Tummy Tuck (Abdominoplasty)

Tummy tucks remove excess skin and fatty tissue from the middle and lower abdomen in order to improve the appearance and contour of the tummy. It is indicated when diet and exercise are not enough to eliminate unwanted fat and loose skin in the abdominal area or to flatten a lax / protruding abdomen such as happens frequently following childbirth. Professor Malata routinely tightens weak muscles of the abdominal wall and this dramatically improves the contour of a protruding, lax or floppy abdomen, as frequently happens in women after child birth. He often combines it with liposuction of the flanks (or “dog ear” areas) for a smoother harmonious look. Abdominoplasty eradicates any overhang or apron thus giving a “flat” tummy. It also improves unsightly lower abdominal scars such as caesarian section, gynaecological and other scars in addition to better definition of the waist-line. If you are concerned by any of the above problems, abdominoplasty (tummy tuck) may be a good choice for you.

After massive weight loss an apronectomy with or without tightening of the abdominal wall is often needed. The resection of loose skin and soft tissue can be performed in a Fleur-de-lys fashion in order to address both horizontal and vertical lasxity of the abdomen. This results in a T-scar abdominoplasty.

Sometimes Professor Malata combines abdominoplasty with a hernia repair be it due to divarication of the rectus muscles (a large gap between the muscles due to pregnancy or increased weight) or a frank herniation due to previous incisions.

For ease of understanding Professor Malata classifies the abdominoplasties into the following categories based on the extent of the surgery.

Types of Abdominoplasty

1. Full Abdominoplasty

2. Mini-Abdominoplasty (umbilicus not repositioned).

3. Apronectomy without repositioning the umbilicus

4. Fleur-de-lys abdominoplasty

5. Extended abdominoplasty

6. Circumferential abdominoplasty (or lower body lift)

7. Other specialized types: Saldana, endoscopic, etc.

To view the before and after photos in Professor Malata’s publications on abdominoplasty click below:

• Abdominoplasty in patients with and without pre-existing scars - A retrospective comparison;

• An algorithmic approach to abdominal flap breast reconstruction in patients with pre-existing scars results from a single surgeon’s experience;

• Abdominoplasty as an adjunct to management of peri-Caesarian section necrotizing fasciitis

As in any cosmetic surgery, there are risks as well as benefits and the final results are not guaranteed. The chance of complications following a tummy tuck depends on the exact type of operation needed and other factors such as your general health. Professor Malata will explain how the risks apply to you. Detailed postoperative instructions will be discussed during consultation and a procedure-specific handout given to you by Professor Malata.

Some risks of abdominoplasty or tummy tuck surgery

Frequent:

• Bruising & swelling of tissues: common

• Tightness and discomfort on movement / coughing: common

• Sensory alterations of the lower abdominal skin: numbness, tingling, sensitivity, tenderness, etc

• Seroma formation (clear fluid collections): common >30%

• Slow healing – mainly in heavy smokers & the overweight: breakdown, skin loss, umbilical loss

• Bleeding and haematoma: infrequent 5-10%

• Infection: rare but can be life threatening

• Long scars: unavoidable and permanent

Infrequent:

• Unsightly scars: uncommon

• Fat necrosis: lumps or discharge

• Lumpiness or irregularities of the tissues usually in areas of liposuction – often temporary

• Umbilicus: malposition, scarring, unacceptable look, total loss

• Occasional need for revisional surgery: dog ears, residual asymmetry, residual tissue, skin excess, scar revisions, dissatisfaction

Very Rare:

• Contour irregularities: asymmetry, depressions, ridges, wrinkling

• General complications: chest infection, blood clots (DVT’s, PE’s)

• Long term effects from: ageing, weight loss/ gain, pregnancy, etc

Alternatives to a tummy tuck:

• Liposuction alone

• Minitummy tuck

• Weight loss: diet + execise

• No surgery at all