Abdominoplasty Primer: A Complete Guide to Tummy Tuck Surgery

Also known as tummy tuck surgery, abdominoplasty is a procedure designed to remove excess skin and fat from the abdominal area while tightening the underlying muscles. Highly requested by many of my patients, I created this primer to serve as a complete guide for anyone who’s interested in undergoing the procedure.

This Article Will:

• Provide an explanation of abdominoplasty surgery (tummy tuck)
• Describe who is a good candidate for the procedure
• Explain the various reasons to consider abdominoplasty
• Illustrate the various types of abdominoplasty procedure
• Identify the benefits of abdominoplasty
• Highlight potential risks and complications
• Go through the preparation steps
• Explain the procedure
• Describe the recovery process
• Review how to choose the right surgeon
• Detail cost considerations

Understanding Abdominoplasty

This body contouring surgery is often sought after by individuals who have experienced significant weight loss through diet, exercise, or bariatric weight loss surgery or have recently given birth, and have been left with loose abdominal muscles, stubborn fat pockets, and excessive and sagging skin, none of which have responded to traditional methods.

Though the primary goal of abdominoplasty is to improve the appearance and contour of the abdomen, a tummy tuck also has benefits beyond aesthetics.

Who is a Candidate for an Abdominoplasty?

Contrary to popular belief, not everyone is a candidate for tummy tuck surgery. Ideal candidates are those who have excess skin and fat, as well as weakened abdominal muscles due to factors like pregnancy or significant weight loss. If you’re in good health, have maintained a stable weight for at least six months, and have realistic expectations, you just might be a good fit for this procedure.

Three Reasons to Consider Abdominoplasty Surgery

1. Loose skin
2. Diastasis recti (Muscle separation)
3. Excess subcutaneous fatty tissue

1. Loose, Sagging Skin

One of the primary indications for abdominoplasty surgery is loose skin, which can occur both after pregnancy and significant weight loss. During pregnancy, the skin and abdominal muscles stretch to accommodate the growing baby, often resulting in excess, sagging skin once the baby is born. The risk for developing loose skin postpartum increases with age and rises exponentially with subsequent pregnancies. 

Similarly, individuals who experience substantial weight loss, either through diet and exercise or bariatric surgery, may find themselves with loose, hanging skin that doesn’t retract to their new body size. In both scenarios, abdominoplasty can be a highly effective solution, removing the excess skin.

It is important to note that abdominoplasty is NOT a substitution for weight loss surgery. Candidates for the procedure must be at or close to their goal weight before undergoing this procedure. 

2. Diastasis Recti (Muscle Separation)

A common condition (experienced by 60% of women during and after pregnancy), abdominal muscle separation, also known as diastasis recti,  occurs as the growing baby stretches the abdominal muscles and connective tissue, often leaving a noticeable gap and a protruding belly after childbirth. While exercise and physical therapy can help to some extent, they may not fully resolve the issue.

Diastasis recti can also occur after significant weight loss following gastric bypass and other types of weight-loss surgery  (also called bariatric or metabolic surgery) or traditional means such as diet and exercise.  

Related post: Does Exercise Really Help Diastasis Recti?

Abdominoplasty surgery can be an effective solution for repairing diastasis recti. During the procedure, the separated muscles are brought back together and stitched into place, creating a tighter and more stable abdominal wall. Not only does this improve the appearance of the abdomen but core strength may be enhanced, stability may be increased, and back pain commonly associated with weak abdominal muscles may be reduced or prevented.

3. Stubborn Fat

For patients looking to maximize the results of their tummy tuck, combining abdominoplasty with VASER liposuction can be a game-changer. An approach, known as lipo-abdominoplasty, combines the benefits of a tummy tuck with the fat-removing capabilities of liposuction without undergoing two separate procedures.

Preparing for Your Abdominoplasty

Preparation is a key component to a successful abdominoplasty experience. This includes following pre-surgery instructions including dietary restrictions, quitting smoking, and medication instructions, all of which play an important role ensuring a smooth procedure, comfortable recovery, and a successful outcome. 

