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Abdominoplasty

Welcome

At Mater Hospital Brisbane, we understand that being hospitalised can be a very stressful experience. In keeping with our Mission to offer compassionate, quality care that promotes dignity whilst responding to patients' needs, this booklet aims to alleviate some of your concerns. It explains the general day to day events that may occur during your visit and the things to expect when you are discharged from the hospital.

It is, however, only a guideline as each person may require differing treatments.

If you have any questions about your treatment please speak to your doctor or nurse. Our pastoral care team offers a caring support network to all patients. The dedicated members of this team will visit you during your stay and are available at your request to discuss any anxieties or problems that you may have.

Abdmonioplasty

An abdominoplasty, also known as a "tummy tuck", is a surgical procedure in which excess skin and fat in the abdominal area is removed and the abdominal muscles are tightened.

This surgery is performed under general anaesthetic which means you will be asleep throughout the procedure and will feel no pain.

What are the risks of having abdominoplasty surgery?

As with any type of surgery there are risks involved and these include: infection, bleeding, haematoma, adverse reaction to anaesthesia and scarring. Smoking increases the risks of bleeding, infection, skin loss and poor scars. Smoking is recommended to be ceased at least six weeks prior to surgery. This includes Nicotine patches.

Other specific risks that are associated with an abdominoplasty are:

  • the skin of your lower abdomen and around the naval area will feel quite numb after surgery. Sensation will return but can leave a small area permanently without sensation
  • skin or fat necrosis—this is where tissue alongside the abdominal incision dies. This can happen if the abdominoplasty has been extensive
  • bleeding, which can occur under the skin, causing the area to swell and become painful. This is called a haematoma. Sometimes it is necessary to return to theatre to stop the bleeding, remove the blood and help avoid infection
  • the formation of fat or blood clots in the blood vessels. These can break off and move to the lungs. This is called a pulmonary embolism and can be life-threatening.

The chance of complications depends on the extent of procedure that is being performed and other factors such as your general health. Your surgeon will be able to explain how the risks apply to you.

Expected length of hospital stay

The expected length of stay for abdominoplasty surgery is two days.

After your operation

Transfer from recovery

You will stay in the recovery room within the theatre suite after the operation until you waken from the anaesthetic. Once awake and your observations are stable, you will be transferred on your bed to your room.

Consults

Your surgical team will visit you throughout your stay and prior to you going home. They will assess your condition and progress your care.

Medication

  • Immediately post-operatively you will have a drip (IV) inserted. This is necessary to maintain your fluid intake and will remain in place until you are tolerating adequate amounts of oral fluids.
  • You can expect your abdomen to be sore and swollen for the first few days. Immediately after surgery and through to day one you will be receiving your pain medication via a 'Patient Controlled Analgesia' (PCA) system. A PCA allows you to manage your own pain. PCA involves specialised equipment which is connected to a drip (IV). You will have a button to push which allows a small amount of pain relieving medication to be delivered directly into your vein via the drip. The equipment has a specialised safety program to reduce the risk of you receiving too much medication. You will remain on PCA until you are able to eat and drink. Your pain will then be managed with tablets. There is no risk of becoming addicted to strong pain relieving medication when it is used appropriately.
  • You will be given Oxygen via nasal prongs or a mask while you have the PCA in place. It is important to always keep this on when sleeping.

Observations

Your nurse will take frequent observations of your vital signs (e.g. temperature, pulse, blood pressure etc) and wound (colour, warmth, sensation and pulses) for several hours after the surgery. Through your recovery these observations become less frequent but remain regular until you leave hospital.

Treatments

You will continue to wear your elastic stockings (TEDs). These can be removed before you shower and need to be replaced immediately following your shower.

Activity

  • Immediately following your surgery, you will be resting in bed. While in bed you will be positioned with your head elevated and your knees and hips flexed to avoid any strain on your abdominal muscles.
  • From the time you returned from your operation and while ever you are resting in bed it is important to continue with deep breathing and leg exercises.

Abdominoperineal

The following exercises help prevent complications suchas chest infections and blood clots in your legs. You should do these every hour that you are awake while resting in bed.

Breathing exercises: take five long and slow deep breaths. Each breath should be deeper than the previous breath. Think about getting the air to the very bottom of your lungs.

Circulation exercises: firmly move your ankles up and down to