By: Dr Anup Dhir
Senior Consultant, Cosmetic Surgeon, Apollo Hospital, New Delhi
Tummy tuck surgery, also known as abdominoplasty, removes excess fat and skin and, restores weakened or separated muscles creating an abdominal profile that is smoother and firmer. A flat and well-toned abdomen is something many of us strive for through exercise and weight control. Sometimes these methods cannot achieve our goals. After multiple pregnancies or large weight loss, abdominal muscles weaken, and skin in the area can become loose. Abdominoplasty can tighten the abdominal muscles and, in some instances, improve stretch marks. In women who have fat that is concentrated in the abdomen, the procedure will remove excess skin and fat. The surgery may not eliminate minor wrinkling or take the place of dieting, but it can improve a loss of skin elasticity in combination with localized fat accumulation.
This operation may be performed under general anaesthesia and you may need to stay in hospital for one or two days. The surgeon works through a low abdominal incision that spans the hips. The skin is detached from the abdominal wall to reveal the muscles and fascia to be tightened. The muscle fascia wall is tightened with sutures. The sagging skin will be pulled down over the abdomen before it is removed, so it would be necessary to release the navel from its surrounding skin and bring it out through a new skin opening in the skin flap. The scars across the pubic area and around the navel are permanent but improve, flatten and lighten in color overtime.
Sometimes, abdominoplasty may be combined with liposuction of the upper part of abdomen and flanks to achieve the best result. In some instances, when skin laxity and muscle weakness are limited to the area below the navel, a modified or mini abdominoplasty may be required. This procedure usually leaves a shorter scar and no scarring around the navel and recovery time is less. Endoscopic abdominoplasty is another technique for limiting scars and is useful when patients have only a minimal amount of excess skin and muscle laxity.
Giving birth is one of the most wonderful experiences in life, but it comes at a price. A lot of women experience some sagging in the lower area of their abdomen after delivering their child. Unfortunately, no amount of exercise and diet will be able to make this pouch completely disappear. This is often because of two distinct contributing factors. The first is that much of the affected area is excess skin that has nowhere to go. The other, larger problem is known as diastasis recti.
Diastasis recti refers to when the right and left halves of the abdominal muscles (the “six-pack”) spread apart. The tissue that connects the two halves of the ab muscles begins to stretch as the baby grows and your uterus expands, pushing against the abdominal wall. Pregnancy hormones add to the thinning of this tissue by making it softer and more pliable. A small amount of widening along the mid line is normal and expected in all pregnancies, but a separation of more than about 2 centimeters is considered a problem. Diastasis recti can happen at any time during the second half of pregnancy, but is most common after childbirth. This is because the abdominal wall slackens, and the thinner mid line tissue can no longer support the torso and internal organs. This results in the appearance of a paunch or pot belly.
Though diastasis recti occur in only about 30% of pregnancies, there are a few mitigating factors that increase its probability. Genetics can play a large role in developing the condition; for some women, it’s simply how their body responds to pregnancy. Women who experienced diastasis resti in an earlier pregnancy have a significantly higher probability of experiencing it again, and more severely, in subsequent pregnancies. Lastly, women expecting more than one child, petite women, and those with poor abdominal muscle tone have the highest risk.
After the surgery, you will be advised to wear a light support garment during the recovery period and to avoid strenuous activity for a few weeks. Dr Anup Dhir performs all types of tummy tuck procedures at Image medical centre.
Tummy tuck risks include:
- Anesthesia risks
- Fluid accumulation (seroma)
- Poor wound healing
- Skin loss
- Numbness or other changes in skin sensation
- Skin discoloration and/or prolonged swelling
- Unfavorable scarring
- Recurrent looseness of skin
- Fatty tissue found deep in the skin might die (fat necrosis)
- Deep vein thrombosis, cardiac and pulmonary complications
- Suboptimal aesthetic result
- Possibility of revisional surgery
- Persistent pain