Dr Nicholas Lotz (FRACS) Specialist Plastic Surgeon
Dr Nicholas Lotz
MBBS BSc(Med) FRACS
Specialist Plastic Surgeon
Main Rooms
Level 1 357 Military Rd
MOSMAN, NSW 2088
Appointments & Enquiries
info@drnicholaslotz.com.au
Ph: 1300 304 209
Fax: 02 9904 0166
BODY

Abdominoplasty

The following information sheet is intended to assist patients undergoing abdominoplasty surgery (or “tummy tuck”) with Dr Nicholas Lotz.

 

Overview

Abdominoplasty

An abdominoplasty (or ‘tummy tuck’) is a procedure to remove excess skin and fat from the stomach area, whilst at the same time tightening the muscles of the stomach.

This is a common procedure for women who have had several pregnancies or for patients who have lost a lot of weight.

During pregnancy, the muscles of the abdominal wall separate and stretch. Often this will return to normal after the birth of your child, but with very large babies, multiple pregnancies, or in women who have already had other pregnancies, the separated muscles may not close. This leads not only to a loss of core strength and a stomach that looks bloated, but can also contribute to a loss of pelvic floor strength and worsen urinary symptoms following pregnancy. Skin which has stretched and lost its’ elasticity can also leave loose folds on the stomach.

Abdominoplasty (Tummy Tuck)

Before the
surgery

During your initial consultation, Dr Lotz will spend time with you discussing exactly what your concerns are. All patients have slightly different requirements, and will require abdominoplasty surgery to be tailored to their needs. Dr Lotz will explain in detail what is required in your case, and the relevant risks and expected recovery will be discussed. You will be shown photographs of other patients who have undergone similar abdominoplasty surgery, so you have an idea what to expect with respect to results.

It is important to be close to your goal weight before surgery, as weight fluctuations after abdominoplasty can detract from the final result. It is also important that you are not planning any further pregnancies.

Smoking should be ceased a month before surgery to decrease the risk of wound healing problems.

You will usually be sent to have an ultrasound of your abdominal wall, to determine the amount of muscle separation that you have, and to document any possible hernias there are that will need to be fixed during the surgery.

You will be given an information pack on the day and a quotation will be emailed which outlines in detail all the associated costs of abdominoplasty surgery.

You will have a second consultation a week or two prior to your surgery to answer any final questions you may have, and photographs will be taken to aid planning your abdominoplasty surgery.

Abdominoplasty (Tummy Tuck)

The surgery

Abdominoplasty is performed under general anaesthetic at an accredited hospital with a qualified and experienced anaesthetist. The surgery takes about 3 hours. Unlike many other surgeons, Dr Lotz does not use a surgical assistant so you can be assured that every part of the surgery is performed solely by him.

Surgical procedure

A catheter will be placed in your bladder and remain overnight, so that you do not need to get up to the bathroom the first night of surgery. An incision will be made (using your caesarean scar if you have one) across the lower part of your stomach, under the bikini line. There will be a circular incision around your belly button.

The skin and fat will be lifted up off the abdominal muscles, which will then be tightened at the same time as fixing any hernia that you have. Liposuction may be performed to aid contouring. The excess skin is then removed, and most of the wounds are closed using internal, dissolving sutures to help obtain the best possible scars. The incision will be covered with a waterproof dressing.

Two small drainage tubes will be placed under the skin to drain any fluid. A compressive garment will be put on you to keep some gentle support on the repaired muscles, and to help minimise swelling.

Abdominoplasty (Tummy Tuck)

After the surgery

Post-operative recovery

Dr Lotz will check you the morning after the surgery. At this time the catheter will be removed from your bladder, and you will be able to get up and walk around a little.

You will generally be in hospital for 3-4 days, depending on how comfortable you are, and how much fluid is coming out from the drains. Dr Lotz will check you each day to determine when you are ready to go home.

Follow-up 

You will be seen in the rooms a week after surgery to check all the wounds, and then once more a week after that to remove a few stitches from around the belly button and see how you are healing.

Rest and Recovery

It is important to rest for a few weeks following the surgery. Once the drains are removed you will be able to shower normally.

You will be able to drive 2 weeks following the surgery

You will need to wear the compression garment for a month following the surgery.

Light activity is started about 3 weeks after surgery, but it will take 6-8 weeks until you are back to full exercise.

Most patients are back at work in 2-3 weeks.

