Why is Tummy Tuck Surgery Required?
Tummy tuck surgery is a cosmetic surgical process. The end result is to achieve a better body contour (shape) for the patient.
Following are indications which could make any person a potential candidate for abdominoplasty:
- After Excessive Weight Loss: People who were earlier over-weight or obese, undergo surgery or a strict exercise regimen to lose weight. After losing the excess weight, they may have a lot of loose skin over the abdominal wall. Removal of the skin flab can be done with tummy tuck surgery.
- For Reducing Fat Deposits: People who have excess of fat in their abdomen could undergo abdominoplasty.
- Post-pregnancy: Women who have had multiple pregnancies, may lose their abdominal muscle tone. Muscle strengthening and toning can be done with tummy tuck surgery.
People who undergo abdominoplasty should be in good health. There are some contra-indications for this surgery. Women who are planning to get pregnant, overweight or obese patients who are planning to lose weight should not undergo this surgery.
Abdominoplasty is an invasive procedure. It involves great skill and planning. The patient and doctor must work together to ensure that the surgery is successful. The procedure is performed by a surgeon who specializes in cosmetic surgery. Before the surgery, following preparatory steps are taken:
Patient and doctor should discuss the surgery along with its advantages and drawbacks. Patients can get all their queries answered during these sessions. The surgery is an invasive procedure and may give the patient an abdominal scar. People who are concerned about cosmetic outcome of the procedure, should discuss alternatives with their surgeon. The purpose behind undergoing surgery should be spoken about. The end result should be discussed as well. The patient is required to provide the surgeon with a signed consent which mentions they are willing to proceed with abdominoplasty.
Patients who opt for abdominoplasty might be taking medicines for some other health conditions. These should be discussed with the surgeon. Patients might be asked to take certain medicines prior to surgery to avoid complications. These medicines include, antibiotics, antacids, medicines to prevent blood clot formation, laxatives.
Before tummy tuck surgery, certain blood tests need to be performed to ascertain that the patient is in good health to undergo the stress associated with surgery. An elevated white blood cell count indicates presence of some infection. Antibiotics are used to curb the infection. Surgery can be performed only when there is no active infection. High blood sugar levels are also an obstacle for surgery. If they are detected in a patient before surgery, they have to be controlled first. Only then the surgery can be performed.
- Pre-operative Restrictions
The patient should be careful to avoid excessive weight loss or weight gain prior to abdominoplasty. This could alter end result of the surgery. If the patient is a smoker, it is advisable to stop smoking about 7-10 days prior to surgery.
Day Before Surgery
Patient is advised to get admitted into the hospital a day prior to surgery. This way, it can be ensured that the patient is on time for surgery. They can also get accustomed to the hospital environment. Patient is advised not to indulge into excessive physical activity or take a lot of mental stress, prior to surgery. A complete physical examination including, checking the patient's weight is done. Blood pressure, pulse, breathing rate, body temperature are monitored at set time intervals. Tummy tuck surgery is performed under general anesthesia. Patient is completely unconscious during the procedure. The digestive tract is temporarily paralysed. There could be complications during surgery, if the patient's intestines were not empty. Stomach contents could come out of the esophagus and enter the lungs via trachea. This could lead to health complications. Laxatives and antacids could be given to the patient before surgery.
On the day of surgery, the patient is asked to dress in a lose surgical gown. All instruments and clothes used for surgery are sterilized to get rid of all microorganisms. Patients are placed in a position such that they are lying flat on their back. Their arms are placed horizontally and secured with straps to prevent them from obstructing the field of surgery.
Anesthesia is administered into a vein via an injection or via nasal route. Blood pressure, heartbeat, body temperature and breathing rate are monitored continuously during surgery. Skin over the abdomen is shaved properly to remove any hair over it. It is then cleaned with an antiseptic solution. Surgery can be started only after the patient is completely under effect of anesthesia.
Methods/Techniques of Tummy Tuck Surgery
Tummy tuck surgery required a big surgical incision to be given on the abdomen. It can be done in the following ways, depending on the accumulation of fat in the abdomen.
- Partial Abdominoplasty
This method can be opted if fat accumulation is below the navel. A horizontal surgical cut is given along the skin between pubis and belly button.
It extends from one hip to the other. Excess fat is removed. If there is excess skin over the abdomen, it is also removed. The muscles are tightened. Fascia covering the muscles is also tightened. The skin over the abdomen is then stretched and sutured together.
- Total Abdominoplasty
For this procedure, the process is the same as described above. Fat from the entire abdominal wall can be removed by this method.
Muscles, fascia and skin are tightened. The position of belly button is also moved to enhance tightening of the abdomen. Skin which is left behind is brought close together and sealed using surgical thread.
After surgery, the patient will remain under effect of anesthesia for sometime. They are transferred to a recovery room. Hospital stay may be needed for a day or two after surgery.
The patient will regain consciousness sometime after surgery is over. There will be tubes placed inside the abdominal cavity to drain any accumulated fluid. An intravenous line that is inserted into a vein in the arm or wrist, provides the necessary nutrition to the patient.
After the effects of anesthesia wear off, the patient will regain consciousness. The surgeon performs a complete physical check up for the patient. The surgical wound is covered with soft cotton and gauze and dressed in bandage.
The patient is not allowed to eat anything immediately after surgery. After physical examination, when the surgeon feels the intestinal muscles are moving normally again, the patient may start on liquids initially, followed by soft food. Smoking is strictly not allowed for some days after surgery. It is not advisable to start weight loss program immediately after surgery. Abdominal support has to be worn for 4-6 weeks after surgery.
Light non strenuous physical activity like walking around can be started soon after surgery. This will prevent accumulation of fluid or formation of blood clots. This is likely to happen if the patient remains in one position for long. However, exercises or activity which will put a strain on abdominal muscles, need to be avoided for some weeks after surgery. While moving around, care has to be taken that there is no traumatic impact on the abdominal muscle wall.
Post operative restrictions have to be followed carefully. Else there can be risks and even unsuccessful final outcome of the surgery.
Risks and Complications
- Bleeding and Blood Clots:
Tummy tuck surgery involves giving a large surgical cut on the abdominal skin. While restructuring the loose muscles, skin and removing excess fat, there is possibility that some blood vessels might be damaged. This could lead to bleeding. Blood will be drained using tubes during surgery. Accumulated blood might go on to form blood clots. Larger blood clots can be removed mechanically. Smaller ones may not be detected and may slip into the blood circulation through a vein. Blood thinning medicines are needed to dissolve the clots.
There could be pain and soreness felt at the site of surgical incision. Pain killer medicines may be taken for the same.
Since abdominoplasty is an invasive procedure, it is highly possible to develop infections at the site of surgical cut, or in the fascia, muscles, belly button. Any signs of infection like swelling, pain, redness, presence of blood or pus, should be reported to the doctor immediately. Antibiotics are prescribed for such patients.
- Surgical Scar
The surgical incision heals in a matter of few days to weeks. It will however leave behind a scar. The scar will fade but might not completely disappear. Creams or ointments might be used to try and fade the scar as much as possible.
Abdominoplasty is not advised for women who plan to have children in the future. If this happens, then during pregnancy, the abdominal skin and muscles will yet again become loose due to stretching. There might be fat deposition in the abdomen. The muscles and fascia which were tightened will lose their tone again.
Abdominoplasty is done for cosmetic reasons in most cases. Whether the result of surgery is satisfactory, will depend on the individual lookout of each patient. The surgeons trie their best to reshape the abdomen and create a better body contour for the patient. It is advisable for patients to go through the details about the planning and execution of tummy tuck surgery prior to taking a decision to undergo it.