Tummy tuck surgery or Abdominoplasty is a plastic surgery procedure performed under general anaesthesia in a hospital.

The abdominoplasty (tummy tuck) involves

1. Removal of excess abdominal skin and fat to reduced discomfort and the risk of skin irritation or infection
2. Tightening of the separated or split rectus muscle (six pack muscle) to improve core strength, improve abdominal muscle tone and narrow the waist
3. Repositioning the belly button
4. Liposuction to adjust the abdomen and the mons area to achieve overall balance.

During the abdominoplasty (tummy tuck) operation, while the surgeon will go ahead and perform the abdominoplasty (tummy tuck) operation, your specialist anaesthetist will monitor your safety throughout the duration of the operation. The abdominoplasty (tummy tuck) operation usually takes between three to four hours, with three to four days of inpatient hospital stay. After the operation you will have drains that are removed in about three to four days, depending on the amount of draining fluid. A postoperative abdominal binder that supports the operative area.

Currently the NSW Government has mandated that all cosmetic surgery operations are performed in accredited hospitals licensed and accredited to perform cosmetic surgery. As with every cosmetic surgery operation, across Australia majority of the tummy tuck operations are performed by specialist plastic surgeons all operations are performed by specialist plastic surgeons, who have years of experience in the field of cosmetic surgery.

Yes, you will need a full general anaesthesia for an abdominoplasty (tummy tuck) as a twilight or local anaesthesia is not adequate to give you the safe level of sedation or pain relief during the procedure. The only exception is if you have a mini abdominoplasty (tummy tuck).

It is important to understand the difference between a mini abdominoplasty (tummy tuck) and a full abdominoplasty (tummy tuck). A mini abdominoplasty (tummy tuck) is when only a small amount of skin is removed from the abdominal area. Mini abdominoplasty (tummy tuck) only provides very minimal tightening of the skin and no true tissue tightening of the abdominal muscles. In a full abdominoplasty (tummy tuck), a longer incision from the hip to hip to remove a significant amount of skin that is then vertically stitched up taking a large amount of fat with it. The muscles are tightened substantially, creating a flatter, more stable abdomen and the skin is trimmed and tightened in the midline.

A mini abdominoplasty (tummy tuck) that involves excising only the excess skin can be performed under sedation with local anaesthesia supplementation. But this depends on a case-by-case basis and your plastic surgeon will be able to give you that information at the time of the first consultation.

If you have a full abdominoplasty (tummy tuck), you will need to stay as an inpatient for a few days to help the healing process. So, it is not appropriate for the full abdominoplasty (tummy tuck) to be performed as a day surgery case. If you have a ‘mini abdominoplasty (tummy tuck)’ you will be able to go home the same day. A mini abdominoplasty (tummy tuck) involves removal of a small amount of excess skin only and no repair of the separated muscle.

The NSW government has mandated that all cosmetic surgery operations (like tummy tucks) are performed in accredited hospitals and day surgery facilities that are licensed and accredited to perform cosmetic surgery.

Yes, you will have a minimum of two drains after your abdominoplasty (tummy tuck) to help with the drainage of the excess fluid. In the first 24 hours, the drainage fluid volume will be very low because you will be resting a lot. Once you start to mobilise and walk about a bit more, the amount of fluid that will drain will be quite significant; this initial rise in output will gradually taper and settle down. When the amount of fluid drainage is less than 25 mls in 24 hours, your plastic surgeon will recommend the drains can come out. This usually occurs around day 3 or day 4 post op. Occasionally, the drainage will persist beyond the usual 3 days. In that case, your plastic surgeon may make a provision for you to go home with the drain, with daily recording of the fluid volume once this daily volume reduces to under 25 mls, the drains will be removed. You will require antibiotics while the drains are in.

Most of the sutures in an abdominoplasty (tummy tuck) will be dissolving. The successful results of abdominoplasty (tummy tuck) depend on meticulous suturing of multiple layers, the choice and strength of the suture materials.  There are specialised barbed sutures that are used to repair, tighten, and reinforce the separated six pack muscle layer. There are specialised deep sutures used to repair, tighten, and reinforce the strong fascial layers. And the final layer of skin closure will, is usually done using dissolving sutures. That means you do not need to take them out.

There will invariably be a special dressing on the skin wound that will be removed in two weeks to reveal a well healed wound of the abdomen.

Yes, you will need a course of antibiotics after abdominoplasty (tummy tuck) surgery, and often plastic surgeons will put you on oral antibiotics if you have a drain. Once the drains come out there is usually no need for antibiotics to continue.