Check out my comprehensive article on preparing for abdominoplasty: “Top Tips for Preparing for Your Abdominoplasty”.

Types of Abdominoplasty

Abdominoplasty can be classified into various types, each tailored to meet specific needs.

• Mini Abdominoplasty
• Full Abdominoplasty
• Extended Abdominoplasty
• FDL (Fleur-de-Lis) Abdominoplasty
• Body Lift( Belt Lipectomy)
• Lipo-Abdominoplasty

Mini Abdominoplasty

A mini tummy tuck might be the most suitable option for patients with minimal excess skin and fat. This procedure focuses solely on the lower abdomen, making it less invasive than a full tummy tuck, it’s ideal for individuals who are generally in good shape but have a small amount of loose skin and fat below the belly button.

Disclaimer: Operation performed by Dr Bernard Beldholm. Adult content, surgery has risks; individual results vary, seek 2nd opinion. Please see the full disclaimer.

A mini abdominoplasty involves a smaller incision and typically results in a quicker recovery time and minimal scarring. This procedure is also designed to address minor cases of muscle separation, focusing on the area below the belly button. 

Read more: 15 Important Mini Abdominoplasty Facts You Must Know Today.

Full Abdominoplasty Surgery

A full abdominoplasty is a more extensive tummy tuck procedure, requiring a larger incision extending from hip to hip. This type of surgery is commonly performed to address post-pregnancy changes such as muscle separation and loose skin.

Disclaimer: Operation performed by Dr Bernard Beldholm. Adult content, surgery has risks; individual results vary, seek 2nd opinion. Please see the full disclaimer.

During a full abdominoplasty, the horizontal incision across the lower abdomen allows for the removal of excess skin, tightening of abdominal muscles, and repositioning of the umbilicus (belly button.) This type of abdominoplasty, which is particularly beneficial for those dealing with more severe muscle separation, involves a more intensive recovery process. Though patients should expect longer downtime and more visible abdominoplasty scarring, the results can be life-changing, offering a significantly firmer and flatter abdomen.

Read more: “Dr. Beldholm’s Modern Approach to “Drainless” Lipo-Abdominoplasty”

Extended Abdominoplasty Surgery

Designed for individuals with significant excess skin and fat not only in the abdomen but also around the flanks and lower back, an extended abdominoplasty requires a longer incision, which allows the surgeon to address more extensive areas of sagging skin.

Disclaimer: Operation performed by Dr Bernard Beldholm. Adult content, surgery has risks; individual results vary, seek 2nd opinion. Please see the full disclaimer.

Though the extended tummy tuck is a more extensive surgical procedure, involving increased scarring and longer downtime, the results can be quite impactful, with significant improvement in the overall shape and tone of their abdominal region and flanks.

Fleur-de-lis Abdominoplasty Surgery

A specialized form of abdominoplasty, the fleur-de-lis abdominoplasty is a designed for individuals with significant excess skin and fat, particularly after massive weight loss. Named after the incision’s shape, which resembles an iris flower, this procedure allows for the removal of a larger amount of skin and fat from both the horizontal and vertical planes of the abdomen.

During an FDL abdominoplasty, the surgeon makes a vertical incision from the lower chest down to the pubic area, in addition to the traditional horizontal incision across the lower abdomen. This dual-incision approach enables the removal of excess skin and fat from the upper, middle, and lower abdomen, as well as the flanks. The result is a more comprehensive contouring effect, addressing both vertical and horizontal laxity.

Disclaimer: Operation performed by Dr Bernard Beldholm. Adult content, surgery has risks; individual results vary, seek 2nd opinion. Please see the full disclaimer.

This type of tummy tuck is particularly beneficial for those who have undergone significant weight loss and have been left with a considerable amount of loose, sagging skin that a mini, full or extended tummy tuck cannot adequately address. The fleur-de-lis technique provides significant improvements in the overall shape and tone of the abdominal region.

