Auckland, New Zealand (Smile Makeover)
would never have though my teeth could look that good
Auckland, New Zealand (Breast Augmentation)
all spoke good English which was re-assuring and nothing was too much trouble
Hawkes Bay, New Zealand (Tummy Tuck) I'm very pleased already with the result I can see
Auckland, New Zealand (Breast Augmentation) So much better than I had imagined and the hospital was great
Hawkes Bay, New Zealand (Breast Lift, Tummy Tuck, Liposuction)
The hospital - well this was way beyond what I was expecting from the head nurse down to the orderly.
Surgery: Tummy Tuck (Abdominoplasty) Time required: 4 - 6 hours Anaesthesia: General Length of Stay (In Hospital): 3 nights in hospital standard room Follow up: 7-10 days after surgery
Procedure
Your skin tone and the degree of loose skin in the abdominal region will be assessed. Your surgeon will also evaluate the amount of excess fat in your abdomen and the condition of your abdominal muscles.
A horizontal incision is placed just within or above the pubic area. The length of the incision, which extends laterally toward the pelvic bones, depends largely on the amount of skin to be removed.
The contour of this incision will vary somewhat according to the structure of your abdomen and the style of bathing suit or undergarments that you prefer. Your plastic surgeon will try to keep the incision within your bathing suit lines, but this may not always be possible.
The procedure may include tightening of the underlying abdominal muscles using sutures. Abdominoplasty will enhance your body contour by making your abdomen firmer and flatter.
Skin of the lower abdomen that contains stretch marks may be removed as well. Any remaining stretch marks may be somewhat flattened and improved, but you should not expect a dramatic change in their appearance.
A horizontal incision is placed just within or above the pubic area. If there is loose skin above the navel, the surgeon may make a second incision around the navel. Skin in the shaded area is separated from the abdominal wall.
The surgeon may make a second incision around the navel to pull the skin downward then remove the excess skin. The position of the navel remains unchanged. A small opening is made to bring the navel through.
To tighten the abdominal wall, the surgeon brings loose underlying tissue and muscle together with sutures.
Pre Operative
You should come to the consultation prepared to discuss your medical history. This will include information about any medical conditions you may have such as diabetes, high blood pressure or heart disease.
Your surgeon will want to know about previous surgeries, medical treatments and medications that you currently take. It is important for you to provide complete information.
Pre-Surgery
Below are important points that you need to consider before undergoing any surgery:
• Stop smoking well in advance of surgery.
• Stop taking Aspirin, herbal or diet supplements and certain anti-inflammatory drugs at least 2 weeks as taking these substances can cause increased bleeding.
• Do not eat nor drink anything at least 6 – 8 hours before surgery.
• Use antibacterial soap and allow the soap lather to cover the skin of the surgical area for 10 minutes on the night before your surgery and in the morning of your surgery.
Post Operative Care
The day after surgery, you will be encouraged to get out of bed for short walks to promote blood circulation. Although you may not be able to stand up completely straight, it is best if you do not sit for long periods of time during the first several days.
There will be surgical drain which helps to remove blood / fluids that may accumulate in the post-operative site. It will be removed within a week following surgery.
• Dressings and bandages will be changed or removed within a week.
• You will be instructed to wear a support garment for several weeks.
• Generally, stitches will be removed in stages over a period of approximately one or two weeks.
Straining, bending and lifting must be avoided, since these activities might cause increased swelling or even bleeding. You may be instructed to sleep on your back with a pillow under your knees.
Swelling and bruising will disappear over a period of weeks. However, it may be months before all swelling subsides and you see the final result of your abdominoplasty.
You may also notice some numbness over portions of the abdominal area, and this may persist for several months.
Incisions will initially be red or pink in colour. They will remain this way for many months following surgery and may even appear to worsen before they finally begin to fade.
You may resume most of your normal activities after a few weeks. Sexual activity should be avoided for a minimum of two weeks or more
Result
Women and men who have loose abdominal skin and fat that is concentrated in the abdomen can benefit from abdominoplasty. Sometimes these conditions are inherited. In other instances, substantial weight loss may cause abdominal skin to become flaccid.
Abdominoplasty also can tighten muscles that have been separated and weakened by pregnancy. The procedure may somewhat improve the appearance of stretch marks, especially those located below the navel.
Potential Risks & Complications
Plastic surgeons take every precaution possible to prevent and minimise the risks of surgery. However, much of the responsibility for risk avoidance rests with the patient as well. You can help to lessen certain risks by following the advice and instructions of your plastic surgeon, both before and after surgery.
Risks of General Anaesthesia
The risks of general anaesthesia include human error, unsuspected inherited hypersensitivity to anaesthetic drugs, accidental overdose of anaesthesia, any undetected airway disconnection or airway blockage. General anaesthesia, which increases the risk of vomiting and impairs protective airway reflexes, can cause aspiration of stomach contents.
Loss of abdominal sensitivity
Permanent sensation loss in the lower abdomen or around the navel may happen. There is also a risk of excessive scarring or inner scar tissue which may require additional treatment.
Necrosis (death) of the abdominal tissue
Necrosis is a risk, although extremely rare. The chances of necrosis are increased if you smoke and have poor circulation, or have temperate therapy or cryo-therapy postoperatively.
Infection
This usually occurs within the first 4 to 6 weeks. A more common is from the Staphylococcus aureus bacteria which are commonly found in the skin.
Blood Clot
Pulmonary Thromboemboli is quite rare but very serious. A thromboebolus is a blood clot that can break free and travel to the lungs resulting in Pulmonary Thromboemboli.
This can put a patient into adult breathing distress and subsequently into cardiac arrest or coma - leading to the patient becoming 'brain dead' shortly thereafter or in a vegetative state from loss of oxygen to the brain.
Pulmonary Thromboemboli can happen within 3 weeks of the surgery but will most likely show symptoms of shortness of breath and fatigue within the first 72 hours. However, pulmonary Thromboemboli can occur suddenly, without warning.
Dog Ears
This is when the suture line ends leaving little tags or triangles of skin.
General Dissatisfaction
There are the risks of surgery not living up to expectation. Computer imaging is often an excellent tool in conveying your desires to your surgeon and determining if you are on the same page as your surgeon.
Pain and tenderness
Pain after surgery is variable and for some people may be quite severe. Tenderness in the scar may last for several weeks.
Swelling
Most patients have swelling for about a month to six weeks after surgery. In women the labia may be swollen and in men the scrotum may be bruised or swollen.
Bruising
It is common on the abdomen and in severe cases it extends onto the surrounding skin. Bleeding or hematoma
Drains are used after surgery but still some patients may collect blood. If bleeding is severe, a transfusion may be needed
Seroma
A collection of Serum is secreted beneath the skin and this leads to a collection of fluid called a seroma (the watery portion of the blood). If severe, surgery or aspiration of this fluid is needed.
Fat Necrosis
When the abdominal wall is stretched, the blood supply to the remaining fat and skin may be damaged. On rare occasions this may lead to necrosis of fat cells which become liquefied and hardened. Infection can sometimes develop in these areas.
Infection
This can be a serious problem. If bleeding occurs, more likely infection may develop in a hematoma.
Thick scar formation
The scar is long and sometimes excess scar can form. This is more common in those genetically prone to heavy scars. Scar revision is sometimes helpful but some scars cannot be improved.
Umbilical retraction or necrosis
When all scars have contracted the umbilicus may not be in the midline.
Numbness or change in feeling
Unusual feeling or numbness in the abdomen may last for many months.
Skin loss
The abdominal wall is stretched during surgery and the blood supply to the skin may be damaged. This may lead to death of the skin. If this happens a skin graft may be needed. This much more common if you suffer from diabetes or are a smoker.
Wound dehiscence or separation
It is not unusual for the scar to heal slowly and some separation to develop. Although rarely a major problem it may lead to a heavier scar and slower recovery.
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