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Abdominoplasty

7 min read

An abdominoplasty is a form of cosmetic surgery to change the shape of the abdomen, and perhaps tighten or repair weakened muscles. It is also known as a 'tummy tuck'.

When might you have an abdominoplasty?

You might have an abdominoplasty if you want to remove sagging fat and skin, and repair any separated muscles in the abdomen.

The operation is usually done for cosmetic reasons, with the aim to improve the appearance of a flabby or bulging belly caused by ageing, pregnancies or rapid weight loss.

It can also be done as a reconstructive operation to:

  • correct abnormalities after a disease or surgery, such as removal of large pelvic tumours
  • fix structural defects of the abdomen
  • correct abnormalities caused by obesity
  • improve the contour of the abdomen after hernia repair.

An apronectomy is another operation sometimes done in addition to an abdominoplasty. It involves removing a hanging 'apron' of abdominal fat that can cover the genitals, make personal hygiene difficult and cause ongoing skin irritation.

If you are thinking about an abdominoplasty

Many people people feel a great deal of pressure to appear perfect. This operation might improve your appearance and possibly your quality of life. But it is major surgery, and not suitable for everyone.

If you are obese, think about whether you have done all you can without surgery. Would seeing a dietitian help? Are there ways to exercise more regularly? Do you have all the support you need?

Consider whether you can afford this surgery and if it will give you the results you expect. Medicare doesn't cover the cost of cosmetic surgery, and often private health insurance doesn't either. However, if abdominoplasty is done for reconstructive reasons, part of the costs might be covered.

Before a surgeon will perform this operation, you usually need to be at a stable weight. You may be asked to postpone the operation if you aim to become pregnant or lose a lot of weight.

You should also be aware that:

  • If you have recently given birth, it can take a long time to get your abdominal muscles in shape again. Before considering an abdominoplasty after pregnancy, try post-natal abdominal exercises.
  • Having an abdominoplasty will not prevent you from regaining weight.

If you are under 18, you will need to have a psychological assessment and wait for a cooling off period of 3 months before having major cosmetic surgery, such as an abdominoplasty, according to Medical Board of Australia guidelines. This won't apply if the surgery is done for reconstructive reasons.

Choosing a surgeon

If you are considering an abdominoplasty, it is important to choose a surgeon you feel comfortable with and who will speak to you honestly about the benefits and risks of any surgery.

The Australian Health Practitioner Regulation Agency (AHPRA) has a register of medical practitioners. You can check this register to ensure your surgeon is a Fellow of the Royal Australasian College of Surgeons (RACS). You can also check if the surgeon has had any serious disciplinary action taken against them.

Some people consider having cosmetic surgery overseas, but there can be many problems with this.

Questions to ask before surgery

There are many things to consider before deciding to go ahead with an operation. Among the questions you might want to ask a surgeon are:

  • What are the risks with an abdominoplasty for a person in my state of health?
  • How many abdominoplasties have you performed and what is your success rate?
  • Are there non-surgical alternatives I should consider?
  • How long is my recovery likely to take?
  • How likely am I to need a second operation?
  • How much will it cost?

You can also use the Question Builder tool to create your question list for the appointment. Prepare your list, then print or email it so you remember what you want to ask.

How to prepare for an abdominoplasty

Your surgeon will need to take a complete medical history. Take notice of any pre-surgery instructions you are given. You might be asked to:

  • stop taking certain medicines, including aspirin and ibuprofen, for a couple of weeks before the operation
  • stop taking certain supplements such as fish oils (fish oil may increase the risk of bleeding). It is important to tell your surgeon if you take supplements.
  • reach your optimal weight first
  • quit smoking.

What happens during an abdominoplasty?

You will be given a general anaesthetic. Then, different techniques are used depending on whether you are having a full or partial (mini) abdominoplasty.

In a full abdominoplasty, the surgeon will make a cut along the line of your pubic hair from hip to hip. Excess fat and skin will be removed across the entire abdomen, between your naval and pubic hairline. Any slack or separated abdominal muscles will be stitched. Loose upper abdominal skin is then stretched down towards your pubic bone and attached.

In a mini abdominoplasty, fat and loose skin will be removed around your midriff only. With this operation, the surgeon will make a small cut around your belly button and reposition your naval, stitching it back in place. This naval cut may also be needed in a full abdominoplasty.

In either version of the operation, the surgeon will stitch, tape or clip the incisions together. The wounds will be covered with dressings. Sometimes one or two small tubes are inserted to drain blood or fluid. These tubes may be left in for several days.

What to expect after abdominoplasty

You won't feel well, and should expect a slow recovery. You are likely to have some bruising, swelling and pain. You might need to take pain medication, antibiotics and anticoagulants, which help prevent blood clotting.

For the first few days after surgery you will need to lie with your upper body raised and knees angled. You may find it difficult to stand up straight because your abdomen feels tight. But very soon, maybe even on the first day, you will be asked to walk around in order to prevent blood clots forming.

Your abdomen will be wrapped in an elastic bandage or compression garment to keep swelling down. Take care not to put strain on the wounds for at least 6 weeks after the operation. If you do make sudden movements, such as bending suddenly at the waist, the incisions might open.

You should be able to return to light work 1 to 3 weeks after the operation.

Risks with an abdominoplasty

Like any surgery, an abdominoplasty procedure comes with risks. You should discuss the risks in detail with your surgeon. You should also discuss the risks of having anaesthetic with your anaesthetist.

About 1 in 25 people have serious complications after abdominoplasty.

The risks include:

  • persistent pain or discomfort
  • prominent scarring
  • infection
  • blood clots in the leg or chest (deep vein thrombosis)
  • heart or lung complications
  • poor wound healing, which may require skin grafts
  • numbness or changes in skin sensation (which usually improves after several months, but could be permanent)

Some people need further surgery because of complications or because they haven't got the result they hoped for.

Cost

The cost of an abdominoplasty varies from patient to patient and includes:

  • surgeon's fees
  • anaesthetist's fees
  • clinic or hospital fees
  • medication, dressings and support garments

Your surgeon and anesthetist must provide you with information in writing about the cost of abdominoplasty. This should include:

  • the total cost
  • details of deposits and required payment dates
  • payments for follow-up care.
  • possible further costs for additional revision surgery or treatment.

More information

If you are considering abdominoplasty, you should first discuss it with your doctor. More information is also available on the Australasian Foundation for Plastic Surgery website, and in our guide to cosmetic surgery.

Last reviewed: November 2017

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