place?

Given that any surgery carries potential risks, the question arises of treatment and advice should complications unfortunately occur – will the clinic cover this within the agreed price? Are there facilities on site, including doctors available 24 hrs, to deal with any acute emergencies?

Will the patients travel insurers cover any costs if any complications or error occur and does such insurance cover this type of trip per se?

IMPORTANT DISCLAIMER:

Whilst every effort is made to give an accurate representation here, these pages cannot be a substitute for professional medical advice and/or treatment under any circumstances. Nor should any inference be taken as to whether patients should or should not choose any particular surgeon or surgical procedure.  Thank you.

Posted by: Health Watcher

References:

1. British Association of Plastic Reproductive and Aesthetic Surgeons. 2008. Cosmetic surgery abroad- what you need to know. [online] London: British Association of Plastic Reproductive and Aesthetic Surgeons. Available at:

http://www.bapras.org.uk/UploadFiles/Cosmetic%20Surgery%20Abroad%20Patient%20Info.pdf

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`1. http://www.sxc.hu/profile/a51media

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Whilst there are certainly many ‘internet horror stories’ circulating about cosmetic surgery complications, one simple fact remains no matter how skilled the surgeon. Any type of surgery carries some risks of complications and plastic surgery risks are no different in this respect.

This highlights the need to choose qualified, experienced and ethical surgeons rather than simply shopping around only for the price. The risk of complications from tummy tucks are  reduced in the hands of a competent surgical team.

Although you may have come across some of the more commonly discussed complications mentioned here, this list shouldn’t be taken as medical advice – it would be impossible to state all the risks and meaningless in some ways as they will vary from patient to patient. There is simply no substitute for dialogue with the surgical team. The descriptions here only serve to emphasise abdominoplasty is a serious surgical procedure requiring specialist surgical expertise. Finally, to balance the picture, it is also equally true that this type of plastic surgery is quite routinely performed around the world.

- Bleeding underneath the skin which the drainage tubes the surgeon inserts may not be able to adequately clear, sometimes accompany by a hematoma (blood clot). This type of complication requires further corrective surgery.

- Wound infection can occur after any surgery, although prophylactic antibiotics given before surgery can help minimise this risk.

- The extent of scarring can vary from patient to patient, and may require further surgery for scar revision if it is severe or ruptures.

- Skin or fatty tissue can be subject to necrosis – literally, cell death. This appears more common in smokers (1).

- Pulmonary embolism invoices a blood clot which migrates to the lungs, although various techniques are used as routine precautionary measures to try to prevent this and occurrence is not routine.

- Numbness to abdominal region or thighs could occur if nerves become damaged during surgery. Generally, this will resolve over months, with occasionally small areas which do not regain sensation.

- Seromas can form due to collection of fluid between the muscle layer and the skin flap and could pose infections risks. Drainiage techniques aim to minimise this risk, which appears greater for patients with very high BMIs or smokers (2).

IMPORTANT DISCLAIMER:

Whilst every effort is made to give an accurate representation here, these pages CANNOT be a substitute for professional medical advice and/or treatment under any circumstances. They also CANNOT be used as the basis for any healthcare decision – please ONLY consult qualified, professional doctors for advice. Thank you.

Posted by: Health Watcher

References:

1. Kroll, S. S., MD. (1994) Necrosis of Abdominplasty and Other Secondary Flaps after TRAM Flap Breast Reconstruction. Plastic Reconstruction Surgery. 94: 637.

2. Kim, James M.D.; Stevenson, Thomas R. M.D. 2006. Abdominoplasty, Liposuction of the Flanks, and Obesity: Analyzing Risk Factors for Seroma Formation. Plastic and Reconstructive Surgery: 117 (3), pp.773-779.

Photo Credit

1. http://www.sxc.hu/profile/Blinc