Risks of abdominoplasty

Serious complication following abdominoplasty surgery is fortunately rare, but risks include:

  • Anaesthetic (nausea, vomiting, allergy, clots in legs)
  • Infection
  • Bleeding
  • Pain
  • Fluid collection after the drain is removed (seroma)
  • Wound healing problems
  • Scarring
  • Asymmetry of the scar or belly button
  • Numbness
  • Elevation of the pubic hair
  • Bulging at the ends of the wounds (dog-ears)
  • Necrosis of some of the belly button skin
Before After
Before After
Abdominoplasty

Frequently Asked Questions

What Can I Do About My Caesarian or C-Section Scar?

This is a very common concern in women who have had a caesarian section. As time goes by the low scar may widen or look crooked and accentuate any bulging over it. The “tummy tuck” procedure (abdominoplasty) can be used here too. The C-section scar can be revised and the abdominal muscles tightened to flatten your stomach.

Should I Get A 'Tummy Tuck' (Abdominoplasty) After Having Children?

Unfortunately after you have had children (especially large babies or multiple births) your stomach muscles may remain stretched, and while you can strengthen these muscles, no amount of exercise will help them to come back closer together.

If you find the shape of your stomach bothers you when wearing swimwear or fitted clothes, then a tummy tuck (abdominoplasty) can be an option to regain or even create a flat tummy.

What Are the Benefits of Tummy Tuck (Abdominoplasty) Surgery?

Studies have shown tummy tuck (Abdominoplasty) surgery offers significant benefits in strength, reduced back pain, better bladder control and improved confidence.

A tummy tuck (Abdominoplasty) is beneficial for those who can relate to the following:

  • Have a protruding abdomen from stretched muscles and skin
  • Have loose abdominal skin that may hang over your caesarian scar
  • Suffer from weakened abdominal muscles caused by pregnancy or ageing, which has caused muscle separation and a “gap”
  • Are unhappy with excess fat in the abdominal area that won’t budge with diet and exercise

What is a “Mini” Tummy Tuck (abdominoplasty)?

Mini-abdominoplasty (or ‘mini tummy tuck’) is helpful if you have a small amount of skin looseness, and that skin is mostly restricted to the lower abdomen below the belly button. It is best if there is less need for major muscle tightening.

The scar is kept short above the pubic area, and is shorter than the full or standard abdominoplasty. Loose fat and skin are removed from the area above the pubis, and some additional liposuction is often also done to improve the overall shape.

In mini-abdominoplasty, the belly button is not moved, and little work is done above the level of the belly button. Unlike the full abdominoplasty, with a mini-tummy tuck there is no scar around the belly button. Since there is less muscle tightening, recovery is usually quicker and the scar shorter. 

What is a “mummy makeover”?

“Mummy makeover” is often the term used to describe a combination of plastic and cosmetic surgery procedures performed for women who wish to improve their body appearance after they have finished having children. Hence, a “mummy makeover” is when a tummy tuck (abdominoplasty)  is combined with breast surgery, such as a breast reduction, a breast lift, or a breast augmentation. The goal is complete restoration of the breasts and stomach following child birth.

Can I Get Pregnant After Tummy Tuck (Abdominoplasty) Surgery?

Tummy tuck (Abdominoplasty) surgery will not affect your ability to have children in the future. However, it is typically advised to wait to undergo the procedure until after you have completed your family. Should you become pregnant after you have tummy tuck surgery, this can undo the results of your procedure. The skin may stretch, and your abdominal muscles can separate again. Although pregnancy after an abdominoplasty can affect your surgical outcome, it should not affect your health or safety.

How Much Does A Tummy Tuck or Abdominoplasty Surgery Cost?

The good news is that if an ultrasound demonstrates that your muscle separation is over 30mm then you qualify for a Medicare item number. Depending on your level of health insurance, some of the surgery cost of for your abdominoplasty will be covered. If you have not had an ultrasound done before your consultation then we will arrange for one to see if this applies top you.

In cases of extreme weight loss, then a Medicare item number is also applicable.

Many patients have an associated hernia around the belly button, and there are medicare rebates available for this as well.

The exact costs will be provided after your consultation. 

(*Is tummy tuck surgery covered by Medicare?)

Are There Any Alternatives to Tummy Tuck (Abdominoplasty) Surgery?

A “mini” tummy tuck may help if you only have a small amount of loose skin on your lower stomach.

If you only want to treat a small area of fat around your abdomen, liposuction alone may be suitable. Liposuction does not, however, tighten the muscles or skin in the abdominal area, and if you are over 40 then this may result in more loose skin following fat removal. 

In some cases, skin tightening lasers may help with small amount of loose skin.

Considering plastic surgery?

If you would like further information or if you wish to make an appointment to discuss a tummy tuck or abdominoplasty procedure with Dr Nicholas Lotz, please contact our rooms.

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