Where more substantial skin and fat excess is present then a formal abdominoplasty (“tummy tuck”) is required. Skin and the underlying fat is removed right up to the umbilicus. [drawing] The upper abdominal skin is undermined and “unfolded” so that it reaches down to just above the pubic region. If the abs are separated in the midline they are stitched together and any umbilical hernia is repaired. The umbilicus is cut around and left on its “stalk”. It is brought through the repositioned upper abdominal skin and stitched at its normal level. The scar runs across the lower abdomen extending beyond the hipbones and some distance round the sides, depending on need. Liposuction of the hip areas is often included. As well as tightening the skin of the abdomen this operation has the additional benefit of a gentle lift of the perineum and the lateral thigh skin. The operation takes 2 – 3 hours under general anaesthetic.

After surgery:

You will normally spend two nights in hospital after a formal abdominoplasty. You have drains (two soft tubes attached to a suction bottle). Generally the drains will be taken out on the second morning before leaving hospital.

Numbness: with abdominoplasty there will be a numb zone of skin between the umbilicus and the surgical scar – a smaller area with mini-abdominoplasty. Some of this persists long term. There can be some patchy numbness after liposuction but this usually recovers.

Seroma: Some people will develop a fluid collection above the surgical scar. If this happens it needs to be aspirated (needle prick through the numb area of skin) twice a week until it dries up. Sometimes this can take several weeks.

Scar symmetry: It is very difficult to get absolutely perfect scar symmetry. Whether or not you have scar symmetry will depend on how closely you look!

Inevitably there will be tightness that may require you to walk slightly stooped. Beyond the first two weeks you should stretch against this tightness. Initially it is skin tightness but subsequently the tightness is caused by the sheet of healing scar tissue over the surface of your abdominal wall. It is some months before this sheet softens.  

See Risks for complications possible with any operation.  

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