What is an abdominoplasty?
Abdominoplasty surgery – often referred to as a tummy tuck – lifts, tones and flattens the abdominal area by surgically removing excess skin and fat, and restoring weakened or separated muscles. It can be cosmetic or reconstructive in nature.
Skin and muscles in the abdominal region can become separated or stretched by weight loss or weight fluctuations, pregnancy, age, genetics/hereditary factors, injury or previous surgery. This can make the stomach protrude; or look distorted or disproportionate.
Tummy tuck surgery achieves a flatter, firmer abdominal wall and more flattering waistline. For women it creates ideal curves, and for men it aims to help you achieve the inverted triangle shape that draws in your lower waist to accentuate your shoulder width, and assist in creating proportion.
before and after abdominoplasty surgery with Dr Sharp
before and after abdominoplasty with Dr David Sharp: this mother of four had achieved massive weight loss following gastric sleeve surgery. She had a tummy tuck and breast augmentation.
before and after abdominoplasty with Dr David Sharp: this mother of three had achieved massive weight loss.
before and after abdominoplasty with Dr David Sharp: this 60 year old woman had undergone three previous abdominal trauma surgeries. Her abdominoplasty removed excess skin and revised internal scarring.
What does tummy tuck surgery involve?
In most cases, Dr Sharp will make a low ‘apron’ incision along your bikini line. The residual scar usually fades over time and is concealed by underwear or swimwear. He will remove saggy skin and excess fat from the middle and lower abdomen, and rejoin separated muscles.
Although a tummy tuck is usually a cosmetic procedure, sometimes it is also classified as reconstructive surgery, particularly in the following circumstances:
- structural or function defects
- obesity / extensive weight loss
- abnormally excessive overhang (called a pannus) of fat, which can cause hygiene issues, inbhibit normal activity and create skin infections.
The surgery is performed under general anaesthetic and takes two to three hours. It can be performed in a day hospital, whereby you return home on the day of surgery, with 24/7 access to our post operative nurse and post operative wound checks on day 2 and day 7 after surgery. Or you may choose to have the procedure as an in patient in a private hospital, with a three to five night stay.
Why have a tummy tuck?
The goals of abdominoplasty surgery are unique to every patient, and can include:
- To create a more normal appearance of the abdomen
- Repair abdominal hernia
- Removal of the apron of excess skin and fat
- Improvement in abdominal muscle tone and shape
- Revision of any existing scars
How do I know if abdominoplasty is right for me?
Abdominoplasty surgery can be beneficial for functional as well as aesthetic purposes, enabling more movement and reducing potential medical problems such a hernias or skin infections – while also improving self confidence and self esteem. Tummy tucks are common, however it is major surgery and should only be undertaken after due consideration under the guidance of a plastic surgeon.
Abdominoplasty should ideally be performed when your weight loss is stable. The best candidates for tummy tucks are in good health, and have stubborn pockets of fat and loose skin – or stretched skin and muscles from pregnancy.
If you are in the process of losing a substantial amount of weight with the view to obtaining an abdominoplasty, it is best to wait until you are getting close to your ideal weight before proceeding with a tummy tuck; this will ensure optimal long term results and healing. Abdominoplasty is not recommended for people who are morbidly obese.
Tummy tuck scars
Abdominoplasty involves an extensive scar, which is why it is important to choose a qualified plastic surgeon, to ensure the best techniques and approach is taken to ensure scars are as minimal as possible. Scars are low along the bikini line, and are well hidden by most underwear, swimwear and clothing.
Dr Sharp and his team offer a proven pre and post operative skin optimisation program that supports you in maintaining healthy skin quality throughout, and after, your surgical journey to reducing long term scarring. Ask us about our laser therapies to reduce the appearance of scars.
How to maintain your results
Healthy nutrition and regular physical activity, including core strength exercises and practicing good posture, are integral to obtaining and maintaining optimal long term results.
