An abdominoplasty (also referred to as a tummy tuck) is a surgical procedure performed with the aim of creating a smooth, flat and firmer abdomen.
The abdominal profile is influenced by skin, any associated underlying fat, and also the position of the abdominal wall muscles. A healthy lifestyle with regular exercise and sensible eating are important strategies that impact body composition and the appearance of the abdomen. However, exercise and diet alone may not be enough to keep the abdomen muscles and skin tightened.
Genetics and lifestyle influence the quality of an individual’s skin and where excess fat tends to accumulate. The skin elasticity is also impacted by weight fluctuations and aging. Previous surgery resulting in scarring to the abdomen, and changes that occur to the abdominal skin and muscles during pregnancy will also influence the appearance and function of the abdomen.
Any combination of the factors mentioned above, may result in stretching of the abdominal skin beyond its ability to retract or shrink back to its previous state. In addition to the overlying skin, any degree of muscle separation (also known as rectus diastasis) will also influence the appearance and function of the abdomen.
How abdominoplasty surgery can restore the abdomen skin and muscles
Abdominoplasty surgery (tummy tuck) consists of the removal and tightening of the abdominal skin, removal of excess fat where appropriate, and repositioning or tightening of the rectus abdominis muscles. The extent of these three components is tailored to individual requirements.
As well as improving the appearance of the abdomen, muscle repair to this area may also restore strength and stability to the abdominal and pelvic region which can reduce back pain and urinary incontinence after childbearing.
At Avery, we welcome the opportunity to have an open conversation with you to understand the changes you are looking for with surgery. Our patients’ stories matter a great deal to us. You can discover some of our wonderful patients’ journeys here.
Wherever you are on your personal journey, we would like to assist you. Dr Avery will listen to your concerns and what you want to achieve with surgery. Dr Avery will assess your health and medical history to ensure any surgical procedure you are considering is a safe and appropriate choice for you.
Common variations on an abdominoplasty include a traditional abdominoplasty, mini-abdominoplasty, a ‘Fleur de lis’ abdominoplasty, a reverse abdominoplasty, and finally a circumferential abdominoplasty or body lift.
A traditional abdominoplasty is the most common type of abdominoplasty performed and is indicated when there is an excess of loose skin that can be pinched and pulled away from the body. A traditional abdominoplasty typically achieves a flat abdominal contour with a scar that extends from hip to hip and an additional scar around the umbilicus (belly button).
The upper layers of skin and fat are then lifted up to expose the abdominal wall. These stretched abdominal muscles are then sutured together to tighten the inner abdominal core.
Once the muscles of the abdominal wall have been repaired, the remaining skin layers are stretched down below the incision on the pubic line. The excess skin is removed and a new hole is made for the umbilicus.
A mini-abdominoplasty (mini tummy tuck) can be performed when less skin removal is required and repositioning of the abdominal muscles is also required. A mini-abdominoplasty is indicated when the skin is a little loose and there is a bulge on the abdomen rather than excess skin. A mini-abdominoplasty typically requires a shorter lower abdominal incision and does not result in a scar around the umbilicus (belly button).
The following abdominoplasty variations may place scars in different locations on the abdomen influenced by the location of skin excess, previous scarring and individual goals:
Fleur de lis Abdominoplasty
The Fleur de lis (FDL) technique for an abdominoplasty is an extended variation of an abdominoplasty and is best suited when there is a pre-existing vertical scar on the abdomen or the skin is loose horizontally on the abdomen as well as vertically. The FDL surgery results in a vertical scar along the midline of the abdomen in addition to the traditional lower abdominal scar.
The reverse abdominoplasty (also referred to as reverse tummy tuck) is less commonly performed and is only considered when there is loose skin in the upper abdomen, or previous scars. This makes this procedure a safer alternative. The reverse abdominoplasty results in a scar that sits along the upper part of the abdomen, essentially underneath the breast line.
The circumferential abdominoplasty (or body lift) has a scar that runs along the full width of the lower abdomen and back.
The length of the surgery will depend on the amount of skin and tissue being removed and any additional operations being performed. A partial abdominoplasty usually takes between 1–2 hours, while a complete abdominoplasty can take between 3–4 hours.
Many women find it extremely difficult to return to their previous body shape after one or more pregnancies, even with proper diet and exercise. Some choose to combine an abdominoplasty with other surgical procedures such as liposuction, breast reduction or breast lift, or breast augmentation in what is commonly called a “mummy makeover” to achieve their desired outcome.
Plastic surgery is a varied specialty with a number of surgeries to treat a variety of conditions or concerns. A unique feature of plastic surgery is the ability of the surgical procedures to produce physical changes that can also impact psychological functioning in a positive way.
The purpose of your initial consultation with Dr Avery is to discuss both your concerns and your goals. It is an opportunity to openly communicate what you want to change, alleviate, improve, restore, enhance, or remove. We will discuss any concerns you may have about your potential surgery and its outcome. We will also collect information that is specific and tailored to you, to add to the knowledge you acquired through your research outside of the consultation process.
When you arrive at Avery, you will check in with our front-desk team and complete a medical history form, if not already completed. We encourage you to bring a supportive family member or friend who can remain with you throughout the consultation if you like, and be a sounding board during your decision-making process following the consultation process.
The consultation with Dr Avery will include an examination of the area of your body that you are concerned with and considering changing. Our aim will be to determine if plastic surgery can achieve what you hope it will, and if so, what specific plastic surgery procedures will address your concerns and meet your expectations in a realistic way.
We will discuss what the surgery involves, how it relates to you specifically given your uniqueness and current state of health, what the possible risks of the surgery are and then decide if having the surgery is a safe and appropriate choice for you as an individual.
After your consultation, our support team will be there to talk through any further questions you have including the cost of the surgery.
Plastic surgery procedures generally impact both physical appearance and your psychological response to the new changes in your body. Besides all the advantages to having plastic surgery, it is important to be fully aware of any potential limitations of the operation and how they apply to your unique situation. This includes possible complications and what can be done if these occur. Dr Avery and the Avery team will be available to answer all of your questions.
In the case of a full abdominoplasty, drainage tubes are often inserted below the main incision to allow the release of fluid. These tubes, and any residual stitches will usually be removed prior to discharge from hospital.
There will be some bruising and swelling, in addition to a feeling of muscle tightness due to the abdominal muscle separation repair, which generally subsides about 2-6 weeks after the surgery. You will be required to wear a compression garment for up to 6 weeks to provide support and reduce post-operative pain or swelling.
It is recommended that you avoid heavy lifting or vigorous exercise for at least 6 weeks after an abdominoplasty. Depending on the physicality of your job, you should be able to return to work and light exercise after 2 weeks.
A customised pain relief program will be created for you and issued before leaving the hospital. If circumstances change at any stage during the recovery period, then the pain medication can certainly be adjusted accordingly.
Scars from an abdominoplasty can vary depending on whether or not the umbilicus (belly button) is relocated and how well your skin copes with scarring. The large scar from an abdominoplasty should be hidden when wearing underwear or a swimsuit and will generally fade with time.
When undergoing abdominoplasty surgery blood clots can develop in the legs and this risk extends into the recovery period. It is also possible to have an infection at the site of the surgery and delayed wound healing.
As part of the consultation process, Dr Avery will have a more in-depth discussion with you regarding potential complications and how to reduce the risk of these.