Tummy Tuck (Abdominoplasty Surgery)

• You will be given an information kit to take home.  We understand that you may not remember or understand everything you hear in the consultation, so we encourage you to make notes as soon as possible after the consultation or bring a close friend or relative who can help you recall details of your meeting with Dr Konrat We encourage you to call or email Dr Konrat with any concerns or questions you may have about the surgery.
• At least one week prior to surgery, blood tests will be taken and we advise that you have your prescriptions for your antibiotics and pain relief medications filled ready for the day of surgery.
• In order to have the best healing result, Brisbane Cosmetic Clinic recommends:
• Eat a diet rich in vegetables, fish, fruit and salads
• Commence taking Vitamin C, D, Zinc and Selenium.
• Drugs:
  • Do not take aspirin or anti-inflammatory drugs ten days before and ten days after your operation.  These medicines can thin your blood and aggravate bruising or bleeding.
  • It is advised to discuss any use of ‘leisure drugs’ with Dr Konrat at the time of your consultation, as these could also have an impact on the success of the surgery.
  • You must cease smoking for at least two weeks before and one month after your surgery.
• Pre-operative and post-operative instructions are provided in the brochure given at the time of the pre-operative appointment, or are sent to you once you have booked a date for your surgery.
• Brisbane Cosmetic Clinic staff are pleased to answer any questions after your consultation, and you are encouraged to return for a second consultation any time you feel it would be useful.

The Operation

The procedure is performed under general anaesthetic, which is administered by a specialist anaesthetist in a licensed and accredited Day Surgery Hospital, and lasts from one to three hours. In addition to the general anaesthetic your abdomen is infiltrated with local anaesthetic to minimise the amount of blood loss and also to ensure that when you wake up after anaesthetic you don’t have any pain.

To repair the abdomen, a fine incision of approximately 10 – 30cm is made across the lower skin crease of the abdomen (usually just above the pubic area and extending across to the hips). Through this incision the surgeon is able to access the muscles of the lower abdominal wall, and tighten them where required. Excess skin and fat are removed from the lower abdomen after the abdominal muscles (rectus) have been tightened. In most patients, the navel is repositioned.

The skin is then lifted off the deep muscle layer as far up as the ribs. The abdominal muscles may then be tightened. Finally, the skin is pulled down, and excess fat and skin are removed. Stretch marks in the remaining skin usually have an improved appearance. Surgical drains are positioned, and exit in the pubic region. The major scar lies in a horizontal line across the lower part of the abdomen and a smaller scar around the navel. It may be necessary to make a vertical incision in the midline in cases with severe skin laxity such as if you have lost a great deal of weight.

A waterproof dressing is applied to your wounds, which means you can shower after your operation.

It is usual that very thin, soft silicone drains are inserted into the space in front of the muscles and underneath the skin to collect any fluid that may accumulate. Initially this fluid is a pinky-red colour and gradually changes to a straw colour over the ensuing 2-3 days.

When this change in the drainage fluid has occurred, the drain tubes are removed. Once the drain tubes are removed, you will be required to wear a compression or support garment to reinforce and support your lower abdomen in the early post-operative period.

Liposuction of the waist, flanks, hips may be done in association with abdominoplasty.

Post Operation

The surgery itself is usually not particularly painful, and as long as the patient rests in the post-operative period, abdominoplasty is extremely well tolerated. Following surgery and recovery in hospital, you will be discharged home on antibiotics and pain relief. During this period we will monitor your recovery and your progress and precisely advise you as to how much activity or exercise you should undertake, and also advise you regarding any modifications we may need to make to your postoperative management. The practice surgical nurse will monitor your recovery and your progress daily for the first week.

On average, most people require somewhere between 4 and 6 weeks off work, particularly work which involves heavy physical activity or exercise. Gentle walking is normally suggested after a week to ten days, and it is recommended that you don’t return to gym or swimming for a period of six weeks.

NORMAL SYMPTOMS: Remember, it is normal to experience soreness, bruising, swelling, tightness and some degree of pain for the first few days following surgery. These conditions will lessen each day. It is common to experience loss of, or diminished skin sensation after surgery. This will resolve for the most part within 4-6 weeks except for the area under the belly button. Residual skin irregularities at the ends of the incisions may be elevated and swollen, but this will improve with time.