Dr Sharp and his team can also medically support your results after abdominoplasty through the non surgical treatments available at his practice, including SculpSure; a revolutionary non surgical fat reduction treatment that reduces stubborn pockets of residual fat by up to 24% in only 25 minutes, while tightening the skin. The treatment is comfortable, quick and has no down time or after-treatment pain.
Contact our experienced clinicians on 3202 4744 to find out more.
Why do I need a tummy tuck?
Even if you have a normal body weight, good diet and active lifestyle, it can be difficult to achieve a flat, toned stomach. Often, pregnancy, age, weight fluctuations, genetics, caesareans, hernias or laparotomies leave your stomach with protrusions, fat deposits and loose or sagging skin.
These need not bother you (and if that’s the case – that’s great!)
But if you find yourself limiting your wardrobe choices, feeling inhibited in front in intimate partners or covering up at the beach – and provided you have realistic expectations, there’s nothing wrong with wanting to do something about it.
How do I choose my surgeon?
Tummy tuck surgery is very safe, and performed frequently by plastic surgeons in Brisbane. However it is a major procedure – and therefore, choosing the right surgeon is of upmost importance. Abdominoplasty surgery should be performed by a qualified plastic surgeon who is registered as a Fellow of the Royal Australasian College of Surgeons. You can confirm your surgeon’s credentials here
Dr David Sharp is a qualified plastic surgeon with a special interest in reconstructive and cosmetic plastic surgery. His personalised approach means that you receive plenty of pre operative time with him to discuss your specific body goals and any questions.
It’s normal to feel both nervous, and an excited sense of anticipation, when planning your tummy tuck. Dr David takes the time to ensure you have as many consultations as you require, to ensure your treatment is customised to suit your body and expectations – and address any concerns you may have.
What is an apronectomy?
This is similar to an abdominoplasty, but is usually in the setting of massive weight loss – or post bariatric surgery. It involves the removal of a large apron of fat, called a pannus, which can cause:
- Skin infections
- Hygiene problems
- Impaired function, mobility or movement
- Chronic dermatitis
Tummy tuck + pregnancy
If you are planning future pregnancies, Dr Sharp recommends that you postpone having an abdominoplasty until you think you have completed your family.
Dr Sharp has a special interest in post-pregnancy transformations - also known as ‘mummy makeover’ surgery. Click here to read more about tummy tuck and breast surgery options for restoring pre-pregnancy body shape and condition.
Do tummy tucks remove stretch marks?
A tummy tuck does not correct stretch marks, however some of these might be removed or reduced if they are located on the excess skin that is removed, generally below the belly button.
Dr David’s clinic offers a range of safe, skin therapies that have been scientifically proven to reduce stretch marks – without surgery, needles or down time. If you are concerned about stretch marks, call 3202 4744.
What kind of anaesthetic will I have?
Tummy tucks are performed under a full general anaesthetic. A specifically selected range of medications are administered during the surgery to ensure your post-operative comfort. Dr Sharp works with an experienced team of anesthetists.
Tummy tuck incision
A full abdominoplasty involves two incisions; a horizontal one from hipbone to hipbone near the pubic hairline and another around the navel. The length of the horizontal incision depends on how much skin and fat needs to be removed, and in which areas. Weakened abdominal muscles are then repaired and sutured to bring them closer together, and excess fat and skin are excised to remove the protubing apperance of the abdomen. The skin is tightened over flat abdominal muscles.The second incision around the navel is necessary to remove additional loose skin in the mid to upper abdomen. The navel is repositioned in an aesthetically sensitive manner.
Sutures and surgical skin tape is used to close the incision.
If you have concerns about scarring after abdominoplasty surgery, talk to our skin clinician regarding the laser options we have available to accelerate healing and improve the appearance of scars.
