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Abdominoplasty (Tummy Tuck) Sydney

Tummy Tuck, also known as Abdominoplasty, is an operation designed to address a number of concerns with the abdominal wall. For many patients, it is far more of a reconstructive procedure than a cosmetic procedure.

To accurately understand this issue, it’s crucial to delve into the true meaning of the term “reconstruction.” This exploration aims to dispel the common, albeit mistaken, belief that a Tummy Tuck is exclusively a cosmetic procedure. The definition of reconstruction is to return to a state (or create a state) that is normal for an individual’s age, race, and gender.

This becomes clearer when dissecting the meaning of the word “normal.” In the context of the human form, normal refers to something functional or acceptable for that particular individual. Excluding those rare individuals with body dysmorphic disorder, ‘normal’ is in the eye of the beholder. The spectrum of normal is broad, meaning what is normal for one person may be abnormal if applied to another. The prevalence of a specific body issue does not make it normal.

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What is a Tummy Tuck (Abdominoplasty)?

Tummy Tuck, also referred to as Abdominoplasty, is a surgery performed to address concerns that relate to the belly following trauma, pregnancy and/or weight loss. The most common concerns are stretch marks (scars caused by skin that has been forced to stretch too much too quickly), excess skin, excess fatty tissue and weakened separated muscles. Other problems can include hernias involving the belly button and significant abdominal wall muscle separation that can affect posture and result in lower back pain. In addition, individuals can express concerns regarding their pubic area which includes fullness and ptosis (droop). This typically causes difficulties with tight fitting clothing and hygiene problems.

These concerns can be addressed with a well-planned Tummy Tuck (Abdominoplasty). The excess skin can be removed including most, if not all, of the lower abdominal wall stretch marks. Doing this means removing many of the stretch mark scars that you can’t hide, and creating a single scar below your bikiki line that can be comfortably hidden. If required (and it usually is), the pubic area is thinned out and lifted.

Also, any muscle separation (along with any hernias) is also repaired. This is a vital part of most Tummy Tucks and provides significant functional benefits. Ultimately the purpose of a Tummy Tuck (Abdominoplasty) is to primarily change function (medical/lifestyle issues) and secondarily change form (appearance).

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THE SURGERY

PLANNING AN ABDOMINOPLASTY IN SYDNEY, AUSTRALIA

Understanding what a Tummy Tuck (Abdominoplasty) is, including some of the different types, and what happens during your first consultation with Dr Dona.

Initial consultation in Sydney, prior to your Tummy Tuck (Abdominoplasty) Surgery

If you’ve booked a consultation to visit and discuss Tummy Tuck (Abdominoplasty) Surgery, then there’s a few things to know about what happens on that day.

Firstly, upon arriving at our Sydney clinic you will be met by our friendly team, and they will walk you through the initial patient registration process. Once this is done, you will be ready to be taken through for your initial consultation with Dr Dona.

During this consultation, you will asked a number of questions, including about your relevant medical background, history of surgery, especially abdominal surgery, and your general tummy concerns.

Dr Dona will then carry out a physical assessment and assess your belly and all concerns you have with it, including skin, fat and muscle issues.

Once you are assessed, and if you are considered suitable for surgery, then a surgical plan is created to suit your goals. Of course, an important part of this process is ensuring you have a realistic expectation about the results achievable.

Dr Dona will then discuss the details of the surgery, your expected recovery period and inform you about the potential risks and complications that allow you to make an informed decision.

During this entire process you will be able to ask any questions you have related to your considered surgery. Fortunately, all of our patients are required to watch a number of explanatory videos prior to their first consultation to make the entire process as productive as possible.

Photos are then taken for our medical records.

Finally, you will then discuss with one of our friendly team members, the costs and any logistics regarding possible surgery dates.

DIFFERENT TPYES OF ABDOMINOPLASTY

The term Abdominoplasty (Tummy Tuck) is really a simple term that encompasses any operation that reconstructs the abdominal wall. This is because the degree of problems one has will dictate the type of abdominoplasty that is necessary.

The different names applied to the different Tummy Tucks typically relates to the surgical scars created. Common names include:

 

  • STANDARD TUMMY TUCK (ABDOMINOPLASTY)

 

 

 

  • REVERSE TUMMY TUCK(Abdominoplasty) – the scar pattern is isolated to the upper abdominal wall and lower chest region and lifts the abdominal wall skin. The scar does not extend to the back and is essentially the front half of a BRA LIPECTOMY (upper body lift).

 

  • BELT LIPECTOMY combines two operations: a Buttock Lift and a Tummy Tuck (Abdominoplasty), which results in one continuous circumferential scar contained within the belt line.

 

Many variations exist within each type and the above is a very simplistic breakdown.

STANDARD TUMMY TUCK (ABDOMINOPLASTY)

A traditional Tummy Tuck operation involves correcting all three abdominal wall layers; that is, the skin, fat, and muscle layers. A horizontal incision is made in your lower abdomen. This incision is usually made from hip to hip, just above your pubic region.

The resultant scar will appear under the bikini line and thus can be easily concealed by regular underwear. Another incision is made around the navel to free the navel from the skin and fatty layer.

The skin and fat are lifted from the underlying abdominal muscles to the level of the rib cage. The ‘six-pack’ muscles are usually stitched together from the top to the bottom to surgically tighten them. This helps to restore a normal alignment to the ‘six-pack’ muscles and corrects any central hernias. Additionally, tightening these muscles acts like an internal corset, strengthening the abdomen and helping create a stronger core. This muscle repair can sometimes help with lower back pain and continence issues. The skin and fat layers are then stretched down, and the excess skin and fat are removed from the lower abdomen. If required, the pubic area is lifted at the same time. Finally, a new opening is made for the navel, and it is stitched into position.

 

Mini Tummmy Tuck

Mini Tummy Tuck (Abdominoplasty)

Many people often enquire about a Mini Tummy Tuck (Abdominoplasty).

The first thing to realise is that only a small group of women would benefit from a Mini Tummy Tuck (Abdominoplasty).

