Tummy Tuck – Abdominoplasty Complications

What Potential Complications Can Occur During and After Tummy Tuck – Abdominoplasty Surgery

Are you considering a tummy tuck – known medically as abdominoplasty – to change your abdominal profile? While this popular surgical procedure can alter the shape and tone of your abdomen, it’s important to approach this change with both eyes open to the possible risks involved.

Abdominoplasty is generally safe when performed by a qualified surgeon. However, like any major surgery, tummy tuck – abdominoplasty comes with potential complications both during and after the procedure that you should be aware of.

In this blog, Sydney Specialist Plastic Surgeon Dr Bish Soliman will discuss the common and less common complications associated with tummy tuck – abdominoplasty surgery.

Ultimate Guide To Abdominoplasty

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More about Tummy Tuck – Abdominoplasty Surgery

A tummy tuck, or abdominoplasty, is a surgical procedure aimed at creating a smoother and firmer abdominal profile. This procedure is particularly popular among those looking to address changes in their body following significant weight loss or pregnancy, which often leave behind excess skin and fat that cannot be eliminated through diet and exercise alone.

What Does a Tummy Tuck – Abdominoplasty Involve?

During a tummy tuck – abdominoplasty, an incision is typically made across the lower abdomen, just above the pubic area. The length and shape of the incision depend on the amount of excess skin to be removed and the specific techniques your surgeon decides are best suited for your situation. After the incision, the abdominal muscles that may have stretched or weakened are repaired and sutured, and excess skin is trimmed away. The remaining skin is then pulled tight and stitched into place to create a more toned look. In some cases, liposuction may also be used to remove excess fat from the abdomen.

Surgical Procedure Overview

The procedure itself generally takes several hours and is performed under general anaesthesia. Dr Soliman will carefully plan the surgery based on a detailed examination of your abdominal area and a discussion of your aesthetic goals. This personalised approach helps ensure that the outcomes not only meet but exceed your expectations.

A tummy tuck – abdominoplasty is not a substitute for weight loss or an appropriate exercise program. While the results are typically long-lasting, the positive outcome can be greatly influenced by maintaining a stable weight and a healthy lifestyle.

Common Complications during Surgery

As with any major surgical operation, there are inherent risks and potential complications that can occur during the surgery:

Anaesthesia-related Issues

One of the first risks involves the use of anaesthesia. General anaesthesia is commonly used in tummy tuck – abdominoplasty procedures to ensure that you are completely asleep during the intervention. However, it can lead to certain complications such as allergic reactions, respiratory issues, and in rare cases, anaesthesia awareness (waking up during surgery). To minimise these risks, a thorough pre-operative evaluation of your medical history and a detailed discussion with the anaesthesiologist are essential.

Medical Complications Associated with Tummy Tuck – Abdominoplasty

A tummy tuck – abdominoplasty carries potential medical risks during and after surgery that must be acknowledged and managed carefully.

Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE)

DVT occurs when a blood clot forms in a deep vein, usually in the legs. This condition becomes particularly concerning if the clot dislodges and travels to the lungs, known as Pulmonary Embolism (PE). PE is a severe and potentially fatal complication if not treated promptly. In the context of abdominoplasty, immobility after surgery significantly increases the risk of DVT and PE. To mitigate these risks, Dr Soliman encourages early mobilisation post-surgery, uses blood thinners as a preventative measure, and recommends compression garments to improve blood circulation.

Pneumonia

Postoperative pneumonia is another serious complication that can occur following extensive surgeries like abdominoplasty. It usually arises from prolonged bed rest, which leads to ineffective airway clearance. Dr Soliman stresses the importance of frequent, deep breathing exercises and even uses incentive spirometry to encourage lung expansion and prevent the onset of pneumonia.

Atelectasis

Atelectasis involves the partial collapse of lung tissue, which diminishes gas exchange and can lead to pneumonia if not addressed. It is commonly seen in patients post-operatively as a result of shallow breathing and limited respiratory effort due to pain. Dr Soliman’s team manages this risk by instructing patients on how to perform proper breathing techniques post-surgery and by providing adequate pain relief to facilitate deeper breaths.

Bleeding

Excessive bleeding is another risk associated with any surgical procedure, including tummy tuck – abdominoplasty. While it is normal to expect some bleeding during and immediately after surgery, uncontrollable bleeding can occur due to a variety of factors such as high blood pressure or a reaction to medication. Dr Soliman takes preventative measures such as careful surgical technique and preoperative planning to reduce the risk of severe bleeding.