Due to the more extensive nature of the surgery, however, patients should be prepared for a longer recovery period and more visible vertical and horizontal scars compared to other types of abdominoplasty surgeries.

Read more: “Dr. Beldholm’s Step-by-Step Guide to Fleur-de-Lis Abdominoplasty”.

Belt Lipectomy (AKA Body Lift, 360 Body Lift, or Circumferential Abdominoplasty)

Also known as a body lift or circumferential abdominoplasty, a belt lipectomy targets multiple body areas with excess skin and fat in one or two surgeries. A belt lipectomy is a major operation that achieves quite dramatic results involves the removal of excess skin from the abdomen, hips, pubic area, thighs, and buttocks, commonly following substantial weight loss, By reshaping the entire mid-section, the procedure not only offers aesthetic results, but it also resolves skin irritations and hygienic issues, while improving comfort and mobility.

Disclaimer: Operation performed by Dr Bernard Beldholm. Adult content, surgery has risks; individual results vary, seek 2nd opinion. Please see the full disclaimer.

Perfect for tightening loose skin on the upper and lower abdomen, mons pubis, hips, lower back, bum, and thighs, and repairing separated abdominal muscles (diastasis recti), all of which are common trouble zones for people who’ve lost weight quickly, a belt lipectomy is the most extreme, extensive, and transformative of all abdominoplasty procedures.

Read more: What Happens During a Lower Body Lift Surgery Operation? Belt Lipectomy Surgery Guide.

Combining VASER Liposuction with Abdominoplasty (Lipo-Abdominoplasty)

Combining VASER liposuction with abdominoplasty can enhance the surgical outcome by providing a more contoured and refined appearance. This surgery involves perfoming liposuction simultaneously with an abdominoplasty to remove excess fat and skin to improve the overall aesthetic results.

A specialized technique that uses ultrasound technology to break down fat cells, making them easier to remove, VASER (Vibration Amplification of Sound Energy at Resonance) liposuction is particularly beneficial for targeting stubborn fat deposits that do not respond to diet and exercise.

During the procedure, the surgeon first performs VASER liposuction to liquefy and remove excess fat from the abdomen. The combination of these two procedures can offer enhanced results, providing both fat removal and skin tightening in one surgery. Patients who undergo this combined approach often experience improved body contours and a more defined waistline.

Disclaimer: Operation performed by Dr Bernard Beldholm. Adult content, surgery has risks; individual results vary, seek 2nd opinion. Please see the full disclaimer.

Benefits of Abdominoplasty

Not only does the procedure dramatically reduce significant skin laxity, creating a smoother and firmer profile, but it can also be particularly beneficial for individuals with separated abdominal muscles (diastasis recti). Quite common after pregnancy, repairing these muscles not only enhances the appearance of the abdomen but can also improve core strength and stability, a highly effective solution for reducing back pain. 

Risks and Complications of Abdominoplasty Surgery

Like any major surgery, a tummy tuck comes with its share of risks and potential complications, including the possibility of hypertrophic scars. The estimated rate of serious complications is about 1 in 25 people, which includes infections, blood clots, and healing difficulties that might require further surgery. Minor complications can include hematoma, skin discoloration, and swelling.

Infections and healing issues at the surgical site may lead to the need for skin grafts, and there’s also a risk of deep vein thrombosis, which involves blood clots forming in the legs or lungs. Changes in skin sensations, such as numbness, can also occur and may be temporary or permanent.

Read more “It’s Complicated: The Patient’s Complete Guide to Abdominoplasty Risks“.

Preparing for Abdominoplasty Tummy Tuck Surgery

The First Step

Whether you are deciding to have abdominoplasty for cosmetic or functional concerns (or both), understanding the ins and outs of abdominoplasty is crucial for anyone considering this transformative procedure. 

During our consultation, I will first assess your medical history and current medical status, discuss your goals and expectations, discuss whether you plan to have future pregnancies, answer all of your questions, and address your concerns. 

Many times the final result that you can expect will depend on the right body shape underneath.