The Mini Tummy Tuck is only suitable for those few women who have a little bit of loose skin in the lower abdominal area – just above the pubic level. It also means that you’re happy with and don’t need to change the skin around the belly button and upper abdominal region.

The Mini Tummy Tuck basically removes this excess and loose skin at the very lower abdomen, just above the pubic area.

The scar is often not much larger that a caesarean scar and the belly button is not “moved”. It’s typically a day surgery procedure and usually not associated with any muscle tightening.

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Fleur-de-lis Tummy Tuck (Abdominoplasty)

Most Tummy Tucks (Abdominoplasty) result in a single scar along the lower abdomen, which is nicely concealed within normal underwear line, and an additional scar around, or within, your belly button. However, sometimes an additional scar is also required along the entire midline of your abdomen up to you lower chest. This type of Tummy Tuck (Abdominoplasty) is referred to as a Fleur de Lis Tummy Tuck (Abdominoplasty).

When someone has lost a massive amount of weight, they often have a lot of excess skin hanging, and also have excess skin side to side. The Fleur De Lis scar pattern will allow for more excess skin removal.

In doing so, you maximise the change in your body form. Of course, the cost for that is accepting a scar vertically along the length of your belly. In the end, only you can say what you are prepared to accept – more excess skin removal which means more scars, or less scars and therefore less excess skin removal.

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OPEN BOOK TUMMY TUCK™ (ABDOMINOPLASTY)

With the ever-increasing number of people undergoing life changing massive weight loss, alternative options were necessary to reconstruct their bodies. As such, the OPEN BOOK TUMMY TUCK™ (OBTT) was an operation born out of necessity. Dr Dona introduced this technique and coined the term ‘Open Book’ based on how the abdominal wall appears halfway through the operation – the skin and fatty layers are opened like a book before being closed into its new form.

An analogy often used by Dr Dona to help patients understand the necessary scars required for the surgery is dressmaking. Your skin represents your older dress or outfit that you wore when you were larger. Your body is now much smaller and healthier, but you’re still wearing that old dress. So basically, the surgeon needs to tailor your skin to suit your now smaller body. With respect to an abdominoplasty procedure, the greater the amount of excess skin that exists, the greater the size and number of scars necessary to reconstruct.

The OBTT is a surgical procedure typically utilised in those individuals who have experienced significant weight loss and therefore require significant reconstruction. In addition to the two scars of a Fleur-De-Lis Tummy Tuck (Abdominoplasty), the OBTT has a third scar extending horizontally along the entire lower chest in the lower breast fold. With an OBTT, the midline scar joins these two horizontal scars – lower abdominal and lower chest scars. Unlike the FDL technique, this additional scar also allows for the removal of excess side to side skin along the upper abdominal wall (not just the lower) via the removal of a wide segment of skin along the midline from top to bottom.

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FAQ'S

Tummy Tuck (Abdominoplasty) FAQ

Some of the commonest questions about Tummy Tucks (Abdominoplasty) including what it can do for you and the potential results.

Diastases Recti

Will a Tummy Tuck (Abdominoplasty) correct muscle separation?

One of the common problems associated with pregnancy is separation of the abdominal six pack muscles, officially known as Diastases Recti.

This can vary from mild to extreme.

This causes a few issues.

  • Firstly, it results in a greater abdominal girth than is necessary, which basically means your belly is bigger than it needs to be.
  • In extreme cases it can act very much like a hernia, so when you strain a large ridge like fullness protrudes along your abdominal wall midline.
  • With significant separation, it can potentially result in a disturbed biomechanical performance of your entire lower back and midsection. So basically, your core strength is not as great as it should be, you get increased arching of your lower back and the resultant back pain.
  • These muscle issues can potentially have an impact on bladder control.

Ultimately, a routine part of most Tummy Tucks is tightening of these separated muscles to help re-align the muscles, tighten your waistline and improve your core strength.

Occasionally, in some women who have great skin quality and tone but significant muscle separation, you could have a minimal access surgery designed to just repair your muscles. This is done via a lower abdominal incision similar to a caesarean scar with or without an additional small belly button incision.

Back pain & rinary incontinence

Will a Tummy Tuck (Abdominoplasty) help my back pain & urinary incontinence?

Some people that have seriously separated rectus muscles and effectively have a large midline hernia often experience lower back pain due to the significant biomechanical disturbance to the core and back. These patients often claim an improvement in back pain after this is corrected. So this can be considered an added benefit to having the surgery.

In addition to this, some women claim that urinary incontinence is improved after a Tummy Tuck with muscle tightening. However, Dr Dona would never encourage a patient to undergo surgery if incontinence is the primary concern as it may make no difference. Any improvement in urinary incontinence after a Tummy Tuck should be considered an additional bonus to the surgery.

Hernia

Can you repair my Hernia during the Tummy Tuck (Abdominoplasty)?

Abdominal wall hernias are relatively common, and many people wanting a Tummy Tuck (Abdominoplasty) that also have hernias ask if the hernia can be repaired at the same time.

The first thing to appreciate is that the muscle separation is very common especially after pregnancy and is in many ways a type of hernia. It is an area of weakness along the midline and in some people, it can protrude ridge like down the midline when they strain.

Repairing this involves tightening up and re-aligning the muscles to close this weakness.

Abdominal wall hernias are common along this midline, and they are typically found at or near the belly button. These are a significant potential problem and ideally should be repaired due to the potential complications they can cause. When performed by a general surgeon, the repair of these hernias can involve an incision within or near the belly button, and often the placement of a mesh to patch the hernia hole. This often means that the belly button has been completely detached from the underlying muscles. This has potential consequences as it can result in problems with the belly button if that patient was to later have a Tummy Tuck. In simple terms, if you’ve had a previous repair of an umbilical hernia, and you then go on to have a Tummy Tuck, depending on how that previous surgeon fixed your hernia, you could end up with wound healing problems with your belly button. This basically means after the Tummy Tuck the belly button could ulcerate and die off, becoming a wound that takes many weeks to heal. This is because without knowing exactly what the previous surgeon has done, it is very easy to potentially cut off all the blood supply to the belly button.