Muscle repair during abdominoplasty
Abdominal wall muscles can become lax or separated due to pregnancy or aging. When toned, the rectus abdominus muscles join to create a flat stomach or ‘six pack’ shape. When repeatedly stretched, they can sometimes sit far apart from where they should ideally meet in the middle (called diastasis or diverication of rectus). This is corrected using permanent stitches, which pulls the muscles together for a firmer abdomen and narrower waist. Sometimes the laxity of the lateral abdominal muscles (obliques) also requires permanent sutures to create an ideal shape (called muscle plication).
Abdominal hernia repair
A weak abdominal wall, previous surgery (such as laproscopy or ceasarean) can be associated with abdominal hernias; whereby the fat surrounding the bowels, or the bowel itself, protrudes through the abdominal wall and can be seen and felt as an irregular lump.
During surgery, the hernia is pushed back through the wall, and the weakened area stitched back together and oversewn to strengthen the site.
If the weakness is large enough, sometimes Dr David places a surgical mesh to provide extra strength to the area and prevent furture hernia from forming.
Mini tummy tuck
Partial abdominoplasty involves a smaller incision; in this procedure, there is no incision around the navel as it does not require repositioning.
A mini abdominoplasty is ideal for people with a moderate degree of excess skin in their lower abdomen, with our without separation of their rectus abdominus muscles – for example, slim women who would like to remove a persistent pocket of fat and excess sagging skin after pregnancy.
Dr Sharp will advise you during your consultation as to whether or not you are a candidate for a mini abdominoplasty.
Combined tummy tuck + breast lift or augmentation
Dr Sharp performs abdominoplasty surgery alongside liposuction, breast lift, breast reduction and breast augmentation surgery. Advantages of combining procedures include the aesthetic benefit of having a ‘total’ result as well as possible cost advantages. Click here to find out more.
Tummy tuck + liposuction
Liposuction is sometimes used during abdominoplasty surgery to achieve an ideal shape and body contouring. Liposuction can be particularly useful for achieving results in areas that cannot be corrected by the tummy tuck alone, such as thighs, flanks and ‘love handles’. It is not used in the abdominal area as this can hinder healing and optimal internal repair.
In patients with an existing vertical (‘midline’) scar from previous abdominal surgery, a vertical tummy tuck may be considered.
Risks and complications
Like any surgery, you must weigh up whether the benefits outway the risks for you. While tummy tuck surgery is very common, it also carries risks. Your pre-operative consultations with Dr Sharp will enable him to discuss potential complications with you, and help you determine whether the surgery is right for you. Possible complications of tummy tuck surgery include:
- Excessive bleeding or haematoma
- Post operative infection
- Blood clots, cardiac and pulmonary complications
- Discoloured or keloid scars
- Slow or poor wound healing
- Skin or fat necrosis
- Loss of the belly button (umbilicus) due to necrosis or infection
- Numbness or sensory changes around the scar and across the abdomen.
- Wound separation (dehiscence)
- Asymmetry (lopsided) appearance to the scarline
- Persistent pain
- General anaesthesia risks
- Swelling or accumulated fluid
- Skin looseness (especially if further weight loss occurs)
Complications are rare, and Dr Sharp and his team manage each of these risks with the upmost care to further reduce the likelihood of them occurring. In the event they do occur, most can be treated quickly and easily with prompt intervention.
Everyone’s body responds differently to surgery. In some cases, post operative revision surgery might be required.
Some factors, such as weight, lifestyle or health problems can increase the chance of a complication occurring. Dr Sharp will take time to learn about your potential risk factors during your pre operative consultations, and will determine if they are relevant to your surgery.
If you have any concerns regarding your tummy tuck and the associated risks, feel free to book additional pre operative consultations with Dr Sharp.
Tummy tuck recovery
After your abdominoplasty, your incisions will be covered by dressings (bandaging) and you will be wrapped in a surgical tape to provide support and reduce swelling. During the surgery, small drains (thin plastic tubing) is placed under the skin, enabling excess blood and fluid to drain away from the site; this reduces swelling, discomfort and the chances of a haematoma forming. These tubes are removed after drainage has stopped.
