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Information about Abdominoplasty (Tummy tuck surgery)

After childbirth, weight loss, or just the passage of time, many people suffer from loose abdominal skin and excess fat that cannot be removed no matter what their exercise and diet regime is. This can result in uncomfortable situations such as difficulty fitting into clothing, chafing underneath excess skin areas, lower back pain, and sometimes even everyday movement becomes laborious.  Fortunately, abdominoplasty surgery can help alleviate some of the effects of these problems!

Abdominoplasty (Tummy Tuck Surgery) is a procedure that can dramatically improve the look and feel of the abdomen. During this procedure, excess skin and fat is removed from the abdomen, and the muscles of the abdominal wall are tightened. This leaves the abdomen looking flatter and tighter, and feeling stronger and firmer.

Abdominoplasty surgery is an effective way to contour your physique, however it is important to note that this procedure is not a method of weight loss. Studies have shown the potential risks are far more pronounced if you possess a Body Mass Index (BMI) above 35. Being mindful of body mass before going forward with surgery can help ensure your health and safety, as well as achieving planned results.

Take the first steps in your abdominoplasty journey by exploring our website’s Patient Journey section and discover more about abdominoplasty / tummy tuck surgery! Following this initial investigation, you will be ready for a consultation with Dr. Konrat. She can provide tailored advice to help you make an informed decision about your procedure. With her wealth of knowledge and experience at hand, she will guide you through each step of this process, addressing any concerns you might have along the way.

There are two types of abdominoplasty surgery procedures:

1. Full Abdominoplasty with muscle repair.

A full cosmetic Abdominoplasty / Tummy Tuck procedure is an ideal choice for anyone looking to dramatically reduce skin laxity, excess fat, and muscle separation.

During the operation, an incision is made from just below one hip to the hip on the other side and just above the pubic region. From the incision to the lower ribs, the skin and underlying fat are lifted free of the underlying vertical abdominal muscles. The muscles are surgically tightened by stitching them into the normal position. This will strengthen the abdomen and result in a smaller, shapelier waistline. An incision is made around the navel, or belly button. When the excess skin has been removed and the remaining skin has been stretched downwards into place, a little opening will be made in the skin, and the belly button pulled through and secured into it’s new position.

At Brisbane Cosmetic Clinic, Abdominoplasty surgery is performed in a day surgery hospital under general anaesthetic. While there is a possibility of having the procedure and returning home on the same day, a one or two day stay in hospital is sometimes required to promote patient health post-surgery, and to allow for proper recovery.

2. Partial (mini) or Half Abdominoplasty/Dermalipectomy

This is not really Abdominoplasty in the true sense of the word. This procedure removes excess skin at the lower part of the tummy or abdomen following either pregnancy or weight loss. This excess skin sometimes hangs over the pubis making it uncomfortable in some types of clothing. This procedure is offered to patients who don’t have enough excess skin or fat for a Full Abdominoplasty and is sometimes referred to as a “Dermalipectomy” or skin excision only.

If the excess skin and fat are below the belly button or navel, with the skin above the navel remaining tight and with minimal excess, then a partial Abdominoplasty may be the best option. The complexity of this surgery is less than that of a full Abdominoplasty due to less skin and fat being removed, as well as the fact that the incision is not as wide and the navel does not have to be moved. A muscle repair is generally not performed during a mini tuck. This surgery generally takes approximately one hour, and in most cases, it is able to be completed as a day surgery.

Patient Journey for Abdominoplasty Surgery

Pre-Operation

An initial consultation with Dr Georgina Konrat (lasting approximately 45 minutes) will include a comprehensive discussion of all the key information regarding Abdominoplasty / Tummy tuck surgery. She will attentively listen to your motivations for going through with the procedure and the outcomes you seek.

Dr Konrat will delve into your health and medical history to allow for a completely informed decision regarding the procedure.

Dr Konrat is dedicated to providing you with the best possible care by carefully evaluating your abdominal area and its surrounding features, ensuring that all details are taken into account when devising a tailored Abdominoplasty plan.

Following the initial consultation, you will be given an information brochure and a quote for the surgery.

To ensure that you have a proper understanding of the details discussed in your consultation, we suggest taking notes as soon after the meeting as possible. Alternatively, bring a trusted family member or friend who can help recall and remember important information from the conversation with Dr Konrat. We encourage you to call or email Dr Konrat with any concerns or questions you may have about the surgery.

Before making a decision to proceed with surgery, please review our Consent for Surgery form about this surgery.

Surgery Consent Form

At least one week before your abdominoplasty surgery, blood tests will be taken as a preparatory measure. We also advise that you take time before your surgery to get your antibiotic and pain relief medication prescriptions filled to allow for a smooth process on the day of your surgery.

We encourage everyone undergoing this procedure to incorporate a diet full of vegetables, fish, fruit and salads into their lifestyle to keep your body healthy during recovery. Additionally, we suggest taking essential vitamins such as C & D, plus the minerals Zinc & Selenium.

Drugs

Avoid taking aspirin or anti-inflammatory medications 14 days leading up to and following your surgery unless otherwise advised by your doctor. Doing so could increase your risk of bruising, bleeding, or more serious complications during recovery.

Before undergoing surgery, it is important to chat with Dr Konrat about any recreational drugs you use, as this might influence the outcome of your procedure.

You must cease smoking for at least 6 weeks before your procedure, and for one month following your surgery.

Pre-operative and post-operative instructions are sent to you once you have booked a date for your surgery.

