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This leaflet is for anyone having an abdominoplasty operation; it will help you to understand the operation and to know what to expect from your hospital admission.

It is important that you read and understand this leaflet before agreeing to have the operation.

What is an abdominoplasty operation?

• An abdominoplasty operation is major surgery that involves removing an area of skin and underlying fat from your abdomen and repositioning your umbilicus (tummy button), it will leave a scar from hip to hip.


• It is performed under a general anaesthetic.


• Abdominoplasty is also known as a 'tummy tuck' or as an 'abdominal resection'.


• During the operation your surgeon may also tighten your abdominal muscles.

Why are you having an abdominoplasty?

An abdominoplasty will reduce excess skin from your abdomen following weight loss or successful treatment for obesity. It may also help to tighten abdominal muscles, which have become weakened.

What are the risks and consequences associated with an abdominoplasty?

In the majority of cases this operation is carried out very successfully with good cosmetic results, however as with any surgical procedure there is a small chance of side effects or complications. This list of complications is not intended to put you off having the operation but you need to be aware of any potential complications before you consent to having surgery.

• Bleeding. During or soon after the operation you may experience excessive bleeding from your wound, which may result in a collection of blood (haematoma) beneath the wound site. If this occurs you could experience excessive pain and swelling in your abdomen. The collected blood may need to be removed in the operating theatre; this may necessitate another operation.


• Loss of skin from your abdomen. During the operation cuts are made through your skin, fat and muscle. This tissue requires a good blood supply. Rarely, the blood supply to the skin is disrupted and becomes inadequate. As a result of this some of your skin may die, causing a wound on the surface of your abdomen; it is also known as skin necrosis. If this happens healing will be delayed and extra scarring may occur. An implication of skin loss may be the need for further surgery to correct the problem; this may include a skin graft operation at a later date.


• Fat necrosis. Your abdomen contains a large amount of fatty tissue beneath the skin; during the operation cuts will be made through this tissue. Rarely, the blood supply to this area becomes inadequate, causing the fatty tissue to die, this is known as fat necrosis. If this happens the fat could liquefy and may leak from your wound. In consequence, healing may be delayed, and you may need further surgery to correct any contour deformity resulting from the fat necrosis.


• Umbilical necrosis. During the operation your umbilicus (belly button) may need to be repositioned. There is a small risk that repositioning the belly button may cause all or part of the skin of your belly button to die. If this happens healing will be delayed and you may need further surgery to correct the problem.


• Fluid collection beneath the wound (seroma). There is a risk that fluid may pool beneath your stitch line after surgery, this is known as a seroma. A seroma can occur at any time after the operation. This fluid is usually re-absorbed by the body over time, however, if the seroma is large or causes discomfort, a doctor may need to remove the fluid using a small needle and syringe. In some cases the fluid can collect again, so this procedure may need to be done more than once.


• Wound infection. A wound infection can occur at any time following surgery. If your wound becomes infected you may need treatment with antibiotics, or you may require hospital admission for further surgery to drain the infection. Symptoms of wound infection can include increased swelling, redness, fluid leakage and increased pain in your abdomen. Some of these wounds infections may become severe.


• Wound breakdown. Wound breakdown may occasionally occur following surgery. Often there is some delay in healing of the stitch line. However in rare cases, the stitch line may not heal properly and the wound may breakdown or gape. As a result, dressings will be required for prolonged periods, and surgical adjustment may become necessary to hasten healing and/or minimise the distortion that this complication can sometimes cause.


• Excess or abnormal scarring. You will have a permanent, scar on your skin. Your scar may be concealed by clothing, however this cannot be guaranteed. Your scar may improve over a period of 18 months following surgery, however some people, for unknown reasons, develop raised, red and lumpy scars; unfortunately this is largely beyond surgical control. The risk of this occurring is greater if you have already developed thickened scars following accidents or operations elsewhere. Scars sometimes stretch as they mature and this is also largely beyond surgical control.


• Asymmetry of the umbilicus and scarring. During an abdominoplasty operation your surgeon may need to reposition your umbilicus (belly button). There is a risk that your umbilicus may not be placed centrally on your abdomen. Some degree of asymmetry of your scar may also be evident. If you are concerned about asymmetry after your scars have had at least 12 months to settle you should discuss this with your surgeon.


• Dog-ears. Once your wounds are healed you may notice an excess of skin at either end of the stitch line, these are known as surgical dog-ears. If these have not settled down after 12 months, it is best to discuss further management with your surgeon, a further operation may be necessary to correct the dog-ears.


• Altered sensation in your thigh and abdominal skin. You may experience some numbness in the lower part of your abdomen and thighs after this operation. In the majority of people this numbness will reduce over a period of 12 months following surgery. However a small number of people may experience permanent numbness of their skin following abdominoplasty.


• Deep vein thrombosis (DVT). This is a blood clot that arises in the deep veins of the leg or pelvis. A deep vein thrombosis can happen if your mobility is restricted or you are inactive for a time following your operation. You may be given injections that help to prevent this from happening. You can reduce the risk of deep vein thrombosis by wearing the elastic stockings supplied, during and after your operation and moving your legs about whilst you are in bed. Getting up and walking as soon as you are well enough may also reduce the risk of a DVT.


• Pulmonary Embolism (PE). This is a portion of blood clot that has become lodged in a small blood vessel in your lung. It can cut off some of the blood supply to your lung causing shortness of breath or pain when you breathe in deeply. PE is a serious complication of surgery. You can reduce the risk of PE by following the advice for the prevention of DVT listed above.


• Chest infection. A chest infection can occur following any general anaesthetic. You can reduce the risk of this happening by taking regular deep breaths following surgery and getting up and sitting out of bed as soon as you are well enough. If you smoke you can reduce the risk of a chest infection by stopping smoking for at least a month prior to your operation.


