The Tummy tuck, or Abdominoplasty, is a great ‘mommy makeover’ postpartum, or an excellent solution for loose skin in both men and women following significant weight loss. Aside from the obvious aesthetic rewards, it can also help repair damage to lower stomach muscles, restore other abdominal functions and ease persistent back pain. Of course, as with any surgery, there is a lengthy list of risks and complications that you need to be aware of before going under the surgeons knife. Here, we’ve put together some sound information and advice about what to look out for post-procedure, to help you and your specialist surgeon manage and identify any problems that may come up during recovery.
Developing an exhaustive list of the potential complications of any surgery is problematic and here’s why: Each surgery, as well as each patient, is unique. Let us clarify this for you: If a surgeon tells you that there are never complications with their procedures, whether it’s a tummy tuck or any other surgery, they are either lying or, at the very least, incredibly inexperienced. Either way, choosing a surgeon who doesn’t completely understand the risks of the procedure himself could spell disaster for you and, in the worst case scenario, could even be deadly. This type of disinterest in a patients well being is were people run into trouble and, if this is your experience, we suggest you find an alternative specialist.
Here’s the bottom line, complications are always a possibility and it’s up to you to choose a skilled FRACS surgeon who can handle any problem that arises and provide quality care with a great recovery plan, resulting in a positive outcome. While major complications are rare, it’s important you are informed and prepared for all eventualities related to your tummy tuck procedure. Some of the risks we discuss here are unique to abdominoplasty while others are general to all surgeries.
Let’s break this down into simpler terms by starting with the most problematic of complications related to any type of surgery:
Heart problems, including heart attack during surgery are one of the top worries for patients and here’s why: Anesthesia and surgery have a range of effects on the cardiovascular system. BUT these days, unless there are any underlying heart conditions such as heart disease, these are very rare due to modern anesthetic techniques.
Anaesthesia can also affect how our lungs work after surgery and though lung problems can be serious, they are mostly manageable. More specifically, small areas of the lungs can collapse and, as a consequence, there is an increased risk of chest infection. This may require antibiotics and physiotherapy treatment. Thankfully, other potential lung complications are incredibly rare.
Blood clots in the legs with pain and swelling may occur and, rarely, part of such a clot may break off and move to the lungs, causing fatal complications. Again, these are very rare side effects but should still be discussed with your surgeon during consultation. Make a point of asking questions, such as, the relative risk according to your own personal health issues and concerns.
Next, let us walk you through some general surgery complications that are more easily managed than those mentioned above.
Allergic reactions to medications should be a priority during consultation with your surgeon pre-procedure. Obviously, it’s important for you to discuss any history of allergic reactions to medications but you also need to be aware of the signs and symptoms related to drug allergy.
Injuries to deeper structures
There is always the potential for injury to deeper structures from surgeries, such as to the nerves, blood vessels, and muscles. This will usually present as itching, tenderness, or exaggerated responses to hot or cold temperatures. Often this resolves during the healing process but, in rare cases, may be chronic and a management plan should be discussed with your surgeon as soon as possible.
Some complications will present visually and need to be managed immediately. For instance, sutures may spontaneously poke through the skin, becoming visible or producing irritation that requires removal.
Things you can do to prevent complications
Discussing your current lifestyle with your surgeon is incredibly important and here’s why: some complications are often preventable, such as wound disruption or delayed wound healing, which are more likely to occur in patients who don’t stop smoking before their operation, as should be advised by your surgeon. Generally, if wounds are dressed daily, this heals up in a couple of months. Necrosis, or skin death, can also occur at this time but is very rare.
Potential Problems Relating to your Tummy Tuck
Now, let’s take a look at some of the complications more specific to your tummy tuck procedure.
Abdominoplasty scar formation
Abdominoplasty scar formation around the umbilicus isn’t particularly unusual and is generally nothing to be concerned about. The scarring is very often pink but will fade to become white, soft and supple in the weeks or months after the operation. Most patients find that the wound heals quickly and that the appearance is ultimately acceptable to them. However, abnormal scarring occasionally occurs within the skin and deeper tissues and these may be unattractive and of a slightly different colour to the surrounding skin. Scars may also exhibit contour variations and “bunching” due to excess skin, or may even be asymmetrical, meaning a different appearance between the right and left side of the body. It is important to note that in some cases scars may require surgical revision or treatment, though this is no real cause for concern.
In rare cases keloid scars may form, which are thickened by an inflammatory process in the scar tissue. This occurs due to an abnormality of the patient’s healing process rather than through surgical error. In such instances, specialist cosmetic surgery provides a special silicone gel tape to wear over the incision after the operation, which will result in less-visible scars.
Tummy tuck infections
Infection after surgery is a big concern for patients in our experience but antibiotics are administered during the operation and you will be prescribed oral antibiotics to take afterwards as well, which will minimise any risk. Nevertheless, infections can occur and, should this be the case, they are treated either by oral antibiotics or, in severe cases, by admission to hospital for intravenous antibiotics and further drainage procedures. It is important to note that infections, superficial or deep, from an abdominoplasty happen in only about 1% of surgeries.
Pain from a tummy tuck
Postoperative pain is another common concern and will occur in varying degrees in each patient, from quite severe to moderate to mild on the first day. It gradually improves over the next few days and is usually well tolerated by patients if they take the painkillers prescribed. Increasing pain unresponsive to pain-killers should be brought to the attention of the surgeon as this may be an indication that complications are developing. Patients may not be able to stand fully erect for up to two weeks after the operation due to the tightness of the abdominal skin with resultant excessive pull on the surgical scar. Intermittent mild discomfort or intermittent sharp pains after the first few weeks after surgery is also common, as the swelling resolves and the nerves recover. Chronic pain, ranging from from mild aching pain to sharp nerve pain can persist for more than one year, but is very rare. While bruising and swelling is normal after the operation, this also varies from mild to severe with each patient.
Patient, Surgeon Management Plans
Finally, we’ll explain some of the most common complications, which are all minor wound related issues and easily managed between yourself and your surgeon.
For instance, bleeding and excessive bruising can indicate the potential for a haematoma developing, which is essentially a collection of blood under the skin. Though haematomas can often be treated with pressure, or needle aspirations in some instances they require removal through further surgery.
If you are considering an abdominoplasty you should also be aware that there are always rather long scars following surgery. Occasionally, a wide, thick or otherwise unfavourable, scars may be visible outside the underwear or bikini. Rare complications related to the liposuction can include injury to deeper structures such as the abdominal wall, bowel, nerves and blood vessels and some numbness in the lower abdomen will result. Sensation usually returns fully, though in rare cases some of the numbness will be permanent.
There is also the potential for a seroma to develop after surgery but this will often dissipate over time. A seroma is a collection of serous fluid, a liquid that your body makes to heal and seal wounds edges together. Generally the fluid naturally drains away, however, in some cases there may be too much fluid produced in the seroma, which will usually occur at the site of incision, and it may not drain away completely but calcify instead. In this case surgery may be necessary, so make sure you bring any prolonged or unusual swelling to the immediate attention of your specialist, so it can be properly monitored.
Surgical drains (tubing) are rarely required for a tummy tuck these days but on occasion, for example in the treatment of haematoma or seroma, they may be necessary and these tubes may protrude from or near my horizontal incision for up to one week.
For the majority, a successful tummy tuck is a life changing procedure. It will give you the confidence and the body that, either you always wanted, or that you previously had, before weight gain or childbirth. At the same time, it is not a simple surgery and recovery can take time. Knowing the complications, risks and side effects discussed here may seem scary but the intent is to inform and prepare you for this big change in your life. We believe that knowledge is power and information is key. Being aware of potential risks as a result of any surgery could be life saving information. At the very least, you deserve the best result from your financial and emotional investment in an abdominoplasty.
The bottom line is that discussing these topics freely with your surgeon will allow you to better understand how they plan to manage any problems that may occur. If you feel your surgeon is not fully prepared for any eventuality, then this is an indication that your investment would be better spent elsewhere and your health and wellness placed in the hands of someone more capable.