Northern Plastic Surgery (NT)
Abdominoplasty
Abdominoplasty removes the excess skin from the abdomen and tightens the muscles of the tummy and is effective for the post pregnancy bulge or post weight loss. It results in a flatter, firm and better shaped abdomen. It is considered both a cosmetic procedure and a reconstructive procedure so a medicare rebate is available for abdominoplasty.
The abdominoplasty may be combined with liposuction or other procedures and Dr Mahajani will help advise you.
When to have an abdominoplasty It is best that your weight is stable and there are no other significant other abdominal problem. After pregnancy, you should wait 12 months from the delivery and with massive weight loss, have achived your ideal body weight ( but discuss this with Dr Mahajani) The patient usually feels a bulge in the tummy and feels they need to get the skin.
Before the operation
Discuss any queries regarding the operation and post operation procedures with Dr Mahajani and his staff. Any fee enquiries please discuss with the practice administration. Do not smoke 2 weeks before the operation to 3 months after the operation. Stop any medications you have been advised to by the anaesthetist. Go to your anaesthetic appointment. We will give you the name of your anaesthetist so you can make contact with them. We will give you your operation date and time. The day before operation you will come for a mark up where the incisions are marked and the operation is discussed. Please bring the completed consent form with you.
The abdominoplasty operation
The operation is done under general anaesthetic or with a spinal. An incision is made from hip to hip and the skin is lifted up to the rib cage margins. We do preserve the belly button. The skin muscles under the skin are tightened with stitches. The excess skin is pulled downwards like a veil and the excess skin is removed. Then drains are inserted to remove excess blood. The skin is removed and finally the belly button is reattached into the tightened abdominal skin. The bed is bent to ease tension off the tightened skin and we apply dressings and support garments.
The mini abdominplasty is a variation of the standard abdominoplasty where just the skin from the lower abdomen is removed and the belly button is kept where it is. It is useful for a person with a slight roll and the belly button doesnt need shifting. Dr Mahajani will discuss this option with you.
After the surgery
You are admitted to the ward for 1-2 days. You have calf stimulators on the legs during the operation to prevent deep vein thrombosis or clots in the legs and these are removed. The abdominal drains are removed. You are discharged from hospital after 1-2 days with antibiotics and pain relief. Go home and rest, but you will come to the clinic for dressings and stitch removal at 1-2 weeks ( most stitches are dissolving) . We will ask you to wear garments for 6 weeks and come back for dressings. You can start driving after 1 week. Do not lift anything heavy for 6 weeks post op or do sit ups. Walking as an exercise is possible after 1 week. At 6 weeks you can commence exercise but build this slowly. At about 3 months, final post operative photos are taken.
Time off work
Most people take 2 weeks on average off work. It can be 1 week with a mostly sit down job. Dont lift anything heavy for 6 weeks
Surgery Expectations, Risks and Complications
For most people abdominoplasty is a safe and straightforward procedure. We would however like you inform you of what to expect along with risks and complications.
Scar
The operation does produce a scar from hip to hip and around the belly button. This scar is red up to 12 months but then settles down. In some people the scar may thicken or stretch. Some form of scar treatment or surgery may be needed ( see scar managment) . This can be seen in both the belly button and the lower abdominal scar. Whislt we attempt to make scars as fine as possible, scars in these areas can thicken and we cannot predict how scars will manifest.
Wounds
Generally heal over 1-2 weeks but can take longer. These can get infected and usually only requires antibiotics to treat. Occasionally stitches that infect need removal. We will help manage your dressings. Rarely some wounds break down and the patient needs a revision of this. Infections that require more than antibiotics like severe necrotic infections requiring surgery are very rare.
Asymmetry
There may be some asymmetry between side to side. Mostly this is not significant or noticeable and it rarely needs any correction.
Dog ears
At the end of the abdominal scar especially if you have a lot of skin to remove, the sides have a bulge that need a minor revision. This is called removal of dog ears. We would wait about 3-12 months to do this to allow the abdomen to settle down.
Bleeding seroma and swelling
It is unusual to have significant bleeding but if you do bleed, we may be required to stop the bleeding and or give a transfusion. There are drains which help indicate this. After the operation, more commonly people get a seroma or wound fluid that collects and doesnt absorb. This may require draining in the rooms. The abdomen takes usually 6 weeks to 3 months to completely settle.
Numbness and pain
In the lower abdomen and very rarely in the upper thighs, numbness may occur. This usually resolves over weeks or months. Occasionally it is permanent but doesnt interfere with function. Pain lasts 1-2 weeks and settles down after this over a 6 week period in most people but can take longer. In some patients, nerves can be irritated and cause pain that is very severe or longer to resolve. This is unexpected but occasionally occurs. If this happens, our practice will help you to manage this where we can.
Other complications
General complications from any anaesthetic include, sore throat, chest infection, deep vein thrombosis, irritation from dressings, rare complications from anaesthetic ( your anaesthetist will discuss ) .
Realistic expectations from an abdominoplasty It is important for your expectations to be realistic. We will try as far as possible , within the constraints of your physical health and the state of the abdomen to help you achieve your goals. The surgeon cannot guarantee all expectations and nor can guarantee the longlasting effect as the ageing process continues and there may be weight fluctuations.