You will have bruising after abdominoplasty (tummy tuck) surgery because the surgery is quite extensive and involves a large body surface area. In addition, as a part of the body contouring operation liposuction is usually performed to remove excess fat to contour the abdomen and the flanks. Liposuction will cause bruising, but the bruising will settle down over the course of 10 days. Bruising is basically the blood staining of tissues. The blood cells that leak out of the blood vessels are responsible for staining the tissues. Bruising often starts dark blue or blackish in colour and over 10 days will go through lighter shades before turning light pink, yellow and finally disappears.

A hematoma means there is an excessive amount of bleeding for abdominoplasty (tummy tuck) surgery that can cause a very large clot under the skin. This clot, unlike clots in the calves or the lungs, does not spread, does not get into veins, and does not enter the lungs or the heart. However, the hematoma will need to be addressed. The outcome will depend on the size of the hematoma.  If it is a large one you can end up with a contour deformity or an infection or both. Large hematomas need to be evacuated and removed under general anaesthesia in the operating theatre where you need to open the wound, remove the clot and resuture the skin. Thankfully this is quite rare.

It is natural that you will feel like stopping over after the operation. This is a normal response to the surgery. Fortunately, this does not last for very long and your body will adapt very quickly. In fact, within the first few days, you will be able to stand straight. And even if you don’t manage to stand straight in the first week because of your body’s protective posturing mechanisms, you’ll be able to feel more comfortable within two weeks when you stand straight and do not feel too tight.

The abdominoplasty (tummy tuck) operation will take on average about three hours. It can take less than three hours or more depending on how complex the operation is and what needs to be fixed during the operation. For example, if the patient is a very large person who has lost a lot of weight and needs extended abdominoplasty or a fleur de lys abdominoplasty, then the operation will take much longer than say somebody who needs a mini abdominoplasty (tummy tuck), or a very small full abdominoplasty. If there is the need to reposition the belly button, to tighten and correct muscle separation, to body contour by liposuction it all adds to the operating time of the abdominoplasty (tummy tuck) surgery.

The most comfortable position is to lie on your back with bent hips and bent knees. And this can be facilitated by the simple action of placing two pillows under your knee, so that the backs of your knees rest on those two pillows. When you are lying-in bed, this will reduce the tension on the tummy area especially the hip-to-hip scar.

The other important fact to consider is getting in and out of bed. Rotational movement of your body is hard because your abdominal muscles have been repaired and they will feel tight and uncomfortable.  Getting in and out of the bed will be a bit slower for the first 4 weeks then with practice you’ll be able to achieve this seamlessly. Similarly, getting in and out of a car will be slow during the first two weeks and will gradually get easier.

Soon after abdominoplasty (tummy tuck) surgery, your abdomen, flanks, and pubic area will swell as a response to surgery and liposuction.  The swelling is a natural response to any surgical operation. The lymphatic circulation either becomes extremely sluggish or comes to a standstill temporarily after surgery. Therefore, the fluid drainage becomes slow and sluggish. In addition, the production of fluid in the surgical site increases after the operation due to fluid leaking from the leaky and dilated blood vessels. This response is essential for the healing of tissues, but the side effect is the swelling.

The production of fluid and the accumulation of fluid usually overwhelms the ability of the body’s lymphatic system to drain the fluid and therefore, there is swelling and fluid pooling at multiple levels. This results in feeling tight, swollen, and bloated.

Compression garments used after the surgery are effective in reducing the swelling and promoting healing. Once you start mobilising and walking, the lymphatic circulation will start functioning that will help resolution of the swelling.

You can fast track the swelling reduction by lymphatic massage done by a specialist lymphatic massage therapist. The therapist will use short, swift, and gentle strokes rather than deep tissue massage, to start to mobilise the fluid that has been pooled in the areas around the abdominoplasty (tummy tuck) surgical site. Lymphatic massage can be done soon after the surgery.

Patients who have attained their ideal weight and who are fit and healthy and are prepared to go through an operation and be diligent in following all the post-operative instructions for 4- 6 weeks are ideal candidates.

It is equally important that patients must remain committed to a healthy lifestyle post-surgery to maintain the results for a very long time. Patient should have completed the family. Because if you do fall pregnant post abdominoplasty (tummy tuck), there’s a risk of undoing the structural repair performed at the time of the abdominoplasty (tummy tuck).

Patients who are concerned about their abdominal skin and contour changes post pregnancy, post weight loss changes or changes due to ageing of the abdomen are good candidates.