Repairing an abdomen is cosmetically appealing but also has great functional benefit. It can make a huge difference to bending, exercising and fitting of clothing. The surgery is carried out under general anaesthetic in a private hospital and generally requires a two day stay. The area of skin and fat between the umbilicus and the pubic region is removed and the skin above mobilised down, leaving the umbilicus in its normal position. Liposuction of the hip region may be included.
Some people have skin that will contract almost completely after pregnancy or weight loss. If this doesn’t happen the result is saggy lower abdominal skin that no amount of exercise will fix. Stretch marks are evidence that the skin has stretched “beyond the point of no return”. If the cause is a large weight loss then excess skin may be removed right around the back as well (“body lift”).
The two vertical muscles (rectus abdominis, the “abs”) begin life side by side in the midline. Pregnancy can separate them by several centimetres which causes a loss of central support. This may be associated with an umbilical hernia. Exercise will strengthen these muscles but not correct their separation. You will be unaware of this separation if it is small. Tighten your abdominal muscles and feel with your fingertips in the midline. You may be able to feel the groove between the two muscles. The normal groove is only as wide as your fingertips.
Many women have a thicker layer of fat on the lower part of their abdomen than on their upper abdomen or elsewhere. This disproportion tends to persist even when weight is lost. This thicker layer is a source of discomfort when wearing fitting clothes and when bending over. If your skin quality it good then the solution may be liposuction alone.
Note the difference between fat under the skin (subcutaneous fat) and fat inside the abdominal cavity (intra-abdominal fat). Men typically lay fat down intra-abdominally which gives rise to the male “pot-belly” – not correctable with surgery. Women usually have the opposite situation with subcutaneous fat predominating but you need to be aware that if your abdominal muscle wall is convex because of intra-abdominal fat, this will persist after abdominoplasty.
- Hypertrophic or keloid scarring is uncommon. Should it happen it can usually be controlled with steroid injections into the scar.
- Asymmetry of ear projection. I have not needed to resort to surgical revision more than three or four times in the last 20 years.
- See risks common to all operations.
out of town?
Ideally a consultation should be face to face but is certainly possible to arrange a telephone consultation. If you can email the photos first so much the better. If it is clear what procedure is required then the in-person consultation can be the day before or the morning of the surgery.