• Anaesthetic risks and complications. You will need a general anaesthetic. Your anaesthetist will give you more information about your anaesthetic and will discuss anaesthetic risks and complications with you prior to your surgery.

There may be other risks specific to your individual case; your surgeon or nurse will discuss any further risks with you.

If you are concerned about any of these risks or have any further queries, please speak to your consultant or a member of the medical team.

How should you prepare for surgery?

• If you are overweight you will be asked to reduce your weight to within normal limits for your height. You will need to achieve this weight reduction before admission to hospital. If you need help to reach your target weight your GP may be able to refer you to a dietician.


• If your GP prescribes aspirin, ibuprofen or other medications which may cause bruising or bleeding such as clopidogrel or Vioxx, you may be asked to stop taking these for a period of time before your operation. These medications may increase the risk of bleeding during and after your operation. Your surgeon will advise you about this when you see him / her in clinic. If you do not hear from the hospital, then continue to take your medication as normal.


• If you normally take warfarin tablets you may be asked to stop taking these 3 days before your operation. You may also be asked to have a blood test on the day of your operation.


• If you take the oral contraceptive pill or HRT you may be contacted by the hospital and asked to stop taking them. If you do stop taking the contraceptive pill remember to use some other method of contraception to avoid pregnancy. If you do not hear from the hospital, then continue to take your medication as normal.


• You may be asked to attend a pre assessment clinic, however this does not apply to all patients.

What happens when you arrive in Hospital?

• A resident doctor along with the nursing staff would admit you and your consultant would take you through the informed consent form and perform any necessary preoperative photographs and markings. You will also see the anaesthetist.


• On the day of your operation you will need to stop eating and drinking for a period of six hours before the surgery.


• Please have a bath or shower before your operation.


• If you have any questions or concerns about your operation, please ask your surgeon or a member of the nursing staff for assistance.

What happens after the operation?

• The operation will take about 2 hours to complete, however you will be in the operating department for longer than this to allow time for recovery.


• When you wake up from your operation you will be lying in a 'jack-knifed' position; this means that you will have pillows under your knees, keeping your hips and knees bent to reduce the tension on your abdomen. You will be asked to sleep with your hips and knees on this position for several days following your operation, to reduce the strain on your stitches.


• You should not lie on your sides or stomach as this will cause discomfort and will put pressure on your stitches.


• The nurse looking after you will regularly check your wound, your drains, and your blood pressure and pulse after you return from theatre.


• There will be bruising, swelling and discomfort following your operation, and you will be offered pain relief either by injections, tablets or a patient controlled pain relief pump.


• You may have a drip, usually in your hand or arm, to replace any fluid lost during your operation. You may lose blood during your operation; rarely you may need a blood transfusion to replace this. Alternatively, you may be prescribed iron tablets to correct any associated problems.


• You will have a dressing over your abdominal wound and you may also have a tummy "corset". You would wear the "corset" for 6-8 weeks following surgery.


• There will usually be a drain (tube) at either side of your abdomen, which drains away any excess blood into a bottle attached to the drain. These drains will be removed when there is only a small amount of drainage. This can take several days.


• Your dressing will normally be left in place for up to 10 days unless it becomes wet, in which case it may be changed earlier.


• You will generally be encouraged to get up on the day after your operation to help prevent the formation of any blood clots in your legs. You will be asked to walk in a 'stooped' position for a few days to reduce the strain on your stitches.

How long will you stay in hospital?

• Your hospital stay will normally be for 1-2 days after your operation, however this depends on when your drains are removed.

Going home

• You may be prescribed a weeks supply of painkillers to take home. If you need a further supply you should contact your own doctor.


• When you are discharged from hospital you should keep fairly mobile but avoid any movements that cause straining or stretching to your abdominal muscles and wound.


• You do not need any special care at home, however if you have small children it may be advisable to arrange for someone to help you to care for them.


• Please do not use a hot water bottle to relieve abdominal discomfort at any time after your operation.

Follow up

• Your dressings will be changed after 10 days, in the dressings clinic.


• Any staples or stitches will be removed in dressing clinic, usually within 10 days of your operation. Most patients will have dissolving stitches that do not need to be removed.


• You will require dressings until your wounds have healed.


• Once your wounds have healed you should massage your scar regularly as this may help it to settle down.


• You will be sent an appointment to see your consultant in the out patients department at approximately 6-12 weeks following surgery. This follow up scheme may vary with the individual patient or type of surgery and only serves as a guideline.

What can go wrong?

• It is normal to have some bruising, swelling and tenderness around your abdomen for several weeks following the operation.


• However if you suffer from any of the following symptoms after your discharge from hospital you should telephone the plastic surgery ward for advice:


• Persistent or increasing levels of pain;


• Fever;


• A feeling of heat in your abdomen;


• Redness or swelling of your abdomen;


• Tiredness or fatigue that lasts longer than three weeks.


• Shortness of breath or pain when you breathe in deeply.

When can you start your normal activities again?

• You should not drive until you can wear a seat belt comfortably and feel able to perform an emergency stop, this could be up to 6 weeks following surgery. Your insurance company may refuse to meet a claim if they feel you have driven too soon. It is also advisable to contact your insurance company with regards to cover following a general anaesthetic.


• You should not go back to work until instructed by your surgeon. This could be 4-6 weeks depending on your job and the type of surgery.


• Please ask if you need a doctor's certificate for your work.


• You may resume sporting activities approximately 6 weeks after your surgery, however you should stop if you experience pain or discomfort during the activity.

Leaflet information
This information leaflet has been devised by:
Mr A.M. Juma, Consultant Plastic & Reconstructive Surgeon

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