Is Abdominoplasty Safe?

Abdominoplasty (tummy tuck) is a procedure to correct abdominal deformity due to excess skin, subcutaneous tissue and laxity of the abdominal wall musculature.

Abdominoplasty (tummy tuck) is a procedure to correct abdominal deformity due to excess skin, subcutaneous tissue and laxity of the abdominal wall musculature. Abdominoplasty is one of the most performed cosmetic surgical procedures. It is usually performed by a plastic surgeon.

• Pregnancy: Pregnancy can stretch the skin beyond its biomechanical capability to spring back and stretches the muscular structures of the abdominal wall. The result is stretching skin and thinning of the abdominal muscle.
• Massive weight loss from dieting, exercise gastric bypass surgery or after pregnancy causes excess skin and laxity of the abdominal wall.

Abdominoplasty is performed under spinal or general anesthesia and it is a major surgery.

• Abdominal wall laxity
• Excess skin
• Striae (stretch marks)
• Diastasis (separation) of the abdominal muscles
• Body contouring

• You would be an ideal patient if your body mass index (BMI) is within normal limits, have no plans for future pregnancies and only seek body contouring after weight loss.
• Moderate amount of excess of skin and fat can be treated. You need to be close to your ideal body weight prior to the surgery.
• If you are planning another pregnancy or planning to lose more than 10 lb, it is advised to postpone the procedure.
• The most accepted criterion for measuring obesity is BMI. Calculated by weight in kg divided by height in meters squared. The BMI categories are:
  • 20-25 - healthy
  • 26-29 - overweight
  • 30-34.9 - obese (category I)
  • 35-39.9 - obese (category II)
  • >40 - morbidly obese (category III)
• It is important to have realistic expectations and aesthetic goals. The excision of excess skin and fat does not flatten an abdominal wall distended from inside. If you have had multiple pregnancies with striae, results would not be like in the magazines.

Preparation

The surgeon will

• Advise the patient to stop smoking and start exercising before the surgery for overall well-being and to speed the healing process.
• Advise the patient to lose enough weight they will be close to their goal weight.
• Perform a physical examination, blood and radiological investigations.

Procedure

• Surgery is performed under anesthesia.
• Various types and sizes of incisions exist which the surgeon picks based on the patient's body shape and/ or choice of clothing.
• In most abdominoplasty procedures, the incision is low on the abdomen and hidden by underwear.
• Absorbable sutures can help reduce scarring.
• Endoscopic abdominoplasty (incision size is 2 1/2 inches) may be done in slim patients who just have a “pot belly”
• A surgical drain may be inserted to prevent blood and fluid accumulation in the operated area.
  • The drain is a clear tube inserted through a small incision below the main incision.

After the procedure

• Pain killers and antibiotics may be administered.
• The surgical site is dressed for up to 48 hours.
• The drain may be removed the same day or within 24-48 hours.
• Removal is not typically painful.
• The patient can be discharged the same day or after drain removal.
• The patient should not shower for 48 hours.
• Feeling abdominal tightness, swelling and bruising is normal and usually resolves without further problems.
• Absorbable sutures take a few weeks to dissolve.
• Patients may experience pain for 10 to 20 days which may need pain killers.
• The patient can resume normal activities after 48 to72 hours.
• Avoid lifting heavy objects, rigorous exercise, swimming and other sports for six to eight weeks.
• The patient may resume moderate walking after 10 to 14 days.
• The patient can return to work, depending on their own comfort level, nature of work, physical activity required, travel distance and approval from the surgeon.

People with the following issues should not receive abdominoplasty surgery:

• Other abdominal scars
• Severe comorbid conditions such as
  • heart disease 
  • diabetes
  • obesity
  • tobacco addiction
• Planning pregnancy
• Bleeding or blood vessel disorders
• Morbid obesity (BMI >40)
• Unrealistic expectations
• Tendency to form keloids or thick scars

Abdominoplasty is a relatively safe and commonly performed surgery. It is important to be mindful of the contraindications, follow advice and have realistic aesthetic goals. But as with any major surgery, there are complications, which include:

• Poor wound healing
• Dehiscence (cut made during a surgical procedure separates or ruptures after it has been sutured)
• Bleeding
• Blood clot formation
• Infection
• Hypertrophic scarring (formation of raised scars)
• Residual deformity
• Blood clots in the vessels
• Wide umbilical scars
• Intra-abdominal hypertension
• Acid reflux
• Temporary or permanent numbness around the incision site