I will then make a personalised recommendation as to the Cosmetic procedures that would be most beneficial for you.  We will also discuss the potential risks and the safety measures I implement to avoid complications.

Pre-Surgery Consultation

The consultation is also the time to discuss your expectations, surgery limitations, and potential non-surgical options for scar reduction and stretch mark treatment.

Discuss any medications and supplements you should start or stop before the surgery. Evaluate the clinic’s environment to ensure it meets your comfort and safety standards. Addressing these aspects, along with your complete medical history, helps you go into surgery with confidence and clarity. Your medical status and abdominoplasty is a significant consideration during the consultation.

Certain lifestyle adjustments are crucial for optimizing a successful outcome of your tummy tuck surgery. One of the most important changes is to stop smoking, as it can increase the risks associated with the surgery. Adopting healthy habits before surgery can significantly improve your recovery and the overall success of the procedure.

I welcome you to book a consultation with me today so that we can have a one-on-one discussion about your goals, recovery, and everything in between.

Arranging Post-Surgery Support

Post-surgery support is as important as the surgery itself. You will need assistance with everyday tasks like household chores, pet and child care, driving, and carrying groceries. Organizing help at home, whether from a family member, friend, or home health care aid can make a significant difference in your recovery process.

The Abdominoplasty Procedure

Taking the mystery out of the process is key to alleviating stress and maintaining a positive attitude, even in the rare event of a complication. Understanding the abdominoplasty procedure can help demystify the process and allow for realistic expectations. 

A partial abdominoplasty focuses on removing excess skin and fat from the lower abdomen without repairing muscle separation. In contrast, a full tummy tuck addresses both excess skin and fat across the entire abdominal area and may involve muscle tightening.

What Happens During Cosmetic Surgery?

The tummy tuck procedure is performed under general anesthesia, ensuring that patients do not feel or remember anything during the surgery. The procedure typically involves a hip-to-hip incision, although the exact style may vary based on the type of abdominoplasty being performed. Once the incision is made, the skin is separated from the underlying abdominal muscles to access and repair the abdominal wall, if necessary.

The surgery concludes with the closure of incisions using sutures, followed by the application of PICO negative-pressure wound bandage instead of a plain sterile bandage. PICO is a high-tech battery-powered apparatus that applies gentle, consistent negative pressure to the wound to aid in healing by keeping it contaminant-free while the incision heals.

Recovery After Abdominoplasty

Recovery is an integral part of the tummy tuck journey. Proper preparation and adherence to post-operative instructions can significantly enhance your recovery and overall satisfaction with the results. Knowing what to expect during both the immediate and long-term recovery phases can help you navigate this period.

While the procedure does not prevent future weight gain, maintaining a healthy lifestyle post-surgery is crucial for preserving the results. Patients might experience discomfort, nausea, and excess fluid accumulation post-surgery, which are common aspects of the recovery process.

Immediate Post-Tummy Tuck Surgery Care

Immediately after the tummy tuck procedure, expect to feel tired, disoriented, and have a sore abdomen. Common post-surgery issues include bruising, swelling, and pain, which can be managed with prescribed pain medications. Most patients will spend a couple of nights in the hospital if they undergo a full tummy tuck, while a mini tummy tuck might allow for same-day discharge.

Compression garments play a vital role in the recovery process after a tummy tuck. They help reduce swelling, provide support, and protect the wound during the first few weeks post-surgery.

Benefits of Wearing Compression Garments After Surgery

Compression garments serve many purposes to help aid your recovery after an abdominoplasty, lipo or body lift. Some of the key benefits include:

• Reduced swelling
• Lower risk of bruising and bleeding
• Speeds the healing process
• Shapes & contours
• Potentially reduced risk of keloid scarring
• Potentially Reduced infection risk
• Less pain & discomfort after surgery

Read more: How Long Do I Have to Stay in the Hospital After Abdominoplasty Surgery? – What You Need to Know

Long-Term Recovery Process

The long-term recovery process for a tummy tuck can last between 4 to 8 weeks. Having a trusted individual to assist you during the initial recovery days is crucial. Following your provider’s recommendations for pain management, taking antibiotics, and wearing compression garments are essential for promoting proper healing and preventing poor wound healing.

