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What is a tummy tuck?

Tummy tuck, also known as abdominoplasty, is a plastic surgery procedure which involves tightening loose muscles and skin around the abdomen. It is usually carried out in patients who struggle to achieve a flat tummy (hence the name tummy tuck) after pregnancy or dramatic weight loss. Tummy tuck is often performed in conjunction with liposuction as the 2 procedures can complement each other in achieving a flatter abdomen.

Why tummy tuck?

During pregnancy, the expansion of the uterus stretches the muscles and skin of the abdominal wall. This stretching can be caused by excess fat (visceral or subcutaneous) as well. After dramatic weight loss or post-pregnancy, the stretched tissues may not return to its original shape, especially when these muscles are not exercised, giving a loose “flabby” appearance. The muscle groups most prone to this is the rectus abdominis (the vertical abdominal muscle group, also known as the “six-pack”), where stretching usually occurs the aponeurosis (the white tissue connecting 2 muscle groups together, also known as “fascia”). The medical term for this condition is “rectus diastasis”.
In these cases, tummy tuck can surgically tighten the muscles and remove excess skin and fat, effectively “tucking in” the tummy and flattening the abdomen.

Surgery procedure

There are many types of abdominoplasty procedures, with 2 types being the most common: Full tummy tuck and mini tummy tuck.

Full tummy tuck

In a fully tummy tuck, the entire abdominal wall is involved. The surgeon will make an incision along the pelvic line, just above the pubic area. A second incision is made around the navel to detach it from the surrounding skin. The skin is then lifted off the abdominal wall and excess fat is removed as required. The gap in the rectus abdominis muscle is then stitched up and tightened as necessary. After which, the skin is pulled over to cover the muscles and excess skin is trimmed away. A third incision will be made for the navel before sutures are used to close the incisions.

Mini tummy tuck

In mini tummy tuck, only the lower abdomen below the navel is operated on. A similar, but shorter incision will be made at the pelvic line just above the pubic area as well. No incision will be made for the navel as it should not move during mini tummy tuck. Excess fat removal and stitching of the rectus abdominis muscles is carried out only on the lower abdomen. The skin is then pulled over and excess skin is trimmed away before the incision is sutured.
In both tummy tuck procedures, some additional incisions will be made under the main incision for fluid drainage tubes to be inserted.
Local or general anaesthesia will be administered for the procedure as required. After the surgery, the patient may be asked to remain at the clinic for a few hours for monitoring, and to allow the anaesthesia to wear off.

Full tummy tuck

In a fully tummy tuck, the entire abdominal wall is involved. The surgeon will make an incision along the pelvic line, just above the pubic area. A second incision is made around the navel to detach it from the surrounding skin. The skin is then lifted off the abdominal wall and excess fat is removed as required. The gap in the rectus abdominis muscle is then stitched up and tightened as necessary. After which, the skin is pulled over to cover the muscles and excess skin is trimmed away. A third incision will be made for the navel before sutures are used to close the incisions.

Mini tummy tuck

In mini tummy tuck, only the lower abdomen below the navel is operated on. A similar, but shorter incision will be made at the pelvic line just above the pubic area as well. No incision will be made for the navel as it should not move during mini tummy tuck. Excess fat removal and stitching of the rectus abdominis muscles is carried out only on the lower abdomen. The skin is then pulled over and excess skin is trimmed away before the incision is sutured.
In both tummy tuck procedures, some additional incisions will be made under the main incision for fluid drainage tubes to be inserted.
Local or general anaesthesia will be administered for the procedure as required. After the surgery, the patient may be asked to remain at the clinic for a few hours for monitoring, and to allow the anaesthesia to wear off.

Possible risks/complications

As with all surgical procedures, there are risks to be considered. The following are some of the risks and possible complications associated with abdominoplasty:

  • Inflammation and infection
  • Complications with anaesthesia
  • Asymmetric or unsatisfactory results
  • Temporary or permanent numbness, persistent pain and soreness due to disturbed nerves.
  • Pieces of loose fat or blood clots can break away and become lodged in blood vessels, clogging them. These fat particles may also migrate to the lungs, brain and other vital organs, severely damaging them. This is a medical emergency and requires immediate surgery.

