Abdominoplasty or “tummy tuck” removes excess fat and skin of the abdomen It is a body contouring procedure and not a weight loss procedure. Most patients lose only a couple of kilos at most, but receive a lot better contour to their abdomen. It is best to lose as much excess weight as possible before this procedure, so Dr Raja can contour your abdomen to a tighter and slimmer silhouette. Underneath the skin and fat is your abdominal wall which Dr Raja will tighten with sutures for contour. Excess weight is also held behind the abdominal wall around your bowels which cannot be surgically removed and prevents optimal tightening of the abdominal wall. It is best to address this area through diet and exercise prior to your procedure. Excess skin and stretch marks are commonplace after childbirth and significant weight loss. This can cause significant problems with clothing and general comfort, and even restrict activities including exercise. In patients who have achieved significant weight loss, other areas may also be affected. Dr Raja can speak to you about other areas that concern you at your first consultation. How does an abdominoplasty work? In an abdominoplasty, skin excision is planned so that the eventual scar sits low in the abdomen around the groin, so it can be covered with undergarments and appropriate swimwear. If the skin excess follows around into the flank areas, the scars may need to be taken out slightly higher into the flanks, so clothing doesn’t rub on the scars against the bony pelvis, which can cause problems. The umbilicus or belly button needs to be repositioned by cutting around it and lifting the skin and fat off the abdominal wall up to the rib cage leaving the belly button behind on its stalk. The abdominal wall is then tightened with sutures and surgical mesh is sometimes used to reinforce this. The skin is then stretched down towards the pelvis with the hips slightly bent and excess skin excised so the skin can be repaired under tension, so it is firm and tight. A new position is marked in the midline where the umbilicus or belly button can be brought out and an incision made to deliver the belly button through for refashioning. Surgical drains are placed, and the tissues are repaired in layers with buried sutures. Mild Skin Laxity If you have only mild skin laxity and stretch marks in the lower part of the abdomen, you may be a candidate for a mini-abdominoplasty which is a smaller procedure whereby only the redundant skin and a small amount of fat in the area is removed, leaving the belly button where it is. If there is minimal skin laxity and excess above the belly button, this may be addressed with non-surgical fat reduction devices or with liposuction which can be performed at the same time as a mini-abdominoplasty. Large Abdominal Roll If you have a large lower abdominal roll with skin irritation below it but are considered to be too high risk for a full abdominoplasty, you may be a candidate for excision of just that tissue without full abdominoplasty and is known as a “wedge excision” or “apronectomy”. Major Skin Laxity If you have a large amount of skin laxity from side to side as well, seen mainly after massive weight loss, you may need a further scar in the midline to allow skin excision in a horizontal plane ie to reduce horizontal laxity. This is called a Fleur De Lys abdominoplasty and leaves an anchor shaped scar with an inverted T-shaped junction scar at the connection of the midline vertical and lower horizontal scars. This T-junction presents a higher risk of wound healing problems. Immense Weight Loss Patients with massive weight loss tend to have thin stretched skin with poor strength. If they have lost a lot of weight recently they may be malnourished and be at risk of poor healing. We like these patients to have completed their aimed weight loss and have stable weight for 6 months prior to body contouring procedures. Also, as the tissues are thin and poor in quality, they cannot be repaired under as much tension as otherwise and tend to re-stretch somewhat after surgery. This is not to say that their results will be lost, only that their results are limited and affected by the tissues that are left behind after weight loss. Significant Flank Fat If you have significant fat in your flank areas, you may benefit from liposuction in this area which can be performed at the time of your abdominoplasty or at a separate sitting. You may also be a candidate for non-surgical fat reduction and skin tightening in this area with Non-surgical devices. Enquire from our clinic staff about Non-surgical treatments. If you also have skin laxity in the lower back with sag in the buttock areas, you may be a candidate for a combined abdominoplasty with buttock lift (belt lipectomy or lower/circumferential body lift). Preparing for surgery It is imperative that smoking is avoided completely for six weeks before and after your surgery. Smoking causes a much higher rate of wound breakdown, as well as skin and fat necrosis. Abdominoplasty Gold Coast Dr Raja will assess your individual situation, desires and risk factors. He will then explain the options, relative risks and benefits of each before coming to a decision with you on a plan for your chosen procedure/s. To request your consultation, please do not hesitate to contact us. Don’t forget to share this via Twitter, Google+, Pinterest and LinkedIn.