So usually if someone wants a Tummy Tuck and has a small hernia, Dr Dona repairs it at the same time, and this would not require the use of any mesh. Of course, once the muscle tightening has also been done, you’ve re-enforced that hernia repair, so it therefore has minimal chance of recurring.

Six pack abs

Will I have a “six-pack” after surgery?

One common myth with Tummy Tuck (Abdominoplasty) surgeries is that you’re going to achieve a six pack after surgery.

This is typically not the case. The operation is designed to remove excess skin and the associated fatty tissue. It is a procedure to improve form and function, tailoring the skin to better fit your underlying body.

A six pack requires two things:

  • A well-formed and defined six pack muscles. If you don’t have those before surgery, then surgery is not going to create them.
  • A very thin fatty layer, or minimal fatty tissue. The thickness of the fatty layer will be consistent with the other areas in your body. In other words, if your body fat percentage is not down to a “shredded” state before surgery, then it won’t be like that after surgery.

Of course, some of the greatest results after a tummy tuck are achieved after the surgery by the patient. The dramatic change achieved by surgery is often used as inspiration and motivation by the patient to continue their personal journey of self-improvement, by changing their lifestyle – that is, an altered attitude, diet and exercise.

Weight loss from Tummy Tuck

How much weight will I lose with Tummy Tuck (Abdominoplasty) surgery?

An important thing to understand is that for the majority of patient’s a tummy tuck should never be considered a weight loss procedure. A Tummy Tuck (Abdominoplasty) is usually performed to remove excess skin that diet and exercise will not remove. As such, the total weight removal with these procedures is often disappointingly low!

Of course, there exists a group of patients who have large fatty aprons. Obviously, these patients do lose quite a significant amount of weight from the surgery, but these patients represent a small minority. Furthermore, they are generally not doing the surgery for weight loss, but to reconstruct the abdomen and address thee the functional (medical) and lifestyle issues associated with an overhanging fatty apron.

Loose big belly after Tummy Tuck Surgery?

Will I lose my big belly after a Tummy Tuck (Abdominoplasty)?

One thing to understand about abdominal fat is that fatty tissue exists deep to the skin, and this is the fat which you can pinch between your fingers.

Then of course there is the fatty tissue that lies deep to your muscle and surrounds your abdominal organs – visceral fat. This fatty tissue you cannot feel but can see. This is the person that has a very full and prominent belly – most of that fullness is secondary to the visceral fat.

A tummy tuck only removes the skin and its associated fatty tissue in front of the muscle. The surgeon does not go deep to the muscle so visceral fat is never reduced surgically.  Therefore, whilst the muscles are typically tightened to help tighten the waistline, the intra-abdominal fat will remain.

This fatty content can only be reduced through an overall reduction achieved through weight loss via diet and exercise. This is often why some people still notice that their abdomen remains “full” after surgery.

Yet a simple fatty pinch test will reveal that most of the problem lies deep to the muscles. That is, the fatty tissue deep to your muscles is the main contributing factor to a persistently fuller girth which is bigger than you might want.

In fact, in certain individuals the upper abdomen can appear larger after surgery. The typical person who experiences this is someone that has a very large lower abdomen with a fatty apron. With the removal of the apron the person undergoes a massive reduction to the lower abdomen. Whilst the upper abdomen also becomes smaller, the degree of change is less than that of the lower belly, and therefore it becomes more noticeable – it looks bigger even though it is smaller!

Can I get pregnant after a Tummy Tuck

Can I get pregnant after a Tummy Tuck (Abdominoplasty)?

Most people tend to undergo a Tummy Tuck (Abdominoplasty) after they’ve completed their family, in other words, not planning on having any more children.

A common question is “can you get pregnant after a Tummy Tuck?” The answer to this is yes you can. Surgery of course will not stop you getting pregnant and most importantly it will not prevent your tummy from growing during pregnancy. So, it’s not going to complicate future pregnancies.

The other question is, “Will pregnancy ruin the Tummy Tuck results?”

The answer to this is “it depends”.

If you put on 20+ kgs during pregnancy, then you will have to expect some change to the results.

So, if you are going to get pregnant, healthy weight gain is always the recommendation. Seeing a nutritionist and personal trainer experienced with pregnant women can definitely help. This way, you are giving yourself the best chance of a healthy pregnancy, and less likely to compromise any of the results achieved with a Tummy Tuck.

What happens on the day of Tummy Tuck surgery?

What happens on the day of Tummy Tuck (Abdominoplasty) Surgery?

The day before surgery, the Sydney hospital will call and advise you when you need to arrive at the hospital and the pre-surgical requirements such as when to begin fasting prior to your surgery. Upon arrival at the allocated hospital, you will be required to check in with the reception staff. You will then be seen by a hospital staff member who will direct you to the pre-surgical waiting area where you are officially “checked in” for your surgery. At this point you will be made comfortable while you wait to be taken into the operating room. We do our best to ensure that you are advised to come to the hospital as close to the scheduled surgery time, however sometimes you may have to wait a little longer than planned before we can start your surgery.

Prior to your surgery, you will be taken into the theatre anaesthetic bay. This is where Dr Dona will again go over the surgery and to remind you about what to expect when you wake up. Dr Dona will also make tentative surgical markings on you. In other words, he will draw his surgical plan on you and discuss this.

The Anaesthetist will also talk to you about the anaesthetic and the medications they’ll be giving you after surgery to keep you as comfortable as possible.

Finally, you get taken into the actual operating room.

What follow-up appointments do I need?

Following your surgery, and once you have been discharged from hospital, you will attend our practice for your first post-operative review with one our post-operative nurses. Generally speaking, your first appointment will be scheduled no later than the day following your hospital discharge.

All of your post-operative appointments are organised and provided to you prior to your day of surgery. Have have standard follow-up appointments for the first 12 months.

Within your first post-operative appointment, one of our friendly and caring post-operative nurses will inspect your wounds and administer light therapy treatment, aimed at optimising your recovery.