Infection

The risk of infection is present in any surgery. In abdominoplasty, the size of the incision and the area of skin removed increase the risk slightly. Signs of an infection include severe redness, swelling at the incision site, fever, and pus. To combat this, Dr Soliman ensures that the operation is performed in a sterile environment, uses antibiotics judiciously, and instructs patients on how to care for their wounds after surgery to prevent infection.

Postoperative Complications

Undergoing a tummy tuck, or abdominoplasty, involves a recovery period during which various complications can arise. While Dr Bish Soliman takes every precaution to minimise risks, it’s important for you, as a patient, to be aware of potential issues that might occur after your surgery. Awareness and prompt action can significantly mitigate these complications.

Immediate Postoperative Risks

• Seroma: One of the most common complications following a tummy tuck – abdominoplasty is the formation of seromas – pockets of fluid that accumulate beneath the skin. This occurs because your body tends to fill the space where fat tissues were removed with fluid. Dr Soliman may place drains to help remove this fluid, but sometimes additional interventions are necessary if the seroma is persistent.
• Haematoma: Haematomas are similar to seromas but involve blood pooling underneath the skin instead of fluid. This complication can increase the risk of infection and might require drainage to prevent further issues.
• Wound Dehiscence: Wound dehiscence is the reopening of a surgical wound, often caused by infection, poor wound healing, or excessive stress on the incision site. To minimise the risk, it is crucial to follow all postoperative care instructions, avoid strenuous activities, and maintain a healthy diet to support healing.
• Infection: Despite preventative measures, infections are possible and can occur due to bacteria entering the incision sites. Symptoms include redness, swelling, fever, and discharge from the wound. Treatment typically involves antibiotics and sometimes additional surgery to clean the wound.

Long-term Complications

• Scarring: All surgeries result in some form of scarring, and the extent and appearance of scars after a tummy tuck – abdominoplasty can vary. Dr Soliman strives to place incisions in less visible areas and recommends postoperative treatments to help minimise scarring.
• Numbness or Changes in Skin Sensation: Nerve damage during surgery can lead to temporary or permanent changes in skin sensation in the abdominal area. While sensation usually returns over months, the numbness can be permanent in some cases.
• Tissue Necrosis: Reduced blood flow to the tissue post-surgery can cause tissue death or necrosis. This is more common among smokers and those with diabetes or vascular diseases. Managing this complication may involve removing the dead tissue and additional corrective procedures.
• Unsatisfactory Aesthetic Outcome: Sometimes, the results may not meet a patient’s expectations. Factors such as asymmetry, misplacement of the belly button, or insufficient removal of abdominal skin can occur. Revision surgery may be necessary to adjust these issues.

Reducing the Risks of Complications after Abdominoplasty

Preoperative Measures

To minimise the risk of complications, Dr Soliman conducts a thorough preoperative evaluation to assess your health status and any conditions that could complicate the surgery or recovery. This includes blood tests, medical history reviews, and in some cases, cardiovascular evaluations.

Surgical Techniques

Dr Soliman utilises different surgical techniques which are designed to reduce the risk of complications. These include precise incision methods, effective management of bleeding, and the strategic placement of sutures for optimal healing.

Postoperative Care

Following Dr Soliman’s postoperative care instructions is important for a smooth recovery and to minimise complications. These guidelines might include:

• Activity Restrictions: Avoiding strenuous activities and heavy lifting for several weeks to prevent stress on the surgical sutures.
• Wound Care: Keeping the incision area clean and dry, and monitoring for signs of infection.
• Medications: Taking prescribed medications, including antibiotics and pain relievers, as directed to manage pain and reduce the risk of infection.
• Follow-up Appointments: Attending all scheduled follow-up appointments so that Dr Soliman can monitor your recovery and address any complications early.

What to Do If You Experience Complications

While Dr Bish Soliman takes extensive precautions to minimise the risk of complications, it is important for you to know how to recognise potential problems early and understand the steps to take if they occur.

Recognising Signs of Complications

The first step in dealing with complications after a tummy tuck – abdominoplasty is to recognise the signs that something might be wrong. Some of the common indicators include:

• Increased Pain: While some pain is normal after surgery, a sudden increase in pain or pain that doesn’t decrease with prescribed medication may indicate an infection or other issues.
• Fever: A fever higher than 38.3°C can be a sign of infection.
• Unusual Swelling or Redness: Any new, expanding, or particularly painful swelling or redness around the incision sites might suggest inflammation or infection.
• Drainage from the Incision Site: Any pus or an unusual amount of drainage, especially if it’s odorous, could be a sign of infection.
• Changes in Skin Colour or Temperature: Warmth or a change in skin colour, particularly blue or black areas, can indicate tissue necrosis or severe infection.