You will stay in hospital for three to five days, comfortably positioned on your bed with pillows under your legs to take any pressure of the wound.
Within days of your abdominoplasty surgery, your physiotherapist will be supporting you in getting on your feet and moving around, showing you how to get out of bed to minimise straining of the abdominal muscles and suture site.
Before leaving hospital, your dressings will be replaced by a customised support garment. Restrictions after an abdominoplasty include no driving for 2 weeks and no lifting or heavy activities for 8 weeks.
Due to the hunched-over posture many tummy tuck patients acquire in the days after leaving hospital, Dr David recommends that you book a home massage to relieve sore back muscles after returning home. We can provide you with a list of recommended masseuses that provide home calls specifically for our post-surgery patients.
Within one to two weeks after your surgery, you will be able to stand up straight, and observe good posture. This will help gently re-tone your core muscles, rebuild strength and accentuate your results.
Most patients require gentle muscle tightening after abdominoplasty surgery, which means you will not be able to lift heavy weights, undertake strenuous activity or normal work outs for 12 weeks. After this time, you will be able to ease yourself back into a normal level of physical activity.
How much time should I take off work?
You should avoid strenuous activity for up to six weeks. Depending on your work, you could need to take up to a month off work, although many people return to work, particularly if it involves sedentary activity, after 2 weeks.
Benefits of having an abdominoplasty
Obvious benefits include the improved sense of body confidence that comes with having a flatter stomach – and the wider selecting of clothing and swimwear available to suit your new body shape.
The procedure will lead to improved abdominal tone, enhancing the appearance of the abdominal wall muscles.
Functionally, repairing the separation of the rectus abdominis muscles will also result in an increase in core strength.
If your ‘apron’ of skin was hanging over your pants or rubbing on the skin underneath, you will also no longer have to worry about chaffing, skin infections, dermatitis in this region.
Some patients also notice improved abdominal and pelvic muscle fnction, which can help them develop better control over defecation and urination – and help with stress incontinence.
In the long term, patients may also notice a reduction in back pain and improved posture.
How much do tummy tucks cost?
Potential costs include:
- Surgeon’s fee
- Anaesthetist’s fee
- Assistant’s fee
- Theatre costs
- Support garments
Dr Sharp performs this procedure as either an inpatient stay or as a day procedure in an accredited private hospital. The decision to have a tummy tuck as a day procedure or inpatient will cause the hospital component of your costs to vary.
Abdominoplasty for cosmetic reasons is not covered by most private health insurers. However, in some cases, your surgery might be classified as reconstructive, and therefore have a Medicare item number. If so, you might be eligible to claim a rebate from Medicare, as well as your private health fund.
In these cases, after a consultation with Dr Sharp, an application for pre-approval can be lodged with Medicare - with photographs and supporting evidence – to assist with forward planning your out of pocket expenses.
After your consultation with Dr Sharp, if there’s a possibility that your surgery meets Medicare’s criteria, you will be provided with an item number, we recommend you contact your health insurance provider and ask them if you are covered for plastic surgery, particularly siting the item number provided.
It is important to understand that, in the case of complications or revision surgery, the cost of your abdominoplasty might extend to future surgical procedures and hospitalisations. We encourage patients to think about how they would fund further treatment beyond the immediate costs expected.
Abdominoplasty results + expectations
Tummy tuck surgery produces a flatter, firmer and tighter stomach, however your immediate results can be obscured by swelling and posture restrictions.
Women who have undergone previous cesarean section are usually pleased to find that their original c-section scar is incorporated into their new tummy tuck incision.
Once you can stand up straight and observe good posture – within a fortnight of surgery – your swelling will be reduced and you will notice your new, contoured profile.
How long do the results last?
Your result will last forever (or at least as long as you do), provided you generally maintain your operative weight and don’t sustain injuries or undergo further abdominal surgery. Pregnancy and substantial weight gain are the two most common reasons why abdominoplasty results don’t last.