Our post-operative nurses will continue to see you, at least three times per week for the following few weeks, and of course, will be available to answer any questions, in-between your in-clinic appointments.

We keep a careful eye on you and ensure you are hitting the correct recovery milestones during the crucial early post-operative period. We ultimately do all that we can to achieve an optimal outcome and that you are comforted and reassured during this phase.

RECOVERY

TUMMY TUCK (Abdominoplasty) RECOVERY

In order to better prepare for your surgery and to help with getting back to normal, it’s important to appreciate what you’re going to experience, all the things that are normal, and how to deal with them.

The first 24 hours after Tummy Tuck (Abdominoplasty) Surgery:

Most of my patients having a full Tummy Tuck (Abdominoplasty) will spend at least two days in hospital. Most patients are medically fine to go home at this stage, although some may benefit from another day or two in hospital.

Now what happens after surgery?

  • You will wake from surgery in a hospital bed with the head of the bed elevated and one or two pillows under your knees all designed to keep your hips in a flexed position. This is to ensure you have minimal tension on your surgical wounds.
  • All your wounds are stitched up using several layers of internal dissolving sutures. Although, often some stitches around your belly button are visible and will need to be removed after one week.
  • All your wounds are covered using waterproof dressings.
  • You will have a body suit or compressive garment on.
  • One or two plastic tubes, or drains, are usually placed and come out from, or just below your wounds usually in your pubic region.
  • You also have a catheter in place, which is basically a tube going into your bladder, so you don’t have to worry about getting up and trying to go to the toilet.
  • You have at least one drip in place to give you intravenous fluids, pain control medication and antibiotics.
  • You will also have special massage devices on both legs designed to minimise the chance of any clots in your leg veins.
  • You will also have a nasal prongs or oxygen mask designed to give you supplemental oxygen.

All these tubes and drains etc., are all in place to keep you as comfortable as possible and so that we can monitor you.

Many women claim they find the experience and discomfort like that after a caesarean, with the first 24 hours being the least pleasant. You’re attached to all these tubes, largely confined to bed, sometimes feeling a little nauseous, and not the most comfortable in the world. This is when most patients question their sanity and wonder why they’ve done this to themselves and paid for it as well.

However, before you leave the hospital, all your drips, drains and catheters have been removed and you’re up walking around, albeit a little slowly and slightly hunched over.

Rest assured, this is normal, fortunately very short lived, and settles down. Learn More About Tummy Tuck (Abdominoplasty) Recovery

Tummy Tuck (Abdominoplasty) Pain after Surgery

Your Anaesthetist will manage and oversee all your pain medication and treatments whilst in hospital and when discharged home. Most patients having a full Tummy Tuck (Abdominoplasty) stay in hospital for a minimum of two days. This is how long it takes before most people are medically well enough to be discharged. When you do go home after surgery your Anaesthetist will provide you with the appropriate pain medication scripts to keep you as comfortable as possible.

The main reason people are in hospital is to keep them comfortable and manage pain.

The first 24 hours is generally the worst, and this is when you’re lying in your hospital bed wondering why on earth you did this to yourself and start to question your sanity! This is normal, and fortunately goes away pretty quickly, and before too long you start to appreciate your results!

A common question is “What can Tummy Tuck pain be compared to?”

Like all surgical procedures, everyone has a different experience. However, it is often described as a significant tightness across the abdomen. Many women who’ve had a caesarean would say a caesarean is worse than a Tummy Tuck (Abdominoplasty), whilst others may say it’s worse than a caesarean. Either way, it’s similar.

In the beginning when you stand up, you’ll feel tight and will need to walk a little hunched over and shuffle along.

All drains, catheters, drips etc will be removed prior to discharge from hospital.

As a very general guide, you will feel like you can’t straighten up for about two weeks. So don’t force yourself to straighten up it, will happen when it wants to happen.

Also, with any chest or abdominal surgery, any straining will cause significant pain. So, anything that causes you to strain your abdomen such as coughing, sneezing etc will be uncomfortable. Therefore, avoid these as much as possible and firmly hold your belly when doing so.

Finally, it is painful taking deep breaths so naturally you will be taking short shallow breaths. Because of this it’s important that every hour on the hour you take two or three nice slow deep breaths to expand your lungs and minimise the chance of any chest problems.

Walking after Tummy Tuck (Abdominoplasty) Surgery

When you first get up to walk, which we encourage with assistance on the first post-operative day, then you will be hunched over and slowly shuffle along. Don’t try to straighten up because you are feeling tight for a very good reason, your skin has been tightened and usually so have your muscles. Of course, those who have not required any muscle tightening, are generally far more comfortable but will still feel tight.

As a very rough guide, it takes approximately two weeks before you feel like you can straighten up. Don’t force the issue, it will happen when it wants to happen.

Sleeping position after Tummy Tuck (Abdominoplasty) Surgery

Whilst in hospital, your bed is positioned with the head of the bed up and a pillow under your knees, designed to ensure your hips are flexed and therefore you have minimal tension on your wound.

So, when you go home, you will need to maintain a sleeping position largely on your back with a pillow under your knees to help with the hip flexed position. Of course, you could also potentially sleep on your sides as long as your hips remain flexed. However, you wouldn’t consider this for the first two weeks.

As a guide, it takes about two weeks before you feel like you can stand up straight. So, it would be at least two weeks before it would be even possible to roll onto your stomach. Given this, we would recommend that you avoid deliberately trying to sleep on your stomach for at least the first 3 weeks. After this let your body comfort levels guide you.

Bowel troubles after Tummy Tuck (Abdominoplasty)

After surgery developing bowel troubles such as bloating, and constipation is common.

This is because:

  • You’ve just had abdominal surgery.
  • You’re less mobile.
  • You’re taking narcotic painkillers which cause a slowing of the bowels with association constipation.
  • You’re eating less.

This can be a very unpleasant experience given that you can’t really strain with the muscle tightening surgery that you’ve had.

