Tummy tuck or abdominoplasty in Sydney

An abdominoplasty or tummy tuck involves removal of excess skin and muscle below the belly button. In patients with post pregnancy muscle separation or rectus abdominis muscle separation, a muscle repair is performed. In situations with combined loose skin and rectus abdominis separation, the tummy may appear to protrude and no amount of exercise or dieting can unfortunately help the abdominal contour in these situations. A tummy tuck is able to contour the waistline and give a flat abdomen in these situations. The belly button is repositioned and refashioned and any hernias repaired which can enlarge the belly button and distort its shape. The operation can involve liposuction for contouring of the surrounding flanks, upper abdomen and mons pubis. The operation is complex and each patient requires an individualised, tailored approach to achieve the best possible abdominoplasty result. Although there are many health care providers offering tummy tuck surgery, this is a major operation which requires specialist training. Be sure to see a qualified Plastic and Reconstructive surgeon (surgeons with the title FRACS (Plast) and members of the Australian Society of Plastic Surgeons) to ensure you get the best possible results and your procedure is done in a safe environment.

Tummy-tuck-plastic-surgeon-Sydney

An abdominoplasty is an operation which gives a dramatic change in abdominal contour and addresses problems that no other more minimal approach can fix such as large amounts of loose skin and muscle separation.

The shortest possible scar hidden in the underwear line

The scar in this operation is long, however well hidden in bikinis or the underwear line. The belly button is often made a smaller more desirable shape with a scar hidden around it.

Removal of loose skin and rectus muscle repair to not only narrow waistline but also provide functional improvement

Muscle repair can improve symptoms such as back pain, abdominal weakness and incontinence. Excess skin can causes rashes and interfere with exercise when present in large amounts.

Liposuction where necessary to enhance results

Contouring the upper abdomen and flanks or other areas is often combined with this procedure for a greater improvement in contour

Can be combined with a breast lift, breast implants or breast fat graft as part of a “mummy makeover” or other body contouring procedures such as arm or thigh lift

Depending on patient problems and desires, a breast lift, breast fat graft or breast implants can be performed at the same time. Massive weight loss patients may require an extended abdominoplasty or even body lift to address large amounts of loose skin and may have other areas requiring contouring such as the arms or the thighs.

 Abdominoplasty

Most frequently asked questions.

Tummy tuck or abdominoplasty options

What kinds of abdominoplasty or tummy tuck are available?

The abdominoplasty and tummy tuck that is best for you depends on your individual goals, anatomy and presenting problems. Tummy tuck surgery is tailored to your needs and an experienced plastic surgeon can advise which one will best achieve your goals.

Mini tummy tuck (takes skin below the below button only with no belly button repositioning)

Radical abdominoplasty (removes skin and fat below the belly button, rectus abdominis muscle repair, belly button repositioning)

Abdominoplasty without muscle repair (usually in patients who have not had a pregnancy or are male)

Extended abdominoplasty or belt lipectomy (the scar is carried around to the flank area in patients that require it)

Fleur de lis abdominoplasty (includes an incision down the midline of the abdomen in patients with very significant weight loss and skin excess)

Reverse abdominoplasty (where the problem is mainly upper abdominal fat or loose skin; the scar is hidden in the bra line)

What components need to be addressed during a tummy tuck or abdominoplasty?

The four components that need to be addressed during a tummy tuck or abdominoplasty are:

Skin (which can have stretch marks and wrinkling from pregnancies or massive weight loss,

Excess fat (which is excised and liposuctined)

Rectus abdominis muscles which can be stretched and separated in the midline usually following pregnancies)

Belly button or umbilicus (which is repositioned in all but the mini tummy tuck)

Do all patients need a muscle repair during a tummy tuck or abdominoplasty procedure?

If patients are presenting for tummy tuck after pregnancy, a muscle repair is usually beneficial.

In patients who have massive weight loss only and no pregnancies, or in male abdominoplasty it may not be required. Recovery time is more rapid without a muscle repair.

