Plastic Surgery

Full Abdominoplasty - The patient is left with a long, usually curved scar across the lower part of the abdominal wall at the level of the pubic hair that can extend from hip to hip. There is also a circular scar around the umbilicus. Any looseness of the muscles of the abdominal wall or hernia is repaired at the same time. Patients who are thinking about becoming pregnant should not undergo this procedure, and should wait until they are sure they are not having any more children

Mini-abdominoplasty - excess skin below the umbilicus is removed leaving a low abdominal scar at the level of the pubic hair.

Fleur De Lis Abdominoplasty - This involves an inverted T shaped incision, excess skin is removed vertically to address the horizontal excess of abdominal tissue.

Liposuction - Liposuction can sometimes be done at the same time as the abdominoplasty. However, liposuction can be recommended instead of an abdominoplasty for younger patients who have good quality, elastic skin and whose main problem is a localised excess of fat.

Panniculectomy - This is a functional operation where excess tissue removed for a functional rather than aesthetic benefit. In some cases it is not possible to reconstruct the umbilicus. This procedure can be funded on the NHS if funding is approved.

After pregnancy the muscles of the abdomen(rectus muscles) can become weaker and separate. This is called a rectus divarification and can be repaired at the time of an abdominoplasty.

Patients tend to go home on day 1 and are encouraged to mobilise early to prevent Deep Vein Thrombosis. Abdominal Drains are removed when they start draining less than 30ml of serous fluid. In some patients Drains are not used and this can reduce discomfort. Wound check is performed 5-7 days after the procedure in the Plastic Surgery dressing clinic. Tight fitting pants or a corset is useful in the postoperative course to reduce swelling. One would expect the wounds to be healed by 2-3 weeks and it is important to perform scar massage at this point.

• Infection
• Wound breakdown (Higher risk if BMI>28 and smokers)
• Scar
• Poor Scarring (Keloid, Hypertrophic scarring)
• Displacement of Umbilicus
• Skin necrosis
• Numbness over lower part of abdomen (can be permanent
• DVT and pulmonary embolism (rare complications)

This is a short daycase general anaesthetic procedure that involves undergoing liposuction to remove any excess fat this preserves the arms lymphatics. Next, the excess skin is removed and sutured shut with dissolvable sutures. The scar is long and extends from the armpit and finishes just above the elbow joint. The arm is then dressed with a bandage.

After 1 week a wound check is performed and it is recommended to wear a compression garment. The bruising will take up to 3 weeks to settle.

• Bleeding
• Infection
• Wound breakdown
• Poor scarring - stretched scar
• Nerve injury - this can result in altered sensation due to sensory nerve damage
• Revision surgery

This is a general anaesthetic procedure that involves a combination of liposuction and skin excision in the inner thigh region. You will feel swollen and bruised and you will be given appropriate painkillers. It is unusual to require drains but you will be given a compressive dressing. You may be able to go home later the same day but some patients opt for an overnight stay.

After 1 week a wound check is performed and it is recommended to wear a compression garment. You will be reviewed in clinic at one-week post op and the dressings are changed. Numbness and bruising is common for a few weeks after surgery.

You can return to light exercise at 2 weeks but should not do anything strenuous for 4 weeks. Lower leg exercises should be avoided for 6 weeks and then you should build back up gradually. You should arrange to take a couple of weeks off work. The bruising will take up to 3 weeks to settle.

Bleeding

Infection

Sensation loss in inner thigh

Wound breakdown

Poor scarring - stretched scar

Nerve injury - this can result in altered sensation due to sensory nerve damage

Revision surgery

DVT or Pulmonary Embolism - blood clots in the leg