ABDOMINOPLASTY

What is an abdominoplasty?
Abdominoplasty is an operation to surgically improve the appearance and contour of the abdomen. Abdominoplasty is more commonly known as a "tummy tuck". The procedure is performed to remove excess skin and fat from the middle and lower abdomen in order to tighten and improve the appearance and comfort of the abdomen.

The best candidates for abdominoplasty are men or woman who are concerned by abdominal fat deposit or loose skin that has not improved after diet or exercise. This procedure is particularly helpful for women that have stretched abdominal muscles after childbirth.

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If you are planning to lose a large amount of weight or become pregnant the procedure is best performed after this.

Thousands of abdominoplasties are performed each year and patients are very happy with the results.

How is the procedure performed?
An incision is made across the lower abdomen, extending out to the hips. The skin and fat are elevated up to the rib cage. Excess skin and fat are removed and upper abdominal skin is brought down. A new opening is cut for the navel which is resited in its normal position. Abdominoplasty is performed under general anaesthetic and takes approximately two hours. Dr Drielsma currently performs this procedure at the John James Memorial Hospital or the National Capital Private Hospital. 1-3 days are required in hospital.

What should I expect after surgery?
After the surgery you will be wearing a garment to provide support to your abdomen. This garment is ordered and fitted prior to the operation. It is worn for 6 weeks following suegery/

Stitches are removed 1-2 weeks after surgery in Dr Drielsma's rooms.

Although you will not be able to stand straight in the early stage after surgery, walking as soon as possible will help circulation and lessen the risk of complications. The body needs time to recovery from surgery. Use your recovery time for just that - resting.

When can I return to normal activities?
Usually 2 weeks are required off work although some people require a longer recovery period.

Gentle exercises can be commenced after 3-4 weeks, however, vigorous exercise should be avoided for 6-8 weeks. It may take 2-3 months before you will feel you have returned completely to normal.

Is there anything I should do before surgery?

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Avoid taking aspirin for two weeks before surgery.
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Do not smoke for three weeks before and after surgery as this will delay the healing process.
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The oral contraceptive should be ceased from the time you decide to proceed with surgery.

Are there any risks?
As with any surgical procedure, there is a small risk of complications. Surgery and anaesthesia are very safe and it is most unlikely you will experience any difficulty. However, there are areas of potential problems you need to understand before proceeding with your surgery. You can reduce your risk of complications by closely following Dr Drielsma's instructions after surgery.

Bleeding: Bleeding can be problematical in about 2-3% of cases. It is most likely to occur immediately following surgery or that evening. It is possible in cases of persistent problematical bleeding that a return to the operating theatre will be required. The likelyhood of this is very rare.

Infection: If infection occurs it will usually become evident within one week of surgery and may delay the healing process or result in the development of scar tissue. This may require treatment with antibiotics. In the unlikely event of infection, the ultimate result of the surgery may be adversely affected.

Anaesthesia: You will be receiving a general anaesthetic and your anaesthetist will be discussing with you possible discomforts following anaesthesia. Again, anaesthesia today is very safe and no major problems should be concerning you. Any questions you have regarding your anaesthetic would be best answered by your anaesthetist at the time of surgery.

Scarring: All surgery carries risks and every incision leaves a scar. The long scar is never invisible but is placed in a position that is inconspicuous when wearing most clothing or swimming costumes.

The scars will often look red and lumpy at about three months after surgery as they heal but this is normal and will settle over the following 3-6 months. It takes 12-18 months before the scars mature completely, flatten out and lighten in colour. The quality of the scar cannot be guaranteed prior to surgery as this is based on the individual healing process.

Because the excess tissue is pulled down, there can be a tendency for the pubic hair to be pulled up a little. This does not show on most clothing and is rarely of concern.

Sensation: Areas of your lower abdomen may be numb for up to six months as the disturbed nerves are recovering. This numbness although usually temporary, can in rare cases be permanent.

Fluid Collection: A seroma is a collection of fluid under the skin and fat. If this occurs it may take a few weeks to absorb. Wearing the pressure garment will help reduce this risk.

Circulation: Although rare, there is a risk of clotting in the veins of the legs. Such a thrombosis may rarely be complicated by pulmonary embolism ( a clot going to the lung). The risk of this is about one in 500 and is increased with use of the oral contraceptive pill. This can be reduced by flexing your calves after surgery to maintain leg circulation and moving around as soon as possible.

Important points to remember before proceeding with surgery:

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There can be no absolute guarantee with any surgery. In the hands of any experienced surgeon, a secondary operation to correct a minor irregularity may be needed.
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Should there be any questions regarding abdominoplasty, be sure they are answered in advance by Dr Drielsma. Well meaning friends are not a good source of information. Find out everything before the operation - a well informed patient is a happy one.
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The best candidates for cosmetic surgery are those who want to enhance or improve their appearance, not those who seek perfection. You will be satisfied with the results of surgery if you have realistic expectations. It is important that you make the decision to proceed with surgery for yourself, not anyone else.

The next step when considering cosmetic surgery is a consultation with Dr Drielsma. You will be shown before and after photos and will be given the opportunity to discuss the procedure with previous patients.

The above information mentions only some of the benefits and complications of abdominoplasty. This information should not be regarded as a substitute for information and advice provided by Dr Drielsma during consultation.