So, we provide a number of medications whilst in hospital to minimise any bowel problems. When you go home, we encourage lots of fluid and fibre, and taking supplements such as Metamucil (or other laxatives) to help making going to the toilet more frequently and therefore less traumatic on your wounds/muscle repair.

The potential bloating, along with general surgical swelling, will make you appear a lot fuller in the beginning, but don’t worry, it’s all temporary and will settle.

Driving after Tummy Tuck (Abdominoplasty) Surgery

As a general rule it takes about two weeks before you can straighten up due to the significant abdominal tightness. Therefore, you shouldn’t even consider driving for the first two weeks.

After two weeks, common sense should be used. If you feel like you are safe to get behind a wheel based on how your body is feeling and how mobile you are, then by all means you can drive.

Returning to work after Tummy Tuck (Abdominoplasty) Surgery

After Tummy Tuck (Abdominoplasty) surgery, how quickly you can get back to work obviously is going to depend on the type of work you do.

However, we do offer some general guides to follow:

  • Firstly, you shouldn’t consider driving for two weeks.
  • After two weeks – You could possibly consider returning work from home office-based work.
  • After three weeks – You could potentially return to an office based/light work environment.
  • After four weeks – Light hospitality work at 4 weeks may be possible.
  • After six weeks – You are free to attempt normal strenuous activities. You will definitely still feel sore and will be far from 100%, but you can try and just use common sense and let your body guide you.

Given this, then any form of employment that involves heavy lifting or straining must be avoided for at least the first six weeks, after that use your common sense and as stated, let your body guide you. You will definitely still feel a little sore, but common sense prevails.

Learn More About Returning To Work After Tummy Tuck (Abdominoplasty)

Exercising after Tummy Tuck (Abdominoplasty) Surgery

Returning to normal physical activity including exercising is important after a tummy tuck. Of course, you will need to understand that a full abdominoplasty is a big operation with a sizeable external wound, usually with muscle tightening and a significant internal surgical wound that need to heal.

So, these wounds need to be given the appropriate respect and time to heal properly so you can achieve an optimal outcome.

With this in mind there are some general guidelines:

  • We try to get you up and walking the day after surgery, although it’s more like a slow shuffle in the beginning.
  • As you continue to become more comfortable and when you get home continue to get up and walk around gently.
  • After about two weeks once you feel like you can actually stand up straight. You can then feel free to increase the walking distance, but no power walking or running.
  • Avoid any physical activities that cause you to strain or activate your core muscles for the first 6 weeks.
  • At six weeks, you can then slowly return to doing normal training and physical activities. Start slowly because you are definitely not going to be able to do what you want to do, and you will still have a reasonable amount of pain and discomfort when you start straining.

At Six weeks:

  • You can certainly ride a stationary bike at the gym to burn some calories.
  • You can also try some light jogging and gradually build yourself up until you feel normal.
  • You can start some light weights and gradually build yourself up week by week until your back to your pre-op levels.

 

Ultimately, there is absolutely no reason why you can’t eventually get back to normal, it just takes time.

Learn More About Exercise After Tummy Tuck (Abdominoplasty) Surgery

Sexual activity after Tummy Tuck (Abdominoplasty) Surgery

The question about returning to sexual activity after surgery is very common.

Basically, you can’t do anything that causes you to strain or activate your core muscles for the first six weeks.

Also, because of the size of the wounds and the healing required you don’t want to be doing anything that gets your heart rate or blood pressure up too much.

Of course, the level of physical activity one undertakes during sex varies for each individual and often each time you’re having sex.

So, with all this in mind some generalisations can be made.

  • Realistically you’re probably not going to be even thinking about for the first week at least.
  • However officially, you should avoid any sexual activity for the first two weeks. Anything that gets your heart rate and blood pressure up is not ideal and any potential pressure etc on your abdominal wall and pubic area will potentially compromise your wound healing.
  • When you do return to having sex, as previously stated, don’t undergo any sexual activity for the first six weeks that involves you being too active or activating your core muscles. So basically, up until the six weeks post op period, you are taking on a very passive role during sex!
  • Your partner also needs to avoid any significant grabbing or handling of your surgical wounds and abdominal wall for the first six weeks. This could compromise wound healing, and in the early stages it could potentially cause bleeding issues and increased swelling.
  • After six weeks, you can do what you like without any fear that you’re going to compromise your results. Obviously you will still be a little sore here and there but just let your body guide you.  Ultimately common sense will tell you what’s right and wrong at this stage.

Weight gain after Tummy Tuck (Abdominoplasty) Surgery

A very important aspect after Tummy Tuck (Abdominoplasty) Surgery is the potential for weight gain. Many of my patients are training quite a lot before surgery and are very strict with their diet. In fact, that’s one of the reasons why they’re getting surgery, because diet and exercise can’t get rid of the excess skin.

However, after surgery when you’re unable to do any significant exercise for the first six weeks, and sitting around a lot more potentially eating more, you are at a high risk of putting on weight.

So the best way to avoid this is to make some serious conscious efforts to control your diet and start walking as soon as you are able. The last thing you want is to get through the first six weeks and realise that you’ve put on 5-10kgs.

Whilst its very reversible, it can put a downer to what should otherwise be a very happy time for you.

Swelling – Long Term

Like any surgery site you will develop swelling after a Tummy Tuck (Abdominoplasty). It is important to understand that the area of surgery for a Tummy Tuck is extensive – from the surgical scar all the way up the rib cage internally. So, you have to expect an extensive area and degree of swelling involving the entire abdominal wall, including the pubic region and down into the groin.

This swelling is often quite dramatic between the scar line and belly button. Also, the pubic area can initially be very swollen, especially if Liposuction or additional surgery was required there.

One of the reasons you are recommended to wear a pressure garment for the first six weeks is to control the swelling. This swelling gradually subsides but typically takes several months to fully settle.

Also, it can fluctuate with some days where you can look quite bloated whilst other days you’re looking trim.

Most patients continue to wear the garment beyond six weeks as it tends to provide some control of this swelling. We also recommend you perform gentle daily massage to these areas starting a few weeks after surgery to help control the swelling and facilitate the settling process.

