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.
The surgeon will make a small incision in the treatment area. A cannula (a thin tube) connected to a specialised vacuum machine will then be inserted through the incision to remove excess fat via suction. In VASER liposuction, ultrasound is used in this stage to emulsify and liquefy the fats before it is suctioned, minimising the damage to nearby tissue and making it a much gentler procedure. The incisions are then sutured after the fat has been removed. The above process can be repeated for multiple treatment areas.
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.
- Dehydration may occur as large amounts of fluid are removed
- Contour irregularities. The skin may become bumpy, uneven or withered due to poor elasticity and healing. The cannula used may also damage the skin and produce a spotted appearance. These changes can be temporary or permanent.
- Temporary pockets of fluid can accumulate under the skin, which will need to be drained manually with a needle.
- Nerve and tissue damage, leading to temporary or even permanent numbness and/or soreness in the affected areas.
- Inflammation and infection are rare, but possible.
- Rarely, the cannula may puncture an internal organ. This requires immediate surgery repair.
- Pieces of loose fat 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 known as fat embolism and requires immediate surgery.
- Shifts in fluid levels as fluids are being injected and suctioned out can cause potentially life-threatening kidney, heart and lung problems.
Although there are risks of complications, most of these can be avoided with good preparation, post-care and surgery techniques. Patients should take care to hydrate themselves both before and after the surgery and adhere closely to the doctor’s instructions.
VASER liposuction uses ultrasound to emulsify fats into smaller droplets before it is suctioned out, making it less invasive and much safer than traditional liposuction. On the other hand, VASER liposuction cannot remove as much fat per session compared to traditional liposuction. However, this is of little concern because of regulations by Singapore’s Ministry of Health on the maximum amount of fat removed per liposuction session.
Because of MOH regulations, the maximum amount of fat which can be removed in per liposuction session is 1 litre for all clinic-based procedures. Any amount larger than that in a single session must be extracted at a registered hospital.
Local anaesthesia will be applied before the procedure, so there will be minimal discomfort. Some mild soreness, swelling and bruising is expected after the procedure, but these will usually subside in a few weeks.
The procedure typically takes 1 to 3 hours depending on the number of areas treated. Although patients may be required to remain at the clinic for a few more hours for monitoring and allow anaesthesia to wear off.
Patients are expected to feel mild giddiness and drowsiness immediately after the procedure due to bodily fluids being removed and effects of the anaesthesia. These will usually subside in a few hours.
Patients can typically resume sedentary work (office, administrative jobs) just a few days after the procedure. Strenuous activities however, should be avoided for 2 weeks or more as advised by the surgeon.
The effects of liposuction 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, and the remaining fat settles into position.
Liposuction permanently removes fat cells from the body. The results will remain as long as patients maintain their post-liposuction weight as the body will not produce new fat cells.
Even if there is weight gain, the fat will be deposited usually in areas where there are existing fat cells. So, areas treated with liposuction will typically gain fat slower than other non-treated areas.
Despite all these, be sure to maintain a healthy diet and exercise after recovery as poor health habits can still eventually allow fat to reaccumulate, and revert the effects of liposuction.
- Drink more water at least a week before the procedure to ensure you are well hydrated
- Smoking and tobacco consumption should stop 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.
- Drink plenty of water after the procedure to replace fluids that are removed with the fat and prevent dehydration.
- Rest well and avoid strenuous activities for at least 4 weeks.
- 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 remaining fat settle into desirable areas to give more pleasing results. The corset can be occasionally removed for cleaning and while you shower.
- Are within 30% of their ideal/desirable weight, and looking to remove stubborn pockets of fat which does not respond to improved diet and exercise habits
- Are in generally good health
- Have good skin quality, elasticity and healthy muscle tones
However, liposuction is not recommended/suitable for individuals who:
- Are pregnant or breastfeeding mothers
- Have bad skin elasticity
- 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
Also, due to regulations by MOH, some liposuction procedures can only be performed in a registered hospital. Such situations may include:
- Liposuction involving the removal of more than 1 litre of supernatant fat per session or repeat removal/injection of fats over the same region
- Liposuction on patients with BMI 28 and above
- Patients requiring/requesting general anaesthesia or deep sedation during the procedure
- Any other situations when doctors/surgeons decide that patients might not be able to be discharged on the same day as the procedure