What Are The Consequences?
The patient is left with noticeable scars. The main scar runs transversely across the lower part of the abdomen and in a standard abdominal reduction there will be a scar around the umbilicus. Other or different scars may be left where the patient has particular problems. Some patients make better scars than others and in any case all the scars are red initially. It is essential that the patient understands where these scars will be and should discuss them with the surgeon. Although we try and hide them beneath underwear and swim wear fashions can change making previously covered scars visible.
There is numbness in the lower part of the abdominal wall after surgery. This is usually temporary but could be permanent. Swelling above the scar is usually present due to a collection of tissue fluid which normally drains to the groin. This swelling or oedema settles within a few months.
What Are The Limitations?
The skin is usually tightened downwards and this does not tighten the waist. If this is desired then one can consider removing skin vertically, but one should bear in mind that vertical scars of the abdomen are less good.
The tissue of the abdominal wall is generally fatter than the groin and if liposuction is not carried out a fatty bulge may remain over the scar.
The beneficial effects of the operation will last well. However, the effects will be maintained better if the patient keeps exercising the muscles and keeps the weight steady. A further pregnancy will of course stretch the skin again, although probably not to the same degree.
What Are The Risks?
The standard abdominoplasty is a large procedure requiring two to four days' hospitalisation. Drains are removed when they stop draining blood and serum a few days after the procedure. This fluid can reaccumulate after drains are removed, requiring drainage aspiration.
Healing can be slow, particularly in the tighter central part of the wound and sometimes dressings are needed for a few weeks. This is more common in patients who are overweight and who smoke. This tends to leave more obvious scars which are tethered - this can be revised.
Secondary procedures are sometimes carried out to tidy up the results and will involve scar revision and limited liposuction. Displacement of the umbilicus to one side has been over publicised and is rare.
Deep vein thrombosis and pulmonary embolus are rare complications of any operation including this one.