Immediate Actions to Take

If you experience any of the above symptoms, the following actions should be taken without delay:

• Contact Dr Soliman: Reach out to Dr Soliman’s office immediately. Most complications are best managed when caught early. Provide a clear and detailed description of your symptoms so that appropriate advice can be given quickly.
• Keep a Record: Document your symptoms, when they began, and any other relevant information. This can be crucial for diagnosing the issue accurately.
• Follow Medical Advice: Depending on the complication, Dr Soliman may advise you to take certain medications, apply or change dressings, or come to the office for an examination. In some cases, immediate medical treatment might be necessary to prevent further complications.
• Visit the Emergency Room: If you cannot reach Dr Soliman immediately and your symptoms are severe—such as intense pain, large areas of blackened skin, or high fever—it is critical to visit the emergency room to get immediate care.

FAQs about Tummy Tuck – Abdominoplasty Complications

How long after a tummy tuck – abdominoplasty surgery do complications typically become apparent?

• Complications can arise at various times throughout the recovery process. Some, like bleeding or infection, might appear within the first few days after surgery. Others, such as poor healing or scar tissue issues, may not become evident until weeks or even months later. It’s important to monitor your recovery closely and keep all follow-up appointments with Dr Soliman to identify and address any issues promptly.

Can I reduce the risk of complications from a tummy tuck – abdominoplasty by losing weight before the surgery?

• Yes, achieving a stable and healthy weight before undergoing a tummy tuck – abdominoplasty can significantly reduce the risk of complications. Excess fat, especially visceral fat around the abdominal organs, can increase surgical risks and impact the healing process. Dr Soliman recommends that patients be at or near their ideal weight for at least six months before the surgery to optimise outcomes and minimise risks.

Are there specific medications I should avoid before and after a tummy tuck – abdominoplasty to reduce the risk of complications?

• Certain medications and supplements can increase the risk of bleeding and other complications. For example, aspirin, non-steroidal anti-inflammatory drugs (like ibuprofen), and certain herbal supplements (such as ginkgo biloba and St. John’s wort) should be avoided for at least two weeks before and after surgery unless Dr Soliman advises otherwise. Always provide a complete list of all medications and supplements you are taking during your pre-surgical consultation to ensure safety.

Is there anything I can do to help minimise scarring after a tummy tuck – abdominoplasty?

While some scarring is inevitable after a tummy tuck – abdominoplasty, there are several ways to help minimise these marks:

• Follow Dr Soliman’s instructions for wound care meticulously to ensure the best healing
• Avoid direct sunlight on the scar for at least six months, as UV rays can darken the appearance of scars
• Consider using silicone gel sheets or scar creams, which can help reduce scar thickness and discolouration
• Maintain a stable weight, as fluctuations can stretch the skin and make scars more noticeable

How can I tell the difference between normal healing pain and pain that indicates a complication?

• Normal postoperative pain is usually managed with prescribed pain medications and should gradually improve over the first week after surgery. Pain that indicates a complication might be characterised by sharp, severe, or persistent pain that does not improve with medication or worsens over time. Additionally, if the pain is accompanied by other symptoms like fever, unusual discharge, or increasing redness around the incision sites, it may indicate an infection or another serious issue and should be evaluated by Dr Soliman immediately.

Further Reading about Abdominoplasty with Sydney Specialist Plastic Surgeon Dr Bish Soliman

• Read Dr Bish Soliman’s Blog about Reducing Bruising after Tummy Tuck / Abdominoplasty
• Read Dr Bish Soliman’s Blog about Can I Have a Hernia Repair with Tummy Tuck (Abdominoplasty)?
• Read Dr Bish Soliman’s Blog about How to Sleep Better After Tummy Tuck – Abdominoplasty
• Read Dr Bish Soliman’s Blog about Preparing for Tummy Tuck Surgery (Abdominoplasty)
• Read Dr Bish Soliman’s Blog about Getting Back to Exercise After Tummy Tuck (Abdominoplasty)

Medical References about Abdominoplasty Complications

• Tummy tuck – Mayo Clinic
• Tummy tuck (abdominoplasty) – NHS
• Minimising complications in abdominoplasty
• ‘Tummy Tuck’ Complications—Study Looks at Rates and Risk Factors
• Abdominoplasty or Tummy Tuck