Body Language

By: Mr Gary Ross
Created on 15th February 2012

Abdominoplasty (more commonly known as a tummy tuck) is a procedure most commonly requested by women post pregnancy or after extreme weight loss. Leading plastic surgeon Mr Gary Ross explains...

Motherhood has a huge impact on a woman’s life, both in terms of her outlook and her figure. The change in priorities can often be a very positive thing – the changes to her body much less so.

Similarly, losing a large amount of weight, whilst fantastic for one’s self esteem, can wreak havoc on your physique. As we age, our skin loses elasticity, meaning it may not adapt easily to your new slimline silhouette but instead will hang in folds, meaning you are still forced to wear the loose-fitting clothes that you had hoped to shed along with the pounds.

Fortunately, it is possible to rectify the physical changes wrought by child bearing or extreme weight loss.

Following pregnancy or weight loss, changes to the abdominal tissues often result in stretching of the skin, redistribution of the remaining fat and relaxation of the abdominal wall muscles. There may also be excess skin in the buttock or back region that may need to be addressed.

Often patients describe both aesthetic and functional difficulties and find it hard to reveal themselves in public. They often find that they have difficulty fitting into certain clothes and will try to cover up their abdominal region, resulting in a further lowering of self-esteem.

The aim of abdominoplasty (tummy tuck) is to meet the needs and expectations of each individual patient using a variety of techniques. A consultation about abdominoplasty must take into consideration the needs of each individual patient.

Abdominoplasty is an operation that can greatly improve quality of life for patients and give renewed self confidence, but like any surgical procedure it does carry certain risks.

Abdominoplasty should be performed, in suitable facilities, by surgeons able to offer a variety of different techniques. It is important to research your surgeon’s experience and qualifications before agreeing to go ahead with the surgery, and if there is anything you are unhappy about you should not be afraid to walk away.

By ensuring that you are well informed about the surgeon and the hospital you choose you minimise the risk involved in the surgery and maximise your chances of a positive outcome.

The following case studies demonstrate the variety of techniques that are available to deal with individual problems resulting from pregnancy or weight loss and the life-changing results we can achieve.

In stitches
Although redefinition of the abdominal muscle is aided by soft tissue excision and liposuction it is the bringing together of the abdominal wall muscles that has the most impact. In this case the patient was most concerned with the
protrusion of her abdomen and underwent a classic abdominoplasty with relocation of the tummy button and a double breasted plication of the abdominal wall. This allowed a flatter contour of the abdominal wall, seen best in profile.

Aesthetic appeal
The effects of weight loss can lead to the presence of excess stretch marks. Abdominoplasty is the only way of removing these. In this case, the patient was less concerned with shape than with the appearance of the stretch marks. A classic abdominoplasty was performed alongside relocation of the tummy button and liposuction at the flanks to improve contour and hip/waist definition. No drains were required and she was able to go home within 24 hours following surgery.

Less is more
Although uncommon, extended abdominoplasty where the scarring almost extends to the back is required to treat patients with excessive abdominal tissue. The same techniques combined with the extended
abdominoplasty as described above can dramatically affect both cosmetic and functional outcome. In this case the patient did not wish to undergo a total body lift and wanted to achieve a functional improvement to enable her to wear clothes comfortably.

Shaping up
Abdominoplasty usually involves surgery to all the lower abdominal tissue, separating the skin and fat from the abdominal wall, relocation of the tummy button and muscle wall plication, leaving a scar that is easily hidden. Liposuction can be performed alongside an abdominoplasty to improve the waist and hip definition. This patient underwent classic abdominoplasty with plication and liposuction also allowing the removal of her scars after previous abdominal surgery.

Excess baggage
Where there is excessive tissue all around the body a total body lift may be considered. This combines both an abdominoplasty and buttock lift. It improves the contour of both abdomen and buttocks. It is a longer procedure and should be performed in facilities with appropriate postoperative monitoring and by a team who can limit the surgery time to less than four hours. Although a more significant operation than a classic abdominoplasty,this patient was able to walk with the aid of a physio on day one post operatively.