What is a tummy tuck revision?
Tummy tuck revisions (also called secondary tummy tucks) can be necessary because of a new pregnancy, post-operative weight loss or weight gain or weight loss, irregularities with outcomes, or dissatisfaction with the results from the first tummy tuck procedure.
A tummy tuck also known as an abdominoplasty, is a surgical procedure to remove loose skin and excess fat from the middle and lower abdomen. A tummy tuck can tighten separated abdominal muscles and flatten the stomach. This cosmetic surgery is most commonly performed after pregnancy or weight loss in women and after weight loss in men.
Why do people get tummy tuck revision?
Common reasons patients seek tummy tuck revision include:
- Poor scars: too high, not well located, stretched, uneven, or with dog ears (big lumps) at the ends of the scar.
- Not a desirable shape: Including lumps, remaining flank fat bulges (love handles) or a poorly corrected upper tummy area.
- Uneven or loose skin, with looser upper abdominal skin.
- Unsightly or poorly stitched or located belly button.
- Failure of the muscle repair.
- Recurrent hernia (if a hernia has been repaired at during the primary tummy tuck operation)
Common reasons to see a Cosmetic Surgeon to get tummy tuck revision surgery include:
- Umbilical distortion
During primary tummy tuck surgery procedure the umbilicus (belly button) can become distorted due to:
- Umbilical stenosis. This occurs when the umbilicus becomes small after surgery.
- An obvious scar around the umbilicus will become obvious if the umbilicus is not made deep enough.
- An elongated slit looking occurs if too much skin has been excised resulting in increased tension of the closure. When the new umbilicus is created, the vertical pull of the skin causes the shape to change from a round to an elliptical and elongated shape.
- An enlarged umbilicus can occur for several reasons including stretched skin in a radial direction due to an intrinsic laxity of the skin or if the new umbilicus is not designed to a proper dimension. It is important to note that a belly button should be no larger than 1.5 cm in its vertical and horizontal dimension.
- Scar revision
With any cosmetic surgery procedure, there will be scars to deal with. The final look and outcome of the scars will depend on how you heal and the genetics of your scar formation. While your Cosmetic Surgeon has specific techniques to make the scar look better, scar thickening and malposition can still occur. If your scar is located as low as possible, your clothes will cover it up. Depending on the amount of residual skin and your skin tone, in many cases correction of the scar position can be achieved.
- Residual deformities
While most residual deformities after tummy tuck surgery are preventable, common deformities can occur. The most common residual deformities include:
- Inadequate tissue removal: This usually occurs due to poor surgical planning where the overall skin elasticity is not taken into account when removing the excess skin. If you have elastic skin, you will need to have more skin removed.
- Dog-ears can occur if the amount of tissue removal is insufficient at the time of closing the scar on the sides. A dog-ear occurs as a result of a significant lack of soft tissue excision, which leads to the tissue bunching on the sides.
- The most common areas that require revision due to fat deposits are the mons pubis. If liposuction is not performed in this area, you will have a flat abdomen but also have unsightly bulginess that will be aesthetically unpleasant.
- Epi-gastric bulginess:
If there is insufficient suturing of the abdominal wall muscles above your belly button, you will have a bulging in the abdominal area. To prevent this bulginess, a highly trained and experienced Cosmetic Surgeon will suture the abdominal wall from the most inferior aspect of the chest to the lowest part of the abdomen area. It is important to note that the suturing needs to be done tight enough to prevent this aesthetic complication.
- Unsatisfactory overall tummy tuck appearance
In some cases, the abdominal skin may need to be elevated to recreate the abdominal contours. If you need to have this done, it is important to note that the abdominal scar will be higher than normal because excess skin has been previously excised during the first tummy tuck.
Key facts about tummy tuck revision surgery
- A tummy tuck revision surgery is always more difficult than the original procedure. To resolve the problem, it is important to consult with highly trained and experienced Cosmetic Surgeons who perform this surgery regularly.
- A major complaint from tummy tuck revision patients is the visibility of scars. It is important to note that with tummy tuck surgery (abdominoplasty) there will always be a scar. If the incision is placed too high, underclothing may not cover it.
