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Abdominoplasty & repair of ventral hernia: [Better known as a Tummy Tuck]
This is the medical term for the operation, which corrects loose, stretched abdominal skin with or without some excess subcutaneous fat.




Who should have this operation?

This operation is ideally indicated for the woman who has developed loose, stretched abdominal skin with or without some excess subcutaneous fat, after having completed her child bearing.





How is the operation done?
This operation involves two elements.

Firstly, an incision is made across the abdomen from hip bone to hip bone just at the level of the top of the pubic hairline. This incision is made in a gently curved fashion and is designed to be hidden inside the line of a bathing costume.

A second incision is made around the belly button, which remains attached to the underlying muscles.

The skin is freed from the underlying muscles from the incision up to the lower margin of the rib cage.

Once this dissection has been completed, the rectus abdominus muscles on either side of the midline which have become separated from one another during the pregnancies are stitched together in the midline to recreate their strength in supporting the anterior abdominal wall.

After the muscle plication (as this manouevre is known medically), the abdominal skin is stretched down so that the point which was originally just above the belly button comes down to the level of the long incision. The excess skin is removed and the wound is sutured, leaving the patient with a smoother, tighter abdominal wall.




What sort of anaesthesia is used for this operation?
This operation is only carried out under general anaesthesia.




How long does the operation take?
On average, 2 - 2½ hours.




How painful is this operation?
The abdominoplasty is the most painful/uncomfortable of all the cosmetic operations because of the work done on tightening the muscles. You will feel tightness in your abdominal wall and will probably have to walk bent over for the first few days after the op.

To reduce the pain after the operation, the wound is anaesthetised at the end of the procedure with long acting local anaesthetic known as Macaine.
In addition, the patient is given whatever intramuscular analgesic is required and anti-inflammatories are also used routinely.

Immediately after the operation, pillows placed under the knees to minimise tension on the wound support the patient's legs.

The day after the operation, the patient is encouraged to get out of bed and start walking around, at first in a bent over position until this is no longer necessary due to a diminution in the discomfort.




How long will I have to remain in hospital?
Patients usually stay in hospital for two days after this operation. After they have been discharged, they will stay at home for further five to seven days taking things easy while being mobile around the house.




Will I be very bruised and swollen?
This is difficult to predict but bruising does not often accompany this op.
Some swelling is always present and will last for up to two or even three weeks. For this reason it is recommended that the patient wear a support panty or step-in to assist in providing comfort and support and to help reduce the swelling as soon as possible.




How soon may I return to regular exercise?
You may be back to walking or cycling after ten days, but will not be able to take part in anything more strenuous for at least six weeks after the operation.




What complications might occur after this operation?
Apart from the rare possibility of complications associated with the anaesthetic, the most significant possible complication is post-operative seroma formation. This occurs as a result of significant weeping from the large raw area created by the operation and occasionally necessitates aspiration or drawing off of the excess fluid. It is a nuisance and uncomfortable but not a serious complication.




How long will the operation last?
This operation is very long lasting and provided that the patient does not put on enormous amounts of weight or have another baby, the effects of the operation will last a lifetime.