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Tummy tuck (abdominoplasty)
This factsheet is for people who are considering having a tummy
tuck operation.
Abdominoplasty, commonly called a "tummy tuck", is
an operation to remove excess fat and skin from the abdomen. The
surgeon may also tighten the tummy muscles. The aim is to produce
a tighter, flatter stomach and it may partially reduce the appearance
of stretch marks.
Why have a tummy tuck?
The reasons why someone may choose to have a tummy tuck include
having excess skin, stretch marks or loose abdominal muscles which
may happen after:
- losing a lot of weight through dieting and exercise
- pregnancy
- successful surgery to treat obesity
A tummy tuck is not a treatment for weight control and is not
a substitute for regular physical activity and a healthy balanced
diet. For more information about maintaining your weight and a
healthy diet, see the separate BUPA factsheets Healthy weight
for adults and Healthy eating.
What are the alternatives?
For some people, an alternative is liposuction (or liposculpture),
where fat is sucked out through small holes in the skin. For more
information, please see the separate BUPA factsheet Liposuction.
Many creams, diet supplements and beauty treatments claim to
reduce stubborn areas of fat and even cellulite. However, there
is no scientific proof that they work.
What happens before a tummy tuck?
It is important to discuss with your surgeon what you are hoping
to gain from the operation and the result you can realistically
expect.
The surgeon will discuss how to prepare for your operation. For
example, you may be asked to:
- lose weight if you are overweight - a tummy tuck gives the
best results in people who are the correct weight for their
height1
- stop taking the contraceptive pill six weeks before surgery
and use an alternative method of contraception as this reduces
the risk of blood clotting (thrombosis) after the operation1
- give up or cut down on smoking - smoking increases the risk
of chest infection and slows the healing of wounds1
What should I expect in hospital?
Most people stay in hospital for one to three days.1
Your surgeon and anaesthetist will visit you before the operation.
This is a good time to ask any questions about the operation.
Your surgeon may draw on your tummy to mark the operation site.
You may also be measured for an elastic garment to wear around
your tummy for the first month after the operation, to reduce
swelling.1
The operation
The operation is performed under general anaesthetic, which means
that you will be asleep throughout the procedure and will feel
no pain. Typically, you must not eat or drink for about six hours
before a general anaesthetic. However, some anaesthetists allow
occasional sips of water until two hours beforehand.
During a tummy tuck, the surgeon removes excess fat and skin
from the lower tummy and if necessary, tightens the muscles of
the abdomen. Liposuction may be carried out in the same operation.
You will be left with a scar around the tummy button (which will
often be moved to a higher position) and a long scar along the
bikini line, which can usually be hidden within your underwear.
A diagram showing the abdominoplasty incisions and scar lines After the operation
When you wake up after the operation you will find a drip in
your arm. This is to give you fluid while you can't eat and drink.2
There will be a drainage tube in each side of your lower tummy
to drain any blood or watery liquid that collects from the operation
site. These drains are usually removed a few days after surgery.1
You may also be wearing anti-thrombosis compression stockings
to help the circulation in your legs and help prevent blood clots
forming (deep vein thrombosis or DVT).
Your doctor or nurse will give you painkilling tablets or injections
to reduce any pain that you have after the operation.
It is important to do deep breathing exercises to help to reduce
the risk of developing a chest infection. Your doctor or nurse
can show you how to do these.4
For the first few days, you will be asked to keep your knees
and hips bent when you sleep at night to reduce strain on your
stitches.1 Stitches in your skin will normally be removed
in five to seven days and deeper stitches closing the operation
site may be taken out two to three weeks after surgery.3
Recovering after a tummy tuck
In general, healing can be slow, particularly in the central
part of the operation site and sometimes dressings are needed
for a few weeks. You may experience some tightness around the
operation site, but this is more common in patients who are overweight
and who smoke.1
You should try to be careful not to strain or stretch the operation
site when you first get home as this will increase fluid accumulation
and reduce healing.1
As soon as you feel able, you should try to walk a little each
day. This will also help to prevent a chest infection, and blood
clots forming in your legs. If you find getting around particularly
painful or difficult, talk to the hospital or your doctor about
effective pain relief.
You may find that wearing an elastic garment helps to reduce
the swelling and makes you feel more comfortable in the first
month.1
Most people are able to return to work between two to four weeks
after the operation, but vigorous exercise is not recommended
for at least six weeks.1
Deciding on treatment
It's important not to rush into the decision to have a cosmetic
operation. And it's sensible to discuss the issue with your GP,
who may be able to recommend reputable surgeons, or give advice
about how to choose which hospitals to be treated in.
A tummy tuck is a commonly performed and generally safe surgical
procedure. For most people, the benefits in terms of improved
appearance are greater than any disadvantages. However, in order
to give informed consent, you need to be aware of the possible
side effects and the risk of complications.
Side-effects are the unwanted but mostly temporary effects of
a successful procedure. For example, feeling sick as a result
of the general anaesthetic. Anyone having a tummy tuck can also
expect that:
- there will be swelling, which may not completely settle for
a few months1
- the incisions will leave scars, which will be pink and noticeable
at first, but should become finer and less noticeable after
a few weeks
Complications are unexpected problems that can occur during or
after the procedure. Most people are not affected. The main complications
of any operation are bleeding during or soon after the procedure,
infection and an abnormal reaction to the anaesthetic. It's also
possible for a blood clot to develop in a vein in the legs (deep
vein thrombosis or DVT).
Specific complications of a tummy tuck are uncommon but can include
those listed below.
- Numbness in the lower part of the tummy which often reduces
over the next 6 to 12 months following the operation but can
be permanent.1
- Poor healing, which results in noticeable scars, may mean
you need more surgery.1,3
- Final position of the tummy button may be off-centre.1
- Bleeding can occur under the skin, causing the area to swell
and become painful. This is called a haematoma. Sometimes it
is necessary to return to theatre to stop the bleeding, remove
the blood and help avoid infection.
Other serious complications of tummy tuck operations are rare.
They include the following.
- The formation of fat or blood clots in the blood vessels.
These can break off and move to the lungs. This is called a
pulmonary embolism and can be life-threatening.
The chance of complications depends on the exact type of procedure
that is being performed and other factors such as your general
health. Your surgeon will be able to explain how the risks apply
to you.
References
- British Association of Aesthetic Plastic Surgeons, Abdominal
reduction.
www.baaps.org.uk
viewed on 26 January 2005
- The Royal College of Anaesthetists, What is anaesthesia?
www.rcoa.ac.uk
viewed on 27 January 2005
- American Society of Plastic Surgeons, Abdominoplasty.
www.plasticsurgery.org
viewed on 26 January 2005
- Clinical Evidence, Postoperative pulmonary infections.
www.clinicalevidence.com
viewed on March 2004
Published by BUPA's health information team, healthinfo@bupa.com,
April 2005
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