- When having your consultations about a tummy tuck revision, make sure all the problem areas of the tummy, waist and flanks are discussed and that there is a plan to address everything during the revision surgery.
- The final outcome of tummy tuck surgery can only be fully recognised once bruising, swelling and scars have reduced. Depending on the type of surgery, this can take months or up to a year or longer.
- If you experience post-surgery changes such as additional pregnancy or weight changes, you may not get a good result. The results of a tummy tuck revision are long lasting, but new fat can develop. To help maintain your slimmer shape, it is important to eat a healthy diet and exercise regularly.
What happens during tummy tuck revision surgery?
Tummy tuck revision surgery is performed under general anaesthesia in hospital. Most patients need to stay for at least one night in hospital.
During the tummy tuck revision surgery your Cosmetic Surgeon will reposition the abdominal muscles so they are tight and flat. This process also ensures that any abdominal muscles that have separated or stretched can be brought back together.
Are there risks or complications with tummy tuck revision surgery?
Any surgical operation brings complications of anaesthesia. Your anaesthetist will be able to discuss with you the possible complications of having an anaesthetic.
General complications of every surgery include:
- Your healthcare team will give you medication to control the pain. To reduce discomfort and prevent headaches, it’s important that you take the medication.
- Infection of the surgical site (wound). Let your surgeon know if your wounds bleed, swell or become tender. An infection usually settles with antibiotics but you may need another operation.
- Blood clot in your leg (deep-vein thrombosis – DVT). This can cause pain, swelling or redness in your leg, or the veins near the surface of your leg to appear larger than normal. Your healthcare team will assess your risk. They will encourage you to get out of bed soon after the operation and may give you injections, medication, or special stockings to wear. Let the healthcare team know straightaway if you think you might have a DVT.
- Blood clot in your lung (pulmonary embolus). If a blood clot moves through your bloodstream to your lungs. If you become short of breath, feel pain in your chest or upper back, or if you cough up blood, let the healthcare team know straightaway. If you are at home, call an ambulance or go immediately to your nearest Emergency department.
Specific complications of tummy tuck revision surgery include:
- Developing a swelling under the skin in your lower abdomen caused by blood or fluid collecting. You may need to have a small procedure to remove the blood or fluid.
- Numbness or continued pain on your abdomen caused by injury to the small nerves that supply your skin. Any pain or numbness usually gets better within a few weeks but can sometimes continue for many months.
- Cosmetic problems: It is difficult to predict exactly how your abdomen will appear after the operation. Sometimes you will still have a small area of excess skin. If you are overweight, particularly on your sides, you may get flaps of skin towards your sides near the ends of your wound. If you had a standard abdominoplasty, your umbilicus may go slightly off-centre but usually only you will notice this. If you had a fleur-de-lis abdominoplasty, your midline scar may thicken and become more noticeable.
What is recovery like after tummy tuck revision surgery?
Recovery time from tummy tuck revision surgery will vary from patient to patient. While some patients feel well enough to return to work and daily activities in 7 days, other patients require 2 or 3 weeks recovery.
After the tummy tuck revision surgery, you will be sore, bruised and swollen for a few days. To relieve this pain, your Cosmetic Surgeon will prescribe pain medication. In some cases you may need to wear compression garments for a few days.
How do I find the best Australian Tummy Tuck Revision Surgeon?
With any elective surgical procedure, the most important factor in choosing a Cosmetic Surgeon is experience. We suggest you look for a board-certified Cosmetic Surgeon who performs the tummy tuck revision procedure frequently and has proven safe results.
Once you have a short list of Cosmetic Surgeons, it’s a good idea to have multiple consultations before you select a surgeon. Find the best Tummy Tuck Revision Cosmetic Surgeons in Australia here.
Important to know
So you can make an informed decision, your elected Cosmetic Surgeon will discuss the possible risks associated with a tummy tuck revision. Although the majority of patients do not experience these complications, it's important to understand how they can be managed in the event that they occur.