Compression garment – why do you have to wear it after Tummy Tuck (Abdominoplasty) Surgery

At the end of your Tummy Tuck (Abdominoplasty) operation, we place you in a compression garment – so basically, you wake up from surgery with your garment already on.

In addition to this, we would typically provide you with an abdominal binder to wear on top of your garment during one of your early post-operative clinic appointments.

These are both designed to apply gentle but controlled pressure to your abdomen.

They serve several functions:

  • Controls swelling.
  • Minimise any early potential bleeding issues.
  • Provides external support for the internal tightening, so the muscle tightening that is often done is further supported by external compression.

We recommend all our patients wear these garments continuously for six weeks, only coming off for brief periods such as when you’re showering or bathing.

After six weeks, patients are no longer required to wear them. However, many of our patients like to continue wearing one or both garments as they find it provides a degree of physical and psychological comfort at a stage when they are slowly returning to normal physical activities.

Also, it is normal for the post-operative swelling to vary from day to day, and this can take many months to fully resolve.

So, after you stop wearing your garment at 6 weeks, some patients experience an increase, albeit temporary, in swelling. For this reason, many people continue to wear garments/binders beyond 6 weeks to control this longer-term fluctuating swelling.

And some people simply find these garments quite comfortable and wear them for a very long time, and that’s not a problem.

Learn More About Tummy Tuck (Abdominoplasty) Compression Garment

What happens to my Belly Button during Tummy Tuck (Abdominoplasty) Surgery

People often think that with a Tummy Tuck (Abdominoplasty) the surgeon creates a new belly button. This is not the case; you keep your original belly button! However, you do end up with a scar around and within your belly button.

Surgically, an incision is made around the belly button, but the belly button does not physically move as it remains attached to the underlying muscle.

The skin above the belly button is lifted off the muscle, the skin is then pulled down over the top of the belly button and stitched to the pubic skin.

Towards the end of the operation an incision is made in the skin at the level where the belly button lies underneath, and the belly button is brought back to the outside world and stitched into position.

Surgeons use all manner of techniques or incisions to deliver the belly button. Ultimately you want the most natural appearing belly button with the least visible scar possible.

Dr Dona has refined his technique over the years. For the majority of patients they end up with a more defined appearing belly button and a minimally noticeable scar.

Muscle strengthening after a Tummy Tuck (Abdominoplasty)

Dr Eddy Dona’s clinic is now offering customised post-operative treatments to maximally improve the results.

We offer non-surgical muscle enhancement, skin tightening and fat reduction treatments. Whilst this technology can be used for any parts of the body, we are extremely excited to be offering it to our Tummy Tuck (Abdominoplasty) patients.

The EVOLVE device has three separate treatment systems – TONE, TITE & TRIM

Muscle TONE – The muscle tightening typically performed with a tummy tuck, and lack of any physical exertion for the first six weeks, will initially weaken your muscles. Therefore, to get your core strength back on track and potentially better than ever before, we recommend the Evolve EMS muscle enhancement therapy.

EMS muscle toning and strengthening system targeted to your abdominal muscles will help you to re-engage and activate your newly tightened muscles with a rapid development of maximal core strength and tone.

We recommend starting no sooner than six weeks after your Tummy Tuck surgery and undergoing six weekly 30-minute treatments.

TITE – Skin Tightening – During a tummy tuck Dr Dona always removes the maximum amount of skin that can be done safely with the least potential complications. However, it is inevitable that within a few months, due to post-operative swelling, stretching and skin relaxation the skin will not be as tight as it was initially.

Using Radiofrequency (RF) skin tightening technology, we can help reduce the natural stretching in your skin and help with further tightening! We recommend starting no sooner than six weeks after your Tummy Tuck (Abdominoplasty) surgery and undergoing six weekly 30-minute treatments.

TRIM – Fat Reduction – Tummy Tucks (Abdominoplasty) are primarily an operation that removes excess skin, with its associated fatty tissue.

Stubborn residual pockets of fat can now be targeted non-surgically using RF energy and suction applicators to deliver a uniform thermal effect to the deepest layers of the subcutaneous fat to help with fat loss.
We recommend starting no sooner than six weeks after your tummy tuck surgery and undergoing six weekly 15 minute treatments.

As an absolute minimum, you should consider the TONE treatment starting at six weeks post-op. However, you can combine any of these three treatments. A popular combination is to have the TITE and TONE during your same clinic visits for six weeks. 

Final results after Tummy Tuck (Abdominoplasty) Surgery

Just like every operation, you need to be patient before you can see the “final” results.

Of course, those who have significant concerns prior to surgery and require major reconstructive surgery, will almost immediately be able to see a dramatic change after surgery. This is despite all the swelling and discomfort.

However, certainly by six weeks once you slowly start to get back to doing your normal activities, you’ll be noticing much more.

Most of the swelling and pains and tightness should have resolved by 6 months. This is when you could say life has largely gotten back to normal and you’ve basically forgotten you’ve had surgery, except for the fact that you’re now very different.

However, it takes at least 12 to 24 months for scars to fully mature.  Scars are initially bright red and noticeable, but ideally they will end up as a fine white lines. Of course scars never disappear completely. Also, scars do not always heal nicely and can sometime develop thickening including keloid scars.

POTENTIAL COMPLICATIONS

TUMMY TUCK (ABDOMINOPLASTY) POTENTIAL COMPLICATIONS

The list of potential complications is not all-inclusive; however, it does include all the general and specific key issues that should be considered and understood.

General Potential Complications from Tummy Tuck (Abdominoplasty)

More information on general potential complications can be found on our site. LEARN MORE 

Whenever someone is having an anaesthetic, no matter what it’s for, then things can potentially go wrong. That is why no surgery should be considered “minor”. Of course, whilst the chances of the following potential problems occurring are extremely small, you still need to know about then:

  • Anaesthetic issues – which can affect heart, lungs or cause strokes
  • Allergic reactions – This can be very mild to life threatening.
  • Clots
    • Superficial vein clots, which is a complication of the cannula or drip that’s placed in your vein
    • Deep vein clots – these can potentially spread to the lung and be life threatening. We do several things during surgery and after surgery whilst you’re in hospital to minimise the risk of you developing these.
  • Wound problems – such as infection and breakdown
  • Bleeding – early or late
  • Death – whilst the chances of this is exceeding rare, any of the previous issues can result in this devastating complication.

