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Abdominal Contouring

Tummy tuck surgery, also known as Abdominoplasty, is performed to smooth and flatten the stomach area by tightening muscles and removing excess skin. 

As we get older, our skin loses its natural elasticity, and our muscle tone can become less defined. This can mean that many people are left with excess or loose skin, or bulges, that leave them feeling self-conscious and unhappy with their appearance. Changes to the abdominal area are also very common after significant weight loss or gain and following pregnancy.

Many patients complain that they have tried hard to firm and tone their abdominal area with exercises and weight loss, but without success. Mr Titus Adams performs four types of abdominal contouring procedures:

  1. Abdominal liposuction
  2. Mini abdominoplasty
  3. Abdominoplasty
  4. Apronectomy

Mr Adams will discuss the best procedure for you during your consultation.

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Before and After Gallery

Before surgery mastopexy and abdminoplasty After surgery mastopexy and abdminoplasty
Standard abdominoplasty pre-op Standard abdominoplasty, 6 weeks post op
Combination mastopexy and abdominoplasty preop Combination mastopexy and abdominoplasty postop
Abdominoplasty pre op Abdominoplasty post op
Minimal access abdominoplasty scarless umbilicoplasty pre-op Minimal access abdominoplasty scarless umbilicoplasty post op
Prep abdominoplasty Postop abdominoplasty
Diastasic recti preop Diastasic recti postop at 6 weeks
Abdominal Contouring

What You Need to Know

What Happens When I Leave Hospital?

Micropore tape is applied directly to the scar in theatre. An occlusive opsite© dressing is placed over the tape. A binder (see below) is fitted. Dressings can be inspected or exchanged before leaving the hospital. Drains, if present, will be removed on the second postoperative day before leaving the hospital. The dressings (and scar) should be kept dry for 7 days. Showering is mandatory after you have seen the cosmetic nurse in the dressing clinic at one week. The brown micropore tape gets wet (it is not waterproof) and dries on the skin as before. The tape provides support and can be changed intermittently for four weeks and then stopped. Soaking in a bath should be avoided until all wounds have sealed (at about 4 weeks). Dressing changes may be required once or twice per week for 2-3 weeks and will be arranged by the cosmetic nurse. The belly button is often the longest to heal. Massage to the scar can take place from 4 weeks onwards once all the tape has been removed.
The stitches are self-dissolving under the skin. Occasionally, stitches can migrate to the surface of the scar (as “stitch splinters”) which can look like red patches along the scar line. Sometimes the stitches can be felt instead. They are usually left to dissolve on their own with tape applied over them for comfort, and the scar can be massaged from 4 weeks once the tape is removed.
The abdominoplasty procedure can be quite painful and uncomfortable for the first week. This is especially so after the tummy muscles are tightened as described above. Regular pain relief should be take for 1-2 weeks, and include Paracetamol or Paracetamol/codeine mixes in combination with other anti-inflammatories. These tablets will be prescribed prior to leaving the hospital, along with laxatives.
Most patients will feel significant tightness in the lower tummy and will not be able to stand completely straight. This will resolve over 1-2 weeks. Some back pain may be felt because of this change in posture, but this too will tend to resolve as mobility improves. Lying on the side can also be uncomfortable. The best sleeping position is on the back with plenty of pillows to maintain a propped-up position, with a pillow under the knees. This will relieve both the back and the lower abdominal tightness and scar.
This garment is measured pre-operatively and fitted at surgery. It should be worn day and night for 6 weeks. The aim is to protect the muscle repair when straining or coughing, and it helps to bring the tissues together and minimise the risk of a seroma (body fluid) collection under the skin. It also helps to mould the tummy skin, especially if liposuction has also been employed. Occasionally, the binder becomes intolerable, and this may be a sign to loosen it during episodes of swelling (later in the day, or following a meal etc.). The binder can be worn over a T-shirt, for example, if it become intolerable on the skin surface itself. The binder should be removed and washed if it gets soiled, and must be removed before showering. You are given two garments whilst one can be washed.
Swelling should be expected for 6-8 weeks. Avoid tight clothes for a few weeks, as this can inadvertently mould the tummy incorrectly. A tight-fitting belt may also cause a problem.
The cosmetic nurse will see Patients at one week following the operation for scar inspection, change of dressings and stitch trimming. Other nurse appointments may be made accordingly. Mr Adams will arrange out-patient appointments for 6 weeks and 6 months to be sent by email.
Rest at home with gentle mobilisation about the house for 2 weeks. Patients are NOT advised to stay in bed for lengthy periods of time because this will increase the thromboembolic risks (see below) and make stiffness worse. Light activities are permissible after 2 weeks, building up to normal activities by 6-8 weeks. Vigorous sports and heavy lifting should be avoided for 12 weeks.
Patients may experience a degree of constipation as a result of both reduced activity and the analgesics that are used following the operation. Laxatives are useful to help reduce straining when opening the bowels. Increasing the fibre content of the diet will also be useful. Heavy meals should be avoided.