Most, if not all of these complications can be avoided with good surgical technique and post-surgery care. Hence, it is important to approach a reputable and experienced plastic surgeon.

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FAQ

Is the procedure painful?

Local or general anaesthesia will be applied before the procedure, so there will be minimal discomfort. Some mild soreness, swelling and bruising is expected after the procedure while the wounds heal and the body adjusts, but these will usually subside in a few weeks. The doctor will usually prescribe medication to ease these effects during the healing process.

How long is the procedure?

A standard tummy tuck procedure usually takes around 1 to 3 hours to complete, depending on the extend of correction needed, and the amount of skin and other tissue being removed. In addition, patients may be required to remain at the clinic for a few more hours for monitoring and allow anaesthesia to wear off.

Is there any downtime?

Tummy tuck is considered a major surgical procedure as the size of the incisions are relatively large. You are expected take up to 10 days of outpatient medical leave from work post-surgery. After which, sedentary work and light activities can resume. However, if you are standing on your feet often for your work, about of 14 days medical leave is recommended.

When can I see the effects?

The effects are immediately visible after the surgery. However, it may take a couple of weeks or months for the best results to show, after swelling and bruising subsides.

Will there be scarring?

As will most surgical procedures, scarring is inevitable. However, scars from tummy tuck procedures are usually easily concealed by undergarments or bathing suits.
If you are a woman who previously delivered via C-section, the incision can be made in the same location to reduce the number of scars.

Will tummy tuck get rid of stretch marks?

Contrary to certain beliefs, tummy tuck is unable to get rid of stretch marks. However, if the stretch marks are conveniently located on the excess skin that is to be removed, it is then definitely removable.

Are the results of tummy tuck permanent?

The results of tummy tuck should remain as long as patients maintain their body weight post-surgery. However, pregnancy can revert the effects of tummy tuck as the abdominal muscle and skin becomes stretched again. In this case, a repeat surgery is usually not recommended, which is why tummy tuck is not recommended for women who would want to bear children in the future.

What should I take note of before the procedure?

  • Control your diet and exercise habits to maintain a stable weight before the procedure can proceed
  • Hydrate yourselves adequately starting at least one week before the procedure
  • Smoking and tobacco consumption should cease at least 6 weeks prior to the procedure
  • Please inform your doctor/surgeon of any medication/supplements you are currently on during the consultation session. You may be asked to stop certain medication/supplements like blood thinners to reduce the risks of complications.
  • On the day of the procedure, please wear comfortable clothing and arrange for someone to get you home.

What should I take note of after the procedure?

  • Drink plenty of water after the procedure to replace fluids that are removed with the fat and prevent dehydration.
  • Rest well at home for up to 10 days. After which, light activities can resume.
  • Strenuous activities should be avoided for at least 6 weeks after the surgery.
  • The doctor will provide you with a fitted corset, which is to be worn for several weeks after the procedure. This corset helps reduce swelling and bruising, and helps sculpt the abdomen into a more desirable shape. The corset can be occasionally removed for cleaning and while you shower.

Am I suitable for tummy tuck?

Tummy tuck is suitable for you if you:

  • Are within 30% of their ideal/desirable weight, and looking to remove or reduce a stubborn ,bulging belly caused by loose muscles.
  • Are in generally good health.

However, tummy tuck is not recommended/suitable for individuals who:

  • Are pregnant or breastfeeding mothers
  • Are obese, and seeking this procedure as a cure-all
  • Are on medication that may interact with the anaesthesia, or increases the risk of bleeding such as non-steroidal anti-inflammatory drugs

Tummy tuck is also not suitable for individuals whose undesirable figure is cause by fat pockets rather than loose skin and muscle. In this case, consider a liposuction instead.

Should I undergo a full or mini tummy tuck?

This depends on the position and extent of loose muscle and skin on your abdomen. The surgeon will examine your body and recommend the most suitable procedure for you during the consultation session.