Tummy tuck (abdominoplasty)

Abdominoplasty – When Loose Skin and the Abdominal Wall Need to Be Brought Back into Balance

After pregnancy, major weight loss or as part of the natural ageing process, the skin of the abdomen may become loose and the abdominal wall may lose firmness. In some patients, the changes are mainly confined to the lower abdomen, while in others there is laxity both above and below the umbilicus. At the same time, there may be localised fat deposits around the abdomen and flanks, together with a widened or weakened abdominal wall.

An abdominoplasty is designed to remove excess skin, improve support of the abdominal wall and create a more harmonious transition between the abdomen, waist and hips.

At AGATA, treatment is planned individually. The aim is not simply to create a flatter abdomen, but a shape that suits the patient’s body and proportions naturally.

The Consultation

During the consultation, the amount of excess skin, skin quality and elasticity, the strength of the abdominal wall and the distribution of fat around the abdomen, hips and mons are assessed.

It is also considered whether tightening of the abdominal wall, additional liposuction or correction of the mons may be appropriate.

Treatment is tailored according to where the changes are located and how extensive they are.

Full or Mini Abdominoplasty

A full abdominoplasty may be appropriate when there is loose skin both above and below the umbilicus, significant skin excess or a stretched abdominal wall.

A mini abdominoplasty may be sufficient when the excess skin is mainly confined to the lower abdomen and the abdominal wall is otherwise relatively intact.

In cases of very significant skin excess, for example after massive weight loss, it may sometimes be necessary to combine the horizontal scar with a vertical scar in a Fleur-de-Lis abdominoplasty. This allows the skin to be tightened in more than one direction.

How is the Procedure Performed?

The procedure is performed under general anaesthesia and usually takes around 2–3 hours.

The scar is placed low on the abdomen so that it can, as far as possible, be concealed beneath underwear or swimwear. Excess skin is removed and, during a full abdominoplasty, the umbilicus is repositioned.

If the rectus muscles have separated, the abdominal wall can also be tightened by bringing the separated structures together in the midline. This can create a firmer abdominal wall and may also enhance the waistline.

If a small hernia is present in the midline or around the umbilicus, it may in suitable cases be repaired during the same operation.

Liposuction as an Additional Treatment

Abdominoplasty can be combined with liposuction, particularly of the upper abdomen, hips, flanks or mons.

Liposuction is used not only to reduce localised fat deposits, but also to improve the transition between the abdomen, waist and hips, helping to create a more harmonious and continuous contour.

Recovery

After surgery, the patient will usually stay overnight in hospital and be discharged the following day. Drains may be used and are generally removed early in the postoperative period.

An abdominal support garment is worn day and night for approximately 3–4 weeks, followed by daytime use for a further 3–4 weeks.

The patient is usually up and walking on the day of surgery. Sport, heavy lifting and more strenuous physical activity should generally be avoided for around 6–8 weeks.

During the initial recovery period, it is recommended to lie and walk with the hips slightly flexed in order to reduce tension on the surgical area.

What Happens to the Scar?

The scar is placed as low and discreetly as possible.

Initially, the scar will be visible, but it usually becomes gradually lighter and less noticeable over time.

Following a standard abdominoplasty, the scar runs horizontally across the lower abdomen. With a Fleur-de-Lis abdominoplasty, there will also be a vertical scar on the abdomen.

Are There Risks?

As with all major surgery, possible risks include swelling, bleeding, infection, fluid collection, altered sensation, minor wound-healing problems and asymmetry.

The level of risk is influenced by factors such as the extent of surgery, the patient’s general health, smoking, body weight and skin quality.

What Can Be Expected from the Result?

The aim is a flatter and more harmonious abdomen with less excess skin, a firmer abdominal wall and better balance between the abdomen, waist and hips.

The result depends on factors such as skin quality, weight stability and lifestyle. With a stable weight, the result can be long-lasting.