Plastic Surgery Singapore

Abdominoplasty is also fondly known by the name of Tummy Tuck. It is a hugely popular surgery amongst women after pregnancy, and for very good reasons. Many ladies develop a lot of loose skin around the abdomen during their pregnancy due to the stretching of the skin to accommodate the uterus and the fetus. This often leaves folds of excess skin after delivery of the baby, which retracts to different degrees. In some ladies, the skin retraction is very nice, and they experience just a slight loosening or flabbiness of the the tummy skin. In the case of ladies who are not so lucky, they may experience severe dangling folds of skin.

The common misconception is that this may resolve with liposuction or exercise, but the harsh reality is that the excess skin may need to be removed surgically to regain that flat stomach.

Depending on the amount of fats and loose skin that a person has, he/she may opt for either of three options:

1. Liposuction
2. Mini-tuck
3. Full tummy tuck

Liposuction – If your skin is in good condition, and has minimal stretch marks, then doing just Liposuction would be sufficient to reduce the excess bulk around the tummy. Liposuction is reserved only for fat deposits which do not respond to normal means of fat loss like dieting and exercise. Because of the good skin retraction obtained after certain forms of liposuction like Vaser, where heat is generated under the skin, this may be a good solution for some patients.

Mini Tummy Tuck – If your skin is excessive, has stretch marks, and scars (e.g. cesarean section), the best combination for you may be to do a mini tuck. This involves removing some of the loose skin, and doing liposuction to remove the excess fats. This combination results in lower downtime, and is called a “mini-tuck”. The advantage of a mini-tuck is that poorly healed scars and stretch marks, etc can be removed by this procedure.

Full Tummy Tuck – If the condition of your skin and muscles is extremely lax, then the most invasive option would be to do a full tummy tuck. This procedure has more downtime of up to 3-6 weeks, and involves removal of more skin and tightening of more muscle than a mini-tuck. This is usually done when the skin is very lax and extends further from side to side.

How does it work?

During a tummy tuck, an elliptical shaped incision will be made to remove the excess skin and any scars in that area. If necessary, the abdominal muscles are stitched together to tighten them (this is called plication). In the case of a mini tuck, liposuction is done on the upper abdomen and love handles area to reduce the overall bulk of fats.

Finally, the skin is stitched together, leaving a scar that is hidden in the panty line.

After the tummy tuck, you will need to wear a compression garment and dressings. The average downtime varies from 2 – 3 weeks for a mini-tuck, to 3 – 6 weeks for a full tummy tuck.

How to decide between a full tummy tuck and a mini-tuck?

Full Tuck

1. A full tuck is a major operation, sometimes requiring hospitalization for a night. Many patients want lesser surgery and in particular, a shorter recovery period. Most patients in particular need minimal down time and a quick, predictable recovery;

2. The ability to remove fat in a full tuck is limited. Although the fat below the belly button can be treated, the fat above the belly button cannot without possibly affecting the blood supply. Similarly the love handle area is often problematic, and may leave dog-ears

3. Scar load – A full tummy tuck leaves a lot of scar. The scar from hip to hip, although it is well sited in a natural body line and usually positioned low and in the panty line, is still a long scar. The scar around the belly button in a full tummy tuck is particularly unattractive.

4. Repeat operations – While it may be necessary to perform a full tuck to address patients who have severe lax skin, repeat operations are sometimes necessary to complete the operation. In particular, some surgeons practice a second stage operation where liposuction is performed on the upper abdominal fats which were not treated to preserve good blood supply, and excessive dog ears are excised.

Mini tummy tuck

With a mini tuck, we find less of these problems. The biggest advantage is that the scars are much smaller, and there is no scar around the belly button. In addition, during the mini tuck, the surgeons are able to remove fats around the love handles and also fat in upper abdomen by liposuction. The downside of the mini tuck is that the belly button is pulled lower, and becomes vertically elongated, instead of previously horizontally elongated. Most patients do not mind this. The other disadvantage is that less skin can be removed, hence not all stretch marks can be reduced. Also, lesser muscle tightening can be achieved.

Comparing the two

The advantages of the mini tummy tuck are therefore that:
1. it is a smaller procedure – it can be done as day case surgery
2. the recovery (down) time is lesser, about 2 – 3 weeks
3. the scar is shorter
4. no scar is left around the belly button
5. the belly button becomes more vertically orientated
6. more fat can be removed, especially from the upper part of the tummy
7. significantly less expensive

The disadvantages of the mini tummy tuck as compared to the classic are:
1. slightly less skin tightening
2. less muscle tightening

Who is not suitable for a tummy tuck?

Patients still considering another pregnancy are advised against a full tummy tuck. Part of the full tummy tuck operation is tightening of the muscles of the tummy and these may be disrupted by the expansion that occurs with pregnancy. Certain abdominal scars, especially the old fashioned open cholecystectomy (gall bladder removal) scar, can interfere with the blood supply of the tummy skin and performing a tummy tuck in a patient with such a scar would be ill-advised. The newer endoscopic or laparoscopic procedures leave smaller scars which still allow the tummy tuck to be done.

Abdominoplasty is a good option for you if:

You are physically healthy and at a stable weight
You have realistic expectations
You do not smoke

Although the results of an abdominoplasty procedure are supposedly permanent, the positive outcome can be greatly diminished by significant fluctuations in a patient’s weight. For this reason, individuals who are planning substantial weight loss or women who may be considering future pregnancies may be advised to postpone abdominoplasty surgery.

What a tummy tuck won’t do:

Tummy tucks are not a substitute for weight loss or an appropriate exercise program. Also, tummy tuck operations cannot correct stretch marks, although these may be removed or somewhat improved if they are located on the areas of excess skin that will be excised which is usually the treated areas below the belly button.