All these potential problems are standard for any operation, although some operations and some patients have an increased risk of developing them.

Skin & Healing Problems after Tummy Tuck (Abdominoplasty) Surgery

Every operation has the potential for wound healing problems. This includes wound bleeding, infection, wound breakdown or even skin and tissue necrosis or loss. These can result wound ulceration and wound breakdown. These issues can be minor or major and warrant further surgery and hospital treatment.

With a Tummy Tuck the wounds are obviously very large so these risks are much greater compared to surgery with smaller wounds. Those patients at greatest risk of these potential complications are:

  • Elderly
  • Overweight
  • Diabetes
  • Smokers
  • Immunosuppressed including those taking certain immunosuppressive medications.

For the majority of people without these risk factors, the chances of any significant wound healing problems are quite small.

Tummy Tuck (Abdominoplasty) Wounds and Scar Treatment

After a standard Tumy Tuck you will have two wounds, a lower abdominal wound and a wound around your belly button.

The lower abdominal wound is closed using several layers of internal dissolving sutures, so usually no sutures need to be removed. However, sometimes during the first few months post-op some of the stitches come to the surface and come out. These can cause a minor pin-hole sized wound irritation, which settles very quickly.

Your belly button wound will often have a number of sutures that will need to be removed one week after surgery.

At the time of surgery dressings are applied involving surgical tape across the wounds and large waterproof dressings. These dressings remain intact until you attend your first post-op clinic appointment. You can shower with these on.

At your post-op clinic appointment, all your dressings are removed, and your sutures are removed at the 1-week stage. All our patients will need to attend multiple clinic appointments per week for the first few weeks. These are vital so our nursing team can assess your wounds and commence post-operative treatments including LED light therapy to optimise your healing and recovery. It also allows our team and Dr Dona to carefully monitor your progress during that crucial early post-operative period. Your entire appointment schedule is organised prior to your surgery day.

It takes at least 12-24 months for the scar to fully mature, at which stage we would want to see a fine white line.

However, sometimes the scars can thicken and widen and end up darker than we would like. So, on the rare occasion we would consider a scar revision surgery after the 12-month mark.

Also, in some rare cases for reasons not terribly clear some people develop patches of skin discoloration or pigmentation in the lower abdominal wall region above the scar but not associated with the scar. Whilst these often fade away, they don’t always do so and can be quite frustrating.

An important thing to understand is that sometimes in the very beginning the scar line can appear very “pleated” with skin folds. This is largely because the upper length of skin (the skin flap that is dragged down to stitch into the lower end), is often longer than the lower length of skin. This is especially the case if the person has multiple wide stretch marks that extend above the line of excision.

So, this longer length of upper skin has to be pleated to match the shorter length of the lower skin.

Do not worry about how the wound might look at this early stage. Any irregularity along the scar line generally irons itself out by six weeks post op.

Also, we do ask you to start massaging the scar at the three-week stage. Initially the scar typically has a deep lumpy feeling along its length. This eventually usually completely settles, but it can take a few months.

Learn More About Tummy Tuck (Abdominoplasty)Scarring

Seroma

Seroma is a well-known potential complication of Tummy Tucks (Abdominoplasty). Dr Dona generally quotes an incidence of 5%, or one in twenty patients developing it.

So, what is it? Basically, it’s the build-up of fluid under the abdominal wall skin. This typically develops during the first couple of weeks after surgery. Your belly, or a part of it will appear fuller and often have a ‘slushy’ water bottle feel. However, in some cases when the fluid is under tension, it will feel tight and firm.

This is not considered a major complication but more of a hassle to you. If it occurs, we will organise for you to undergo an ultrasound and the doctor doing it will insert a needle and drain the fluid (aspiration).

The need to undergo an ultrasound and aspiration often requires repeating, sometimes multiple times, until it eventually dries up.

Seroma’s do not compromise long term results, but it is a personal inconvenience.

On the rare occasion, surgery may be required to deal with a chronic seroma.

Numbness after Tummy Tuck (Abdominoplasty) Surgery

Abdominal wall numbness will happen after a Tummy Tuck (Abdominoplasty).

All women that have had a caesarean will notice that the belly above the scar, typically has a dull or numb feeling. The scar from a Tummy Tuck is much larger than that of a caesarean, so the numbness covers a much greater area – above the full length of the scar and often extending above the level of the belly button. This odd feeling is quite noticeable initially, but over time it does improve, but never completely. So, expect permanently reduced sensation in this area.

This is not a clinically significant area. However, with the reduced sensation it is possible that you could injure that skin without knowing about it – such as burning your skin with a hot water bottle.

The reason why loss of sensation occurs is that the surgery involves lifting the skin and fatty tissue from the muscles to allow it to be moved down for the excess to be removed. In doing so, the small nerves that run from the muscle to the skin are by necessity divided to allow this to happen.

In addition to this, some people may experience some numbness or even pain down the front and outer aspect of their thighs. This will occur in small percentage of people as the nerve that supplies this area runs immediately deep to the outer aspect of the wounds on each side. So, any possible irritation or disturbance to this nerve (often due to the sutures used to close the wound), can cause this sensory disturbance. This typically resolves after a few months, but on the rare occasion it can be permanent.

Belly Button Healing Problems

People often think that with a Tummy Tuck (Abdominoplasty), a new belly button is created – this is not the case as you keep your original belly button! However, you do end up with a scar around and within your belly button.

Like all wound healing, the belly button needs a healthy blood supply to ensure it stays alive.

During the surgery, the original belly button remains attached to the underlying abdominal wall muscles via a stalk of connective tissue. It is through this stalk that the delicate blood supply to the belly button is keeping the skin alive. If the surgery results in too much tension, then the belly button blood supply could be cut off and it will die off. This will result in a belly button that ulcerates, and you end up with a scar where the belly button should be.