POST-OPERATIVE CARE/DRAINS: A drain will be placed in the lower abdomen to help remove the fluid that can be present after surgery. This drain is removed after 3 – 5 days. There will be an attachment to collect the fluid, which you will need to empty every 12 hours. You will need to record the drainage amount. Empty the bulb by opening the plug at the top and pouring out the contents. Instructions will be given to you regarding this.

BATHING: Keep your incisions dry. Do not shower or bathe until after your first postoperative appointment. You may take a sponge bath. Do not have a bath, spa or swim or completely immerse yourself until advised.

DRIVING: You must have someone drive you home after surgery and to your first postoperative appointment. Do not drive until approved by Dr Konrat.

ACTIVITIES: When released from the hospital, you must REST! Absolutely NO strenuous activities. These include pushing, pulling, lifting or general exercise. You may walk the day of surgery. Put pillows behind your back and under your legs to keep your waist slightly flexed. This flexed position decreases back discomfort. You may walk up the stairs with assistance, one step at a time, and no more than twice a day. When at rest, flex and extend your feet to help decrease leg swelling. Walking is an excellent form of exercise. You should change your position and walk around the house every few hours. Absolutely no sexual intercourse or sit-ups for six weeks after surgery as this increases intra-abdominal pressure, which may be detrimental to the abdominal muscle sutures.

MEDICATIONS: You will be prescribed medicines for pain, and antibiotics. It is important in the first few weeks after surgery not to strain on the toilet. Kellogs Guardian Flakes for breakfast every day will assist with softening the stools.

GARMENTS: After surgery, you will be placed in a garment that will be provided to you for abdominal support and to reduce swelling.

SCARS: All surgery leaves scars, some more visible than others. Many may need no treatment, others may improve with the use of silicone sheets or scar remedies. All incisions are located so they can be hidden in the panty or underwear lines.

Allergic reactions to anaesthetic are extremely rare, especially in patients who have had an anaesthetic before. However, they can occur, and can be life threatening. If you have a history of allergy, it is important that you discuss this with your anaesthetist and with Dr Georgina Konrat.

Deep Venous Thrombosis and Pulmonary Embolism

There is a small risk that blood may accumulate in the large veins in the lower legs and may clot once the patient starts to move and walk post surgery. These clots may then move from the calf into the lungs where they may cause severe breathing problems, or occasionally death. The oral contraceptive pill and hormone replacement therapy can increase the risk of deep venous thrombosis. If you are taking such medication, you should discuss this with Dr Konrat and your anaesthetist prior to surgery.

Poor wound healing

Occasionally, despite an uneventful operation and normal postoperative course, you may experience problems with the healing of your abdominal wound. We know that patients who are diabetic and patients who continue to smoke are more likely to experience wound healing problems. We also know that people who do not adequately rest are more likely to have delayed healing. It is most important therefore that you don’t smoke, and that you allow time for sufficient rest after your operation. In most instances, the areas of delayed wound healing are treated with simple dressings, which we change in our clinic rooms. If the wounds are more severely affected, or if there is tissue damage, we may need to take you back to the operating theatre for further surgical repair.

Smoking

Because cigarette smoke constricts the small blood vessels within the tissue, smokers have a higher incidence of wound healing problems. In particular, smokers are much more likely to develop wound breakdown. For this reason, it is extremely important to stop smoking before the operation and for 6 weeks postoperatively.

Bleeding and haematoma (bleeding into the tissues)

Sometimes, despite using drains, fluid and blood may collect in your wound. Rarely, this may require a return to the operating theatre, or even a blood transfusion. Aspirin, as well as other non-steroidal anti-inflammatory agents taken up to 2 weeks prior to surgery, even as a single small dose, can increase the risk of bleeding. Multivitamins can also alter your bleeding profile. It is important therefore not to take aspirin or multivitamins in the 2 weeks prior to surgery.

Other risks

There are other rare risks of abdominoplasty that Dr Konrat will discuss with you during your consultation.