Am I a candidate for a mini tummy tuck or abdominoplasty?

The majority of patients are not suitable for a mini tummy tuck. This procedure does not reposition the belly button so a long distance between the belly button and pubis is required, minimal loose skin confined to the lower abdomen. Most patients will do much better achieve their goals with a full tummy tuck in which a proper muscle repair and more extended skin excision is performed.

Is liposuction a better alternative for me than a tummy tuck or abdominoplasty?

Abdominal liposuction is definitely an operation with much less scarring and recovery time than abdominoplasty or tummy tuck. However, in patients with a lot of stretch marks, loose skin or poor quality skin, wide muscle separation, liposuction may give a minimal result. In these patients, abdominoplasty is a much better alternative and will give a much more dramatic result. Abdominal muscle separation post-pregnancy can be the main problem in patients with a normal weight and the reason they feel the tummy looks large.

Abdominal liposuction should be reserved for patients with a significant pocket of fat, minimal or no muscle separation and good quality skin with no overhanging skin.

How is a male abdominoplasty different?

Men seldom need an abdominal wall plication (sewing the rectus abdominis muscles together) as they don’t tend to have rectus muscle separation. Men can also carry more intraabdominal (visceral) fat which contributes to enlarged abdominal girth,  but cannot be addressed during abdominoplasty surgery. Scars placement is also slightly different due to differences in underwear styles, hair patterns and anatomy.

Men who have not had major weight fluctuations usually have good skin quality compared to many females and may benefit from liposuction alone.

Abdominoplasty or tummy tuck scar placement

Where are the scars in a tummy tuck or abdominoplasty?

The minimum length of an abdominoplasty scar is from one hip bone to the other. In patients with large amounts of loose skin, this may need to be extended into the flanks. Some will require a circumferential body lift for the best results. The scar is placed in the lower abdomen and hidden in the underwear line.

What is done to minimise scarring following tummy tuck surgery?

Dr Simone uses the smallest possible incision to provide adequate correction of the skin problem and to contour the waistline.  Following surgery, you are given a scar management regimen. Your scars are closely monitored in the months following your surgery; if you appear to be prone to more significant scarring due to genetics or other factors, extra scar management is instituted early to give you the best possible result.

Abdominoplasty or tummy tuck surgery

Do I need a general anaesthetic for a tummy tuck or abdominoplasty?

Abdominoplasty is absolutely performed in a accredited hospital under general anaesthetic with an anaesthetist. This is not a procedure that can be performed under local anaesthesia.

Patients usually remain at least overnight in hospital after the surgery; the length of time depends on the size of the abdominoplasty.

Do I need drains after a tummy tuck or abdominoplasty?

Most patients will require drainage with a large abdominoplasty. This is still the best way to avoid fluid collections post surgery and ensure the best abdominoplasty results.

What is the pain like after tummy tuck surgery and how will I manage it?

The pain after the muscle repair can be fairly significant. Long acting local anaesthetic is used in the tummy tuck site and all liposuction sites at the time of surgery. Patient controlled analgesia post-operatively is available.

Patients when ready to go home are given adequate prescribed strong pain killers. With regular use of pain relief, the pain is manageable. The worst of the pain settles within the first few days. In the uncommon event that pain after the surgery is not under control, Dr Simone and her anaesthetist are available at any time after your surgery to advise about pain relief.

Small twinges of pain in the muscle are common for some weeks afterwards. Muscles take six weeks to completely heal and manageable small pains and awareness that an operation has been done during this time is entirely normal.

What do I have to do when I go home after abdominoplasty or tummy tuck?

Waterproof dressings are placed over the wounds at the time of surgery and these should remain in place until you come for your follow up. No showering is permitted once the drains have been removed.

A compression garment is worn for six weeks after surgery to ensure the skin heals uniformly and swelling is controlled.