At Brisbane Cosmetic Clinic, our knowledgeable staff can provide you with helpful advice after your consultation. We not only welcome any questions that may arise following the session, but also encourage follow up consultations to ensure all your needs are met before surgery.

Abdominoplasty Operation

Abdominoplasty (tummy tuck) surgery is conducted in a licensed and accredited day surgery hospital under general anaesthetic, which is administered by a specialist anaesthetist and lasts from one to three hours. During your procedure, careful measures are being taken to provide you with the best possible care. A combination of general and local anaesthetics ensure that not only is blood loss minimized, but also to reduce post-operative pain as best as possible.

During the procedure, 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 from hip to hip). By doing this, the doctor 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 sheath) 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.

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 3-7 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 abdomen in the early post-operative period.

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

Post Operation

Post operative pain can be effectively managed as long as the patient precisely follows recovery instructions during the postoperative period. Following surgery and recovery in hospital, you will be discharged home on antibiotics and pain relief prescribed by your doctor. At Brisbane Cosmetic Clinic, the team is committed to providing you with the best postoperative care possible. During your recovery period, we will monitor and assess your progress at 24 hours, 7 days, then again in week 2, 3, 4, and 6 weeks. These important post operative appointments allow the provision of precise instructions on how much activity or exercise is appropriate, as well ensuring any required modifications to your recovery plan, along with dressing changes and care which we will implement.

Taking the recommended amount of time for healing and rest is essential when returning to work, especially in a role that requires physical labour. Generally, a break ranging from 2 to 4 weeks helps facilitate optimal recovery after the procedure. Gentle walking is normally suggested after a week to ten days, however more strenuous activities such as swimming or gym workouts should be avoided for at least 6 weeks post procedure.

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 6-12 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 5-7 days. There will be an attachment to collect the fluid. You will need to record the drainage amount daily by marking the height of fluid in the bag with a texta pen, and detailed instructions will be given to you regarding the proper care of the drain.

BATHING: Keep your incisions dry. Do not shower or bathe until after your first postoperative appointment when you have your drains removed. A sponge bath with minimal water can be appropriate. Do not have a bath, spa or swim or completely immerse yourself until advised.

DRIVING: Securing a trusted ride home after surgery and to your first follow-up visit is essential for healing. Be sure Dr Konrat gives you approval before getting behind the wheel of any vehicle.

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 hour on the hour. 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: A carefully tailored course of antibiotics and pain medication will be prescribed to you following surgery. However, be wary that it is essential in the first few weeks after surgery not to strain on the toilet. Kelloggs Guardian Flakes for breakfast every day will assist with softening the stools.

GARMENTS: After your surgical procedure, an abdominal garment will be provided to you for both comfort and optimum post-op recovery. This specialized piece of apparel offers support by reducing swelling during the healing process.

SCARS: Incisions for surgery are strategically placed in the panty or underwear lines to reduce the visibility of scars. However, scarring is still an unavoidable outcome of the procedure. While some scars may not require a procedure, others may find improvement through the use of silicone sheets or creams specially formulated to diminish the look of surgery-related scars.

You should never make a decision by reading a web page alone, no matter how comprehensive the information is. We encourage you to book a personal consultation with Dr Konrat, where she will assess you, explain the procedure in detail and help you to understand all the options as well as the risks and complications of surgery in general and abdominoplasty surgery in particular.

The decision to undergo a surgical procedure is based upon the risks of surgery versus the benefits of the procedure.

Abdominoplasty is conducted under general anaesthesia. Despite the safety protocols of using professional specialist anaesthetists, modern facilities and equipment to reduce risks associated with anaesthesia, it is important that you are counselled on any potential risks.

Despite being infrequent, allergic reactions to anaesthetic and medications can still occur. Prior history of allergies must be discussed with Dr Konrat as well as the anaesthetist prior to the procedure.

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. Patients who do not adequately rest post-surgery, patients who are diabetic, and patients who continue to smoke are more likely to experience wound healing problems. 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 apply in our clinic rooms. Surgical repair may be required if the wounds are more severely affected, or if there is tissue damage. A diet rich in protein such as meat, fish and poultry, and legume along with greens, fruits and nuts will nourish your body and provide nutrients needed for recovery and healing following surgery.

Smoking

Due to cigarette smoke constricting the small blood vessels within the tissue, smokers have a higher incidence of wound healing problems and 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)

Even following the implementation of drains post surgery, fluid and blood may collect in your wound. Rarely, this may require a return to the operating theatre, or even a blood transfusion. Taking non-steroidal anti-inflammatory agents such as aspirin up to 2 weeks prior to surgery, regardless of the dosage size, can increase the risk of bleeding. Multivitamins can also have an impact on post surgery bleeding, therefore it is essential to avoid aspirin or multivitamins in the 2 weeks leading up to your procedure unless otherwise advised by your doctor.

Seroma

This is mentioned last but it is possibly more common than all other events post surgery. Seroma is a special fluid produced by your body post surgery that can sometimes collect in the abdominal space between the skin and the muscle surface of the abdomen. It contains immune factors, inflammatory factors and growth factors along with albumin (a protein involved with healing). This fluid routinely helps with healing but may also collect and feel a little like a water bed of fluid under your skin. If the fluid build-up is too large, Dr Konrat performs an aspiration or drainage of the fluid. This usually occurs at the end of weeks 2/3 after your surgery and rarely may need drainage a second time. Rarely, a patient will experience persistent collection of fluid and will need a corrective procedure.