The key questions to think about before considering a tummy tuck are:
What bothers you about your tummy and why do you want a tummy tuck?
Good candidates for tummy tucks are those who have loose/excess skin and fat with or without muscle wall weakness. It is not a means of weight loss but a tool for body contouring.
Do you plan to have any further children?
A tummy tuck is not a contraindication for further pregnancies and children, but it does stretch the abdominal wall muscles and stretch the skin, undoing the effects of a tummy tuck. If planning on having more children, it is advised that one should wait until after completing the family to have a tummy tuck.
Do you have any medical problems that would need to be optimised prior to this surgery?
Smokers should stop smoking 4 weeks before and 4 weeks after surgery to reduce the risk of wound healing complications and minimise general complications from surgery.
Those with chronic medical conditions should see their treating GP or physician to ensure they are medically optimised prior to surgery.
Patients on aspirin, plavix, warfarin or other blood thinning agents need to see their treating physician to see if it is possible for these medications to be reduced or stopped in advance to minimise bleeding complications.
Those who have had a DVT or PE or prior anaesthetic issues should advise the anaesthetist and surgeon of these prior to surgery so measures can be taken to reduce the risk of complications.
What are your expectations?
Good candidates for tummy tuck understand that a tummy tuck is to re-contour their abdominal wall to remove loose/excess skin and fat, to reshape and redefine the waistline, to tighten the abdominal wall muscles and not as a means of weight loss.
Good candidates understand that the results of the tummy tuck will take weeks to months to appreciate once bruising and swelling have subsided. They understand that there will be a significant scar and risks of complications. Ideal candidates are realistic in their expectations for the postoperative recovery to take at least 6 weeks before one can return to most activiies of daily living.
Those considering having a tummy tuck should be considering it for themselves with the goals that it could give them the tummy they once had before the advent of kids, weight loss, age etc. and that they will feel more confident in their clothes and within themselves. Those contemplating this surgery for the benefit of someone else or in the hope that it will solve a problem in their life, may well end up disappoined.
Is your weight stable?
A tummy tuck is best performed on people with stable weight for atleast the past 6 months.
What are the risks and potential complications?
General risks of anaesthetic, bleeding, infection, wound breakdown and delayed healing, scarring, pain, DVT/PE and AMI.
Specific risks include seroma, haematoma, bruising, swelling, skin necrosis, fat necrosis, asymmetry, malposition of the umbilicus, pain, numbness and paraesthesia, recurrent muscle bulge, infection, need for revision, need for return to theatre and wound dehiscence.
What is involved in the surgery and aftercare?
The surgery is performed under a general anaesthetic in an accredited hospital. It usually takes 2-4 hours. Most patients wake up with drains and in a banana or bent position due to the tightness of the muscle wall. Most patients are in hospital for 5 days and are back to the gym by 6 weeks.
Who is your surgeon, what are their qualifications and do you feel comfortable with them?
Do your research carefully and thoroughly. Make sure they are a plastic surgeon with an FRACS (Plast) and a member of the Australian Society of Plastic Surgeons (ASPS). Ask to see their results (before and after photos, patient testimonials etc). Make sure you see them many times, ask lots of questions and feel comfortable.
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