Patients at high risk of developing this problem are those that have previous surgery to the belly button, such as the correction of a belly button hernia.

Excess Flank Skin & Looseness

After a Tummy Tuck (abdominoplasty), one of the common complaints is residual looseness or excess on the sides.

This occurs for a number of reasons.

If it occurs, it typically happens in those who have experienced massive weight loss. In this situation the excess skin and residual fatty tissue extends all the way around to the back.

Pre-surgery the most noticeable problem is of course only on the front and this is what the Tummy Tuck addresses.

Of course, during a Tummy Tuck, the segment of skin that needs to be removed, in other words the surgical scar, has to end somewhere, and that’s basically along the sides towards the back region. Therefore, at and beyond the region where the scar ends the looseness in this area will remain.

In some people they may wish to have further surgery to address this region, which will involve surgery to remove the flank and even back excess. Which largely amounts to a two-stage total Body Lift (or Belt Lipectomy).

Some patients may have significant concern to this region prior to the Tummy Tuck and may want, and be a good candidate, to have a single operation to address the front and sides/back – a Belt Lipectomy.

Finally, when a surgeon has removed a wedge-shaped segment of skin which is typically what occurs in a Tummy Tuck, at the end of the scar on either side, the skin and fatty tissues can sometimes bulge out – this is often referred to as a dog ear. This can be quite dramatic and to some degree unavoidable, but not always. If it’s a significant problem, that does not settle, then further surgery may be required.

“Dog Ears” and irregular olds

A potential complication of any surgery where skin has been removed is an abnormality at the end of the scar which are referred to as Dog ears. These are not uncommon in Tummy Tuck (Abdominoplasty) surgery.

As stated, they occur at the end of a scar and it’s where the skin and fatty tissue abnormally bulge out and create an unusual protrusion. These often do settle after several months, however they sometimes don’t.

If it’s very small and minor, it can often be removed with a minor surgical procedure under local anaesthetic.

However, a large dog ear is a real problem. Of course, this is not to be confused with the natural looseness almost everyone has along the sides and flanks, with of course some people having more than others. This common excess tissue along the sides is what’s often hangs over the top of tight trousers.

Due to this not uncommon natural looseness along the sides, for some people these apparent “dog ears” seen after surgery are almost unavoidable and can’t be changed (without a full Belt Lipectomy).

However, for others the development of dog ears after surgery is a problem that can be addressed. In these cases, a dog ear typically occurs when the surgeon has not made the scar long enough, and therefore the angle of the segment of tissue that’s been excised is too great. In other words, the surgeon has tried to make the tummy tuck scar too short! So, when he/she stitches things up, the apex of the scar area bulges forward! This is the classical dog ear.

As a Plastic Surgeon, Dr Dona always states that you should never sacrifice form and aesthetics for the simple sake of trying to make a scar a little bit shorter. Not only does this potentially result in dog ears, but it may also result in significant creases along the lower abdominal wall. This is because the upper length of skin often ends up much longer than the lower length of skin and needs to be pleated to fit. Small creases seen immediately after surgery almost always resolve, or as Dr Dona often says, “irons out”. However, large creases along the lower abdomen often don’t completely resolve.

So basically, irregularities associated with the Tummy Tuck scars can occur. If they haven’t resolved after six months, and are significant, then you may need further surgery to improve them.

Tummy Tuck (Abdominoplasty) Revision Surgery

It’s not uncommon for a Tummy Tuck (Abdominoplasty) patient to require further surgery to “fine tune” the results.

Dr Dona often uses dressmaking as an analogy for many surgical procedures following massive weight loss. This simplistic analogy of a complex operation is used to help the patient understand the relevant scars required for these operations and the potential for further ‘revision’ surgery.

Of course, a Tummy Tuck surgery many times more complex than any dressmaking. The skin and tissues are not static and rigid objects. They swell, they stretch, they shrink, they sag etc. In addition to this, the underlying body is also changing.

So as a surgeon Dr Dona needs to reconstruct and reshape everything that’s 3D and not static, whilst at the same time making sure that he does not push things too far and make it too tight. The risk of wounds not healing and complications arising is always the major concern and dictates what can and can’t (or shouldn’t) be done.

So, with all this in mind, after everything settles and swelling starts to settle and things “relax” into position, it’s normal for things to be nowhere near as tight as they initially were. Given this, it’s not uncommon for patients to require further surgery to “fine tune” the results, just like you would for a second fitting of a tailor-made dress.

Therefore, you should not undertake any surgery if you’re not prepared or willing to have further surgery, and the potential time off and costs involved.

COSTS

How much Does a Tummy Tuck (Abdominoplasty) Cost in Sydney, Australia?

Not all Tummy Tucks are the same. Some Tummy Tuck (Abdominoplasty) procedures are straight forward, while others may be complex and can take much longer to perform. In other words, it can take Dr Dona anywhere from two hours to five hours to do a Tummy Tuck based on the complexity. Therefore, the pricing can vary significantly.

Other issues such as your private health insurance status and whether you fit the criteria to be able to claim a rebate also has a massive difference on the potential out-of-pocket costs. These factors relating to your Tummy Tuck procedure will be discussed with you at the time of your initial consultation.

Whilst many of the smaller Tummy Tucks procedures may be deemed a “cosmetic” procedure, many of the larger Tummy Tucks are far more of a functional (medical) procedure. This is because for these people the belly in the pre-surgery state is often a significant functional concern to that individual. Loose skin, sweat rash and ulceration within the belly button and abdominal folds, a fatty apron, a low hanging pubic area, hygiene issues, relationship issues, clothing issues etc. Also, the underlying muscle problems is often a major functional and medical concern for the patient.

These are all concerns that affect the day to day functioning of that individual, and the surgery is designed to first and foremost improve function, with the secondary benefit being an improved appearance.

Learn More About Tummy Tuck (Abdominoplasty) Pricing

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