Abdominoplasty

A traditional tummy tuck is a major procedure with the potential for a number of complications. These include fluid collection, poor healing, scarring and bleeding, meaning a number of large drains and multiple follow-up visits to the surgeon may be required.

The Cadogan Clinic Brazilian Abdominoplasty delivers better results than a traditional tummy tuck, minus the complications of the full abdominoplasty. The Brazilian technique removes the same amount of skin as a full abdominoplasty would, tightens the rectus abdominis muscles and repositions the belly button. Unlike its traditional counterpart, the Brazilian uses liposuction to mobilise the skin, speeding up the healing process. 

Although this technique provides improved results and quicker healing, the Brazilian is a far more complex and advanced surgery than a traditional abdominoplasty. Because it is a highly precise surgery, it takes longer to perform, but it achieves a superior result.

The Brazilian Abdominoplasty can be carried out as a day case.

Benefits of The Cadogan Clinic Brazilian Abdominoplasty include:

• Far less pain
• Shorter downtime
• 30% less risk of hematoma seroma (blood or fluid collecting at the operation site)
• Usually carried out as a day case
• No drainage required
• Improved ‘nipped-in waist’ appearance
• Speedy recovery
• More liposuction

In comparison with a traditional tummy tuck:

• Several nights’ stay in hospital
• Increased downtime
• 30% higher chance for hematoma seroma (blood or fluid collecting at the operation site)
• Longer recovery time
• Highly unpleasant drains required for the surgery area. 

A mini tummy tuck only removes the loose skin and bulge of fat below the belly button to sculpt the lower abdominal wall. The abdominal muscles below the navel can also be tightened if necessary. Unlike the Brazilian or full abdominoplasty, the tummy button is not moved. A mini tummy tuck leaves just one scar running across the lower abdomen. Very often it is not much longer than a caesarian section scar and easily hidden.

If you are not a candidate for a full abdominoplasty, then a mini tummy tuck - also called mini-abdominoplasty or mini stomach correction - can offer a good solution. 

A mini tummy tuck is a popular choice for younger people who may not require the more invasive full abdominoplasty. A mini tummy tuck is also a great way of targeting smaller areas of lax skin following more minor weight loss. This includes the ‘pouch’ which can appear following pregnancy and doesn’t seem to be flattened by diet or exercise alone. The mini-abdominoplasty is particularly appropriate for patients who have had a caesarian section, and are left with a fold of skin above the scar visible through clothing.

One of the benefits of this technique is that it can target smaller, more specific areas of the tummy.

A mini tummy tuck is an effective way to flatten and tighten the lower stomach and the results are often permanent. It is important to maintain a healthy weight in order to maintain the result.

We use the same techniques as for the full Brazilian Abdominoplasty and perform the procedure as a day case, avoiding drains and reducing complications.

This is for the unsightly fold of skin that so often develops above a caesarean section scar. It is due to tethering of the scar and any loose skin and fat will bulge above it. This is unsightly and visible through tight clothing and swimwear. We treat this by simple excision, with or without liposuction. It is normally carried out under local anaesthesia as a day case.

This is for patients who are left with a bulging abdominal wall after pregnancy without a surplus of skin and is due to an over-stretching of the muscles and the fascia retaining the vertical rectus muscles. We introduce a telescope through small incision in the pubic area and at the umbilicus to repair this weak fascia. It is very important that patients do not overexert the muscles of the abdominal wall for at least three months following this surgery.

The main difference between fleur-de-lis and a full abdominoplasty is the shape and size of the incision. The fleur-de-lis technique is the best option if the patient requires the removal of a large amount of skin. Good candidates for a fleur-de-lis procedure will have significant skin laxity.

Sometimes patients have an extra surplus of skin vertically and laterally and it is desirable to remove some skin centrally to tighten the waist. Here as well as the long horizontal cut of the standard abdominal reduction there is a vertical cut too, so that the resulting scar looks like an anchor with a small vertical element extending from the lower scar upwards towards the umbilicus (tummy button). It is this shape where the fleur-de-lis gets its name from.

A fleur-de-lis may take longer to heal than other abdominoplasties because of the area where the horizontal and vertical incisions meet.

This particular technique is perfect for people who may have undergone dramatic weight loss, but their new slimmed down figure is hidden beneath a large amount of surplus skin.

This is a modified mini tummy tuck for patients who have a lot of skin and fat hanging down over the pubic area, here only extra skin and fat is removed. This leaves a long horizontal scar. If there are scars from previous operations the usual tummy tuck may be modified to incorporate them.

Also known as a full abdominoplasty, or traditional tummy tuck, this is for patients who have surplus skin and fat extending right around the abdominal wall into the flanks and beyond. In these cases, the low horizontal scar is extended laterally into the flanks.

At the Cadogan Clinic, we consider it to be obsolete. It is, however, the common procedure carried out countrywide to remove excess skin and fat. All the skin and underlying fat of the abdominal wall from the umbilicus (tummy button) is removed allowing the muscles beneath to be tightened. The skin of the upper abdomen is freed up as far as the ribs and pulled down and stitched leaving a long scar across the lower part of the abdomen to be hidden beneath panties or bikini. The freed-up tummy button is brought through at the appropriate level.

This is a big procedure requiring several nights in a hospital and, because of the undermining (freeing up) of all the skin and soft tissues of the abdominal wall, carries risks of blood and serum collecting under the wound. This issue is solved to some degree by using multiple drains, which remain in place for some days. These drains are uncomfortable, inconvenient and only partially reduce these risks. 

At the Cadogan Clinic, we can produce a tight, slim contoured abdomen without using drains and allowing patients to walk out of the clinic the same day. The risk of blood and serum collecting under the wound is small. The key is liposuction used both to thin and contour the abdomen, but also to mobilize the skin without cutting its blood supply.

In the body lift the surplus skin and fat extends from the abdomen around the flanks and across the back. It is possible to remove a strip of skin all the way around the abdominal wall in the shape of a tyre. However, if this is carried out tightly the tension is too great to allow proper healing both on the front and the back at the same time. At the Cadogan Clinic we prefer therefore, to carry out a body lift in two stages, with an extended abdominoplasty on one occasion and then the tissue of the back removed separately on another occasion.

An endoscopic tummy tuck is a minimally invasive option which leaves no scarring and requires minimal downtime. The procedure is carried out internally.

The surgeon will create a small sideways incision in the abdomen, above the pubic hair. The procedure will stretch the abdominal muscles from the inside of the body. This will return the tummy to its original shape and form. An endoscopic tummy tuck is generally performed on younger patients who have experienced pregnancy. 

This procedure is perfect for patients with good skin elasticity but have issues with loose tummy muscles. This includes diastasis recti, the separation of the abdominal muscles, which occurs during pregnancy. It is very common in pregnancy, with about two-thirds of pregnant women experiencing diastasis recti. Men can also experience diastasis recti, often due to yo-yo dieting or doing certain exercises incorrectly, such as sit-ups or weightlifting.

If you are suffering from excess loose skin, you may wish to consider an alternative abdominoplasty treatment, such as a Brazilian abdominoplasty or fleur-de-lis tummy tuck.

There is no skin removal in an endoscopic tummy tuck as this is a treatment which focuses purely on the muscles. However, the procedure can be carried out in conjunction with liposuction to help improve body contours and help achieve an enhanced result. 

The first step for all of our patients is to meet with the surgeon we feel is best placed to perform your procedure for a consultation. At the consultation you will be able to discuss with your surgeon what your hope to achieve from the procedure, as well as discuss in detail what may or may not be possible given your existing abdomen profile.

Your surgeon will take you through the various options (Full/Mini/Extended) and which is most suitable and preferential for you. Having established this, several key abdominal measurements will be made and standard clinical photography will be taken.

Finally a comprehensive discussion regarding risks and complications will take place, alongside a discussion regarding the post procedure and recovery phase. Your previous medical history will also be recorded (including previous surgery, medications, allergies etc.) and an assessment of your fitness for surgery.

If your surgeon feels you are a good candidate for surgery, you are then invited to consider whether you would like to proceed for surgery or otherwise following a two week 'cooling off' period.

Within this period you are welcome to come in and discuss your potential surgery with your surgeon as many times as you like.

If you choose to proceed with surgery, the next time you come into the Clinic after your final consultation will be the day of your procedure. Before admission the following behavioural changes are recommended / required:

• In the 6 weeks before your procedure we recommend smoking is discontinued as patients who smoke have a higher risk of healing more slowly and complications
• In the week before your procedure you must cease taking Aspirin or any medication that contains Aspirin
• In the 6 hours prior to surgery you must not consume food or any drink, other than small sips of clear fluid (e.g. still water, black coffee, black tea) which are allowed up to 2 hours before admission

On the day of your procedure we ask that you arrive for your admission an hour before the agreed start time of surgery. At this point a nurse will come and record blood pressure and other relevant vitals, you will meet with your anaesthetist and your surgeon who will make the final mark-ups.

The procedure itself takes place under general anaesthetic over the course of two to three hours. An incision is made across the underwear line to ensure inconspicuous scarring, and the abdominal skin lifted to allow the surgeon to tighten (and if necessary repair) the weakened muscles underneath. The skin itself is then pulled back down over the wall, excess skin is trimmed away, and the skin is then sutured back to original incision line with increased, but not excessive, tension. A new opening for the naval (belly button) is then created.

Following the procedure, you will recover in our ambulatory recovery rooms for between two to three hours, dependent on the scale of the procedure. Once our specialist nursing team are happy that your initial recovery is complete and you are safe to return home, you will be allowed to leave the Clinic accompanied by a friend or member of your family.

Once home you will have access to our dedicated oncall nursing team 24 hours a day, 7 days a week. This team of specialists are dedicated to your comfort and pain control, and are there to field any questions you may have in the immediate post operative phase.

Post procedure pain can take one to two weeks to fully subside and tightness may be felt for several weeks. You will be fitted with a post surgical garment to provide support and help with bruising and swelling. This should be worn day and night for 4 – 6 weeks. Strenuous exercise should be avoided for 6 – 12 weeks, with results improving for up to 12 – 18 months after the procedure.

We ask that you come in and see our nursing team 1 week after surgery to ensure your incision sites have been properly reviewed. At this juncture we also recommend you meet with one of our on site aestheticians to discuss ongoing treatment to support the healing and scarring process.

We ask that you come in to see your surgeon after 6 - 8 weeks for a final check up.