Patients feel the incision feels “tight”; this is entirely normal. For the first few days, it can be difficult to walk upright, however, the skin rapidly stretches out. During this time, patients are advised to sleep with the legs flexed under a pillow and walk slightly bent over.

Recovery time after abdominoplasty or tummy tuck

When can I return to work after a tummy tuck or abdominoplasty?

This depends on the type of work whether it is a desk job or requires any heavy lifting.

Around two weeks would be normal for getting around a desk job work environment. For those who have highly active jobs requiring lifting, to be back doing this type or work would take six weeks.

The exact amount of recovery time a patient needs depends on the size of the abdominoplasty, associated procedures and the specific work requirements.

Patients with young children at home will require assistance and need to avoid lifting for six weeks.

What are the exercise restrictions after tummy tuck or abdominoplasty?

Any exercise that involves activating the abdominal muscles needs to be avoided for six weeks in those with a muscle repair.

In those without a muscle repair, abdominal exercise can be resumed at around 3 weeks once the scar is healed and if pain is controlled. In others, light cardiovascular exercise can be resumed at four weeks.

At six weeks, abdominal activating exercises should be introduced extremely slowly and carefully. Start with lighter weights and lower repetitions than you are used to and build up slowly to your baseline level.

What do I need to do during the recovery phase after a tummy tuck?

Instructions will vary slightly if a fat graft has been performed and with different pockets or types of implants.

Implants do not require massage or any specific taping. They are precisely placed at the time of surgery.

When can I drive after a tummy tuck or abdominoplasty?

In most people this is around two weeks.

You need to feel strong and pain free enough to be able to manipulate the steering wheel and turn your head easily. For some people this may be longer.

Getting the most out of your tummy tuck or abdominoplasty surgery

Do I need to lose weight before tummy tuck or abdominoplasty surgery?

Being an ideal weight prior to abdominoplasty surgery if definitely the goal. Sometimes people with massive weight loss reach a plateau and although still in the overweight range no BMI, are unable to lose further weight. In these cases, loose skin and an overhanging belly can be interfering with the ability to exercise and performing surgery can lead to further weight loss down the track. This is fine, however, if there is significant weight loss after an abdominoplasty, there can be recurrence of loose skin and this is more likely to require a scar revision to improve appearance.

Patients who are in the very obese weight range are best to attempt to lose weight prior to surgery. In these patients, the upper abdominal fat is transferred down to the lower abdomen, giving a less than ideal abdominal contour. As well, they are at a higher risk of fat necrosis and other post-surgical complications. Dr Simone does not have a specific BMI cutoff and examines each person on a case by case basis.

She will give you a diet and exercise program to try for several months to ensure you are in the best possible shape for your abdominoplasty. Sometimes even a few kilograms of weight loss can greatly improve your results.

To qualify for Medicare and health insurance rebates, there must be demonstration of a significant amount of weight loss that has been sustained over a certain period (6 months minimum).

What happens if I gain weight after an abdominoplasty or tummy tuck?

There is currently no scientific evidence that breast implants are responsible for symptoms of autoimmune disease, joint disease or other non-specific complaints.

Severe capsular contracture can cause pain and discomfort in patients with breast implants.

There is a very rare form of cancer known as ALCL (Anaplastic large cell lymphoma) which has been diagnosed in just over 300 women worldwide. As numbers are small and research regarding this topic is in its infancy,  it is difficult to make any defintive conclusions at this stage regarding this form of cancer. It usually presents with a mass or a fluid collection which in the majority of cases are visible to the patient as a change in their implants.

Will I have a six pack after abdominoplasty or tummy tuck surgery?

If you are extremely fit after your surgery, this is possible. The central line and the outer rectus abdominis contour in slender individuals will be much better defined. Liposuction, however, contrary to popular belief will not create a “six pack”, at least not a real one.

The six pack is created through diet and exercise, and the appearance occurs because of a very thin (or almost no) layer of fat over the abdominal muscle interdigitations which become visible. Liposuction this close to the skin surface can lead to skin problems such as irregularity, rippling and wrinkling. An abdominoplasty can kick start you towards a six pack but will not create one! People offering sick pack creation via liposuction are just creating grooves in the remaining fat.

How soon will I see results after my tummy tuck or abdominoplasty surgery?

It is normal for the lower abdomen and any liposuction sites to remain swollen for some time.

In patients having a smaller abdominoplasty, they may be more aware of swelling and take longer to see their final result.

The majority of the swelling will be gone within a few weeks. However, it takes a minimum of 3 months for full skin tightening to take effect following any liposuction and for almost all the swelling to be gone.

The scar takes one full year to settle and fade and to look its best.

How soon after pregnancy can I have a tummy tuck or abdominoplasty?

The earliest it is recommended to have a tummy tuck or mummy makeover after pregnancy is six months. If you are breastfeeding you should wait until six months after you stop. This give the tissues enough time to settle and the weight to stabilise.

Can I get pregnant after a tummy tuck or abdominoplasty?

Patients considering a tummy tuck who are planning to get pregnant in the near future are advised to wait to have their surgery until they have completed having children.

It is possible to get pregnant after a tummy tuck, however, it is advisable to wait at least six months before doing so after abdominoplasty surgery. Pregnancy will stretch the muscle repair and skin again and cause the surgical result to deteriorate somewhat.

Abdominoplasty health fund and Medicare rebates

Is abdominoplasty or tummy tuck covered by my health fund or Medicare?

Sadly, patients with loose skin who have maintained a normal weight and have muscle separation do not qualify for tummy tuck surgery that is covered by their health fund. This is despite its significant functional benefits.

The only patients qualifying for rebates are weight loss patients that fulfil the below strict Medicare criteria. In these situations, a health fund rebate may be available for the hospital stay, and part of the surgical and anaesthetic fees. There are still associated out of pocket costs with this surgery.

Item number 30177

Lipectomy, excision of skin and subcutaneous tissue associated with redundant abdominal skin and fat that is a direct consequence of significant weight loss, in conjunction with a radical abdominoplasty (Pitanguy type or similar), with or without repair of musculoaponeurotic layer and transposition of umbilicus.

(a) there is intertrigo or another skin condition that risks loss of skin integrity and has failed 3 months of conventional (or non surgical) treatment; and

(b) the redundant skin and fat interferes with the activities of daily living; and

(c) the weight has been stable for at least 6 months following significant weight loss prior to the lipectomy

Additional procedures with tummy tuck surgery

Is liposuction performed during a tummy tuck or abdominoplasty?

Liposuction is a beneficial adjunct in many patients undergoing tummy tuck surgery.

Common areas for liposculpture in conjunction with  abdominoplasty surgery include the upper abdomen, flanks or mons pubis area can improve abdominal contour and definition even more.

What is a "mummy makeover"?

Mummy makeover is a popular combination of plastic surgery techniques, designed to specifically address common body issues faced by women who have been through pregnancy and breastfeeding.  It usually involves both a breast and abdominal contouring procedure as these areas are most affected by childbirth and often do not bounce back to their pre-baby shape. The surgery can consist of abdominoplasty or tummy tuck in conjunction with a mastopexy or breast lift with or without breast implants, breast fat grafting, liposuction or labiaplasty.

The “mummy makeover” has no set components; each series of procedures is customised to fit each patient’s unique needs. Procedures can be performed during one operation, or sometimes spread out over multiple surgical sessions.

Can I combine a tummy tuck or abdominoplasty with other procedures?

As well as the commonly performed combination known as the “mummy makeover”, patients with massive weight loss may combine a thigh lift, arm lift,  breast reduction or breast lift with abdominoplasty surgery.

Fat grafting can be done to augment the breasts or buttocks as both areas commonly lose significant volume in massive weight loss compared to other body areas.

View abdominoplasty before and after gallery

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