Most patients can return to light work within one to three weeks, but strenuous activities should be avoided for several weeks post-surgery. Avoid strenuous activities and lifting heavy objects until you get the all-clear from your surgeon.

Following post-operative care instructions, such as managing pain, caring for the incision site, and gradually resuming normal activities, is crucial for achieving the best results. Wearing a compression garment continuously for the initial weeks post-surgery supports the healing process and reduces swelling.

Read More: Recovery Following Abdominoplasty Surgery

What to Look for in a Surgeon

Finding a qualified medical practitioner to perform your abdominoplasty is critical. Here are some of the important attributes of a qualified surgeon.

• Experience: When choosing a surgeon, look for someone who has experience in performing abdominoplasty procedures.
• Reputation: Your surgeon should also have a good reputation, and be willing to answer any questions you may have. Read reviews and ask for before and after photos of past patients.
• Comforting: It is essential to feel comfortable and confident in your surgeon’s abilities. A good surgeon will take the time to address your concerns about your appearance and answer your questions about the surgery, risks, recovery, realistic expectations and scarring.
• Specialist Surgeon: A specialist surgeon in Australia has the post nominal FRACS. This stands for Fellow of the Royal Australasian College of surgeons. Surgeons from the Royal Australasian College of Surgeons (RACS) are highly trained and undergo five or six years of surgical training that is certified by the Australian Medical Council (AMC) or Medical Council of New Zealand (MCNZ). This training is in addition to their medical degree and prevocational training in a hospital.  

Cost Considerations for Abdominoplasty

The cost of a tummy tuck can vary widely based on several factors, including the surgeon’s fees, anesthesia, and hospital costs. In Australia, the price range typically falls between $15,000 and $24,000. It’s crucial to get a detailed estimate during your consultation, which should cover all associated fees.

Read more: “What is the Average Cost of Abdominoplasty (Tummy Tuck) Surgery in Australia in 2024?”

Dr. Beldholm’s Final Thoughts

In conclusion, an abdominoplasty can be a truly transformative procedure for those seeking to tighten their abdominal muscles and remove excess skin. As a surgeon, I have seen first hand the incredible difference it can make in a patient’s life. From understanding the different types of abdominoplasty to preparing for surgery and navigating the recovery process, being well-informed is crucial for a successful outcome. It’s also important to consider the costs, potential risks, and how to choose a qualified surgeon to ensure the best possible results.

As you contemplate this significant surgery, remember that the journey doesn’t end at the operating table. Proper preparation, realistic expectations, and a commitment to a healthy lifestyle post-surgery are essential for long-lasting results. I hope this guide has provided valuable insights and helped you with your decision.

Frequently Asked Questions

Can I undergo an abdominoplasty if I’ve had previous abdominal surgery?

Yes. One can still get a tummy tuck after previous abdominal surgery. Just make sure to chat with your surgeon about your medical history so they can plan it right for you.

Do I need to wear compression garments 24/7?

After surgery, many surgeons recommend wearing the garment day and night for the first 4 weeks, except to shower. Of course, this can vary depending on the exact procedure and extent of surgery. During the second phase of recovery (usually weeks 4-6), you may only need to wear the garment during the day.

What are the potential complications of abdominoplasty?

As with any cosmetic surgery or other operation, there are always potential risks and complications. Discussing them with your surgeon can help mitigate potential complications and ease your mind.

More concerning complications following abdominoplasty include cardiac issues, serious wound infection, deep vein thrombosis (blood clots forming in the legs or lungs), and healing difficulties that might require further surgery. Minor complications can include hematoma, skin discoloration, swelling, and healing issues at the surgical site. Visible and prominent scars as well as changes in skin sensations, such as numbness, can also occur.

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