The main problems following abdominoplasty operations are related to wound healing problems and deep vein thrombosis. These should be discussed pre- operatively. Wound infections and delays in healing are relatively common. Increasing age, Diabetes and smoking increase these risks. Wound infections may occur centrally at the point of maximum tension on the scar. The wound may split open and a little discharge is possible. In the absence of cellulitis (red, hot surrounding skin) with no feelings of being unwell, then these wounds are dressed regularly and kept clean. Spontaneous resolution is expected after a period of delay. Patients are likely to require antibiotics if signs of cellulitis are present. Medical advice should be sought either through the hospital, GP or Mr Adams’ secretary. Avoidance of smoking is critical during this time.

Deep vein thrombosis (DVT) is a clot in the veins of the calf or pelvis and can be a serious complication if the clot separates and goes into the lungs. The usual symptoms of DVT are a painful swelling in one calf occurring several days after the operation, which may or may not be associated with breathlessness, coughing of blood or pain on deep breathing. Urgent medical advice should be sought if these symptoms occur. This condition is rare. The risks of DVT are significantly reduced by early mobilisation after the operation, avoidance of smoking and wearing the compression stockings provided by the hospital until patients are fully mobile once more (between 2-3 weeks post-operatively).

Patients must seek advice if there are any problems or questions related to this.

Resources

Read the full abdominoplasty fact sheet for more information on tummy tuck surgery, pre-operative advice and what to expect following the procedure.

Abdominoplasty Fact Sheet 000662564.PDF
Common events and risks in anaesthesia.pdf
Want to Know More?

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The first step of your cosmetic surgery journey should be a consultation with your plastic surgeon. It is your chance to get accurate information and professional reassurance, both of which can be hard to find online.
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“Recommendation after recommendation has put Adams firmly on the Cotswolds map (he has clinics in Berkshire and Oxfordshire). It’s partly down to his nature (he’s a wonderful conversationalist and has charisma in spades), but also his manner, which is thoughtful and careful. His forte? Womanly tummies, with curves in the right places. New mummies in particular love the way he recontours the waistline and creates the illusion of a lightly toned abdomen.”

“Titus Adams makes light work of postpartum tummies, slimming the silhouette and nipping in waists by pulling the underlying muscles tight, like a corset. ‘Though it’s best to leave some fat behind,’ he says. ‘It allows fluid to drain from the body, rather than building up in the tissues’. The fat he does take, however, is useful if there’s need to plump a deflated cleavage. And, because he’s chatty and approachable, smoothing over even the most awkward of questions (like ‘how do you wear your undergarments?’ – crucial, as it ensures the best positioning of scars), you feel at ease. You trust him.”

“Adams listens carefully & closely. And his results are truly top notch whether he is tidying things up after some impressive weight loss or putting you back together after the last baby. The key phrase is ‘preservation of tissues’, to retain a natural appearance.”