Can I have an abdominoplasty if I have had previous surgery?
Previous operations will have changed the blood supply to the skin of your abdominal wall, which will be made precarious should I embark on certain types of abdominoplasty. So the answer is yes you can, but your previous surgery and the scars that result may mean that you are limited in what type of abdominoplasty you are suitable for. In some circumstances, I may have to re-use your previous scars (and modify and improve them) so as not to further damage the blood supply to the skin of your abdomen.
How is an abdominoplasty performed?
During the operation, I make an incision in your abdominal skin and lift it off the muscles of your abdominal wall. The belly button is released from it’s original position in the skin, but remains attached to you through your abdominal muscles and will be re-positioned appropriately in your new tummy.
The muscles are then tightened and the skin re-draped over the abdomen. Your skin is stitched back in place with absorbable stitches.
The operation typically lasts between two and three hours.
What should I expect from my consultation?
During your consultation, I will take a full medical history. I will ask you specifically about any diseases you have suffered that have affected your abdomen, as well as any previous surgery you may have undergone. I may need to write to surgeons who have operated on you in the past to discover what you have had done, so the more detailed information you can bring with you, the better.
I will examine you completely, then focus on your abdomen to assess whether you have muscle or soft tissue herniae, and the size, symmetry and shape of your excess subcutaneous fat. I will also look at the quality and elastic tone of your abdominal skin.
Finally I will then take standardised-view photographs in order to help plan and discuss your operation.
What does my operation involve?
Before surgery, you will meet and be assessed by your anaesthetist who will prescribe medications for your comfort and to lessen anxiety if need be.
On the evening before, or the morning of your operation I will review what we have discussed and planned previously and we will both sign your operative consent forms. Then I will draw the incision lines on your abdomen with a marker whilst you wear typical underwear ‘ with the aim of concealing your final scar (allowing for future variations in underwear fashions!)
The operation is performed under General Anaesthesia ‘ you will be asleep. Once anaesthetised you will be catheterised to drain urine from your bladder for your comfort and safety during the peri-operative period.
Two drains are placed under the incisions made in the abdominal skin that will remain for a week to ten days so as to remove the normal healing fluid that the body produces.
After surgery you will be monitored in a recovery area. You will have some discomfort following surgery for which you will receive pain relief. You will be able, and encouraged to walk with help within 8 – 12 hours of surgery to maximize your recovery.
Typically you will stay in hospital for two days after the operation and then most patients are able to go home ‘ usually with their wound drains still in place.
What about my recovery and return to normal activities?
Following surgery, you will wear a compression garment for three weeks, 24 hours a day; 7 days a week (except when washing it or you!) and then during the night for the next two weeks ‘ this helps your new abdomen settle in the correct position.
When you are discharged from hospital, someone must drive you home and someone must stay with you to assist you the first few days whilst at home.
Plan on at least six weeks to recover fully. For the first few days you will walk slightly stooped over. As the skin relaxes you will slowly straighten up. Wound drains are usually removed within 3 weeks depending on their output ‘ based on a record of how much fluid is draining that you will keep. Wound care around the drain sites is easy and you will be taught how to care for these areas before you leave the hospital.
You will feel tired and somewhat sore for a week or two following your surgery, but you will be able to move around and function relatively normally.
You will have buried, soluble stitching which will dissolve and doesn’t need to be taken out.
Generally, you can return to work if your occupation is sedentary, after 3 – 4 weeks, but if your work involves heavy lifting or is strenuous in other ways, for instance women police officers, 6 – 8 weeks might be a more realistic period off work. So long as you can do so with due care and attention, you can begin driving 3 – 4 weeks after surgery.
You should restrict yourself to light exercise for 4 – 6 weeks – avoiding lifting anything over 5Kg and aerobic exercise for at least 4 weeks.