All About Abdominoplasty (Tummy Tuck)
Jun 01, 2021
This is a surgical procedure that primarily addresses the excess skin and adipose tissue of the lower abdomen as well as rectus muscle divarication (abdominal muscle separation.) There are 2 types of patients who typically present for this surgery. Mothers who have a rectus divarication and loose skin post pregnancy and those who have experienced massive weight loss. The second category will include men.
Rectus divarication can lead to lower back pain, mild urinary incontinence (usually stress), poor posture and lower abdominal convexity. Excess skin and lower abdominal adipose excess can be uncomfortable and be difficult to manage personal hygiene. These symptoms are unlikely to improve without surgery.
Ideally the patient should have an optimal BMI and maintain their weight loss. Future pregnancies can be tolerated after an abdominoplasty however it is strongly recommended that the patient waits until she has had all of her children, with the exception of massive weight loss patients. Contraindications to the surgery include smoking, larger upper abdominal scarring and unrealistic expectations.
This surgery is completely customised to address the concerns of each patient. There are different types of abdominoplasty designed to address vertical and horizontal skin excess. The standard abdominoplasty results in a low horizontal scar from hip to hip. The fleur de lis abdominoplasty will result in the same horizontal scar as well as a full length midline abdominal scar. This permits the removal of horizontal excess skin. The corset abdominoplasty will have the same scarring as the fleur de lis with the addition of another horizontal scar along the inframammary. The body lift is a circumferential wedge excision + rectus divarication repair to address skin laxity on the abdomen as well as the back. Panniculectomy is a wedge resection of the overhanging abdominal pannus usually preformed without rectus divarication repair. This is indicated in patients with large pannus which has a negative impact on their daily activities and personal hygiene.
Abdominoplasty is often complimented with liposuction to achieve the desired contours and can also be performed in conjunction with a breast reduction/lift or other procedures.
A standard abdominoplasty takes approximately 3-4 hours to perform under General Anaesthetic. The patient will remain in hospital for 3-5 days. The recovery is usually 6 weeks but patients can return to work at 2-3 weeks depending on their work requirements.
The complication profile of an abdominoplasty may include bleeding, infection, seroma and tissue necrosis. However the patient satisfaction is very high for this procedure. Repair of the rectus divarication results in improvement of lower back pain, mild urinary incontinence and the convexity of the abdomen. Removal and tightening of the skin and adipose tissue restores an aesthetically pleasing anterior abdominal wall and frees the patient of the discomfort of hanging tissue and the associated hygiene issues.
Unfortunately, in 2016 Medicare altered the item number specifications for abdominoplasty, such that patients no longer can claim the item number for rectus divarication, having an immediate negative impact on mothers who suffer from this. The item number is applicable for massive weight loss patients who have lost 5 BMI points and maintained this weight loss for 6 months, as well as suffer from intertrigo on their abdomen.
For further information patients can be directed to Dr Kelly Thornbury’s website for consultation and Instagram for before and after photos.
Dr Kelly Thornbury
Plastic, Reconstructive and Cosmetic Surgeon
Southside Plastic Surgery
Level 1, Suite 3
354-358 Crown Street
P: 02 9159 0707
F: 02 91590709