Everyone’s abdominal wall contour is bound to change as years go by. The skin’s elasticity will decrease and will weaken the abdominal wall’s strength. Other important factors are build, weight (local or general fat accumulation) and possible pregnancies that have stretched the abdominal muscles. After a substantial weight loss a so called fat apron is often developed. The stretched skin and sub skin fat tissue hang like a sort of apron from the underbelly.
People often complain when their abdominal wall changes in time. Sometimes it is a matter of shame: people think you might be pregnant when you are not, you cannot find appropriate clothing, or you are even ashamed for your partner. Sometimes the complaints are of a more mechanical nature: clothing is too tight or causes back ache as too much strain is put on the muscles.
A surgical correction of the abdominal wall should not be seen as a substitute for losing weight. In case of overweight the first thing to do is lose weight, because overweight is one of the risks of complications and influences the outcome of the tummy tuck.
There are different techniques for correcting the abdominal wall. Mostly the choice is based on the outcome of the physical examination, taking into account the elasticity of the skin, the condition and aspect of the abdominal wall muscles and the amount of accumulated fat.
When skin elasticity is good, abdominal wall muscles are firm and fat accumulation in the area is local, liposculpture is ideal. First a liquid is injected into the area to be treated. Then local fat is sucked away using a very thin liposuction cannula. This operation lasts about 45 tot 60 minutes and is carried out under local anaesthetic. Risks are minimal, post operative complaints hardly occur and recovery is speedy.
After the liposculpture one is advised to wear special tights. These will exercise pressure on the treated area so less blue colouring will occur and a long lasting overall slimming effect of the area treated will be guaranteed. These tights need to be worn for about 4 weeks.
When skin elasticity is not so good, the abdominal wall muscles are less firm in the area under the belly button and some fat has accumulated, a mini abdominoplasty is considered to be the best method, sometimes combined with liposuction. This involves loosening the skin and sub skin fat tissue from the abdominal wall as far as the navel. Then the abdominal muscles are sewn together again tightly in the middle of the abdominal wall.
Then the loosened layer is pulled down tightly and sewn back after first removing any excess tissue. This treatment can be combined with a liposuction of fat accumulated in the nearby area (upper belly/ flank). The advantage is that this treatment is less rigid than a total abdominoplasty, leaves less scars (no scar near the belly button) and recovery is reasonably speedy.
Abdominoplasty (tummy tuck)
When skin elasticity is poor and the abdominal muscles weak and overstretched a full abdominoplasty (tummy tuck) is to be preferred. Through a horizontal incision underneath the bikini line the skin and sub skin fat tissue are cut loose from the abdominal wall as far as the ribs. The belly button is detached from the belly skin and both abdominal muscles are sewn together tightly in the middle of the abdominal wall. Then excess tissue is removed and the wound is stitched. Finally the belly button is sewn into place again.
This treatment can also be combined with liposuction of locally accumulated fat.
Following abdominoplasty one often needs to wear a special corset which is made to measure. One will need to stay in bed for one or more days with bent knees in order not to put any pressure on the wound. It is advisable to keep wearing the corset for 3-6 weeks, especially when the abdominal muscles have been sewn together tightly. After abdominoplasty drains are usually left in the wound to collect excess liquids and blood. Drains are usually removed after two to five days.
After liposculpture some small bruising is to be expected. Larger bruising does sometimes occur. Infection of the wound is seldom seen.
Also after lipoplasty bruising is the most common form of complication, local infections do occur more often than with liposculpture (5-7%).
It will take 6 to 12 weeks before the final result can clearly be seen. Slight differences in thickness of the sub skin fat tissue may have formed.
The little holes resulting from the liposculpture will eventually be hardly visible as a tiny scar. After abdominoplasty the belly is usually flat. The horizontal scar in the underbelly tends to become a little wider. After a while it may look somewhat red and thick, but after some time almost always flattens and fades. The scar near the belly button is usually unobtrusive.
It is best to rub the scars regularly with a hydrating skin cream and to massage them for a few months to make them suppler. As the skin of quite a large area of the belly is cut loose during the operation it will become insensitive for some time. This will cause an awkward sensation when touching it, but this is usually only temporary and will disappear in the course of the next few months.
In case you have overweight, we advise you to loose some weight beforehand, as this will enhance the result of the operation. It will be more beautiful and make it more worthwhile.