Is Abdominoplasty Major Surgery?

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Dr Bernard Beldholm

After pregnancy or weight loss, you may be thinking of a tummy tuck to get rid of loose skin and excess fat. It’s normal to have questions. A common one patients have is whether a tummy tuck is considered major surgery. The answer is technically no, it is not a major surgery. However, that can be misleading based on the definition of major surgery alone. Most cosmetic surgeons consider it a major operation. Like major surgery, the recovery time can be significant. So even though it’s not technically a “major” surgery, patients should know it’s not a quick surface procedure like most minor surgeries.

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What is a major surgery?

The definition of a major surgery is an operation that involves major organs such as the head, chest, abdominal cavity, etc. Some examples of major surgery include an organ transplant, brain tumour removal, hysterectomy, bariatric surgery, c-section birth, kidney surgery, or open heart surgery.

Often, major surgery involves potentially life-threatening illness or injury. These procedures involve major organs of the body. Since the major organs are involved, the risks are higher. Moreover, a person with major surgery likely has a serious underlying disease or traumatic injury requiring life-saving surgery. Again, that increases surgical risks. Operating on an individual not in good health always carries slightly more risk than operating on a healthy individual. Major surgery has little room for error in the operating room. Patients may have major surgery to save their life.

Another feature of major surgery is a prolonged recovery time. After an organ transplant or triple heart bypass, for example, the person will need to stay in the hospital for some time. Recovery continues at home. Several weeks of recovery are expected. Even then, it can take a few months for the patient to feel ‘back to normal’ again.

What is a minor surgery?

Minor surgical procedures are minimally invasive. They usually involve tissues and internal structures that are closer to the skin surface. Laparoscopic surgery or arthroscopic surgery, techniques that are less invasive than traditional surgery, are often used.

Another feature of minor surgery is smaller incisions and less tissue trauma. Small incisions allow surgical tools and/or a small camera to be inserted into the body. Meanwhile, major surgery often has larger or deeper incisions. It reaches deeper into the body, causing trauma to more tissue along the way. That’s why the recovery time is longer.

Because less tissue damage occurs, the risk of infection is greatly reduced with minor surgeries. Patients undergoing minor surgery may not be in as poor health as someone undergoing a major life-saving operation. Healthy patients often heal faster with fewer post-op risks. It’s also safer for healthy patients to undergo anesthesia than sick people.

Superficial surgeries have a fast recovery time. The patient can usually go home the same day. There is less time needed off work and driving. Examples of minor surgery include a biopsy, scar revision, sewing up a laceration, or cataract surgery,

These types of minor surgeries might surprise you

Given that major surgery involves major organs, it creates some confusion. So, what is the definition of a ‘major organ’? A major organ is defined as one you can’t live without. However, all the organs are important to a healthy, fully functional body. Yet there are some organs you can survive without.

A well-known example is appendectomy. Appendix removal is used for treating appendicitis. While it involves an organ, it is possible to live without an appendix. This procedure can be done with less invasive methods such as laparoscopy. Since it isn’t considered a major organ and can be performed with less invasive techniques, it is considered minor surgery. Recovery time is rapid and there’s a lower risk of infection compared to major operations.

Tummy tuck surgery: Here’s where things get tricky

A tummy tuck is a loose skin removal surgery. It’s often done to help women get a flat tummy after pregnancy. Post-weight loss patients also benefit from excess skin removal. Once the skin stretches due to pregnancy or weight gain, it leaves hanging skin that looks deflated. The abdominal skin is most often affected. The answer? Abdominoplasty to remove loose skin.

The extent of surgery varies based on how much loose skin a person has. Patients that have lost a substantial amount of weight often have a lot of loose skin. They may need a major tummy tuck known as a belt lipectomy, or lower body lift (LBL). This is one of the biggest tummy tuck surgeries you can have. A large amount of skin is removed 360 degrees around the tummy. Then the lower body skin is lifted, similar to pulling up a pair of pants. This is definitely a major surgery, even though major internal organ might not be involved. The skin is an organ, though. In fact, it’s the largest organ of the human body!

That’s not to say any surgery that involves skin is a major surgery. Certainly not. Since the skin is on the outermost part of the body, surgery usually isn’t too invasive. However, removing a lot of skin at once is pretty invasive. Minor surgery techniques cannot be used.

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Why else is a tummy tuck major surgery?

If a lot of skin and fat is removed, there can be more tissue trauma than other kinds of minor surgery. A full tummy tuck uses traditional surgical methods, such as cutting away the skin.

Yet it’s unlike major surgery because it doesn’t go deep into the body

A tummy tuck doesn’t involve major organs that would be life-threatening if damaged during surgery. It’s working on the skin layer and fascia. There is less tissue trauma than major surgeries that go deep into the body cavity. Sometimes abdominal muscle repair for diastasis recti is performed during a tummy tuck. There are many abdominal muscle layers. A tummy tuck with muscle repair involves the “six pack muscles” or “abs” that are closest to the skin. It’s not going very deep into the abdominal cavity like a major surgery would.

Can you have a tummy tuck under local anesthesia?

Not all abdominoplasty are major surgery. For example, a mini tummy tuck gets rid of a small flap of skin hanging on the lower abdomen after a c-section birth. Mini tummy tuck recovery time is faster than a full tummy tuck or extended tummy tuck. You may have even heard about having a mini tummy tuck under local anesthesia in the surgeon’s office.

While removing a small amount of skin may not require general anesthesia, most patients prefer not to be awake during the procedure. Then there is liposuction. Liposuction has a local anesthetic to numb the tissue mixed in it. Some surgeons perform liposuction under light sedation. Significant liposuction may require general anesthesia. A tummy tuck with liposuction definitely requires general anesthesia.

Is a tummy tuck safe?

Yes, in general. Despite being a major surgery, the risk of tummy tuck infection is low. The reason? A tummy tuck is an elective surgery. It is done for cosmetic reasons, not to save someone’s life. Most tummy tuck patients are in overall good health. This puts them at a lower risk of tummy tuck side effects such as infection. In the rare case of infection, healthy patients can usually fight off the infection with ease using antibiotics.

How long does a tummy tuck surgery take?

For example, Doctor Bernard’s Lipo-abdominoplasty (VASER lipo-abdominoplasty ) takes about four or five hours. It has two hours of liposuction. Traditional tummy tucks can be done in three to five hours. That’s quite a bit longer than most minor surgery.

You’re under a general anesthetic. You will need to stay overnight in an accredited private hospital. There are some surgeons that send you home on the day of the surgery. However, that’s not usually the safest option for the patient. Getting into a car right after the operation also causes unnecessary discomfort. Going home too soon can be risky. Staying in the hostel allows you to be monitored for complications. In Dr. Bernard’s opinion, a minimum of three to five days in the hospital is advisable. In the rare event of a complication such as wound infection, bleed, or breakdown, you can be treated immediately.

Summary

When people say minor surgery, they’re usually referring to surface procedures like skin lesion removal or something that can be done with local anesthetic. These procedures don’t require hospital admission. They don’t have a long recovery time. It doesn’t involve major organs. While tummy tuck surgery doesn’t involve major organs, a standard tummy tuck uses general anesthesia. It’s performed in a hospital. Certain types of tummy tucks like belt lipectomy or fleur-de-lis abdominoplasty may require a few days in the hospital. With most tummy tucks, you’ll need to take a few weeks off work and driving. For these reasons, most cosmetic surgeons consider a tummy tuck major surgery.

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This website contains adult content. You must be 18 years or over to read. All surgery carries risks. You should seek a second opinion before proceeding. Results vary from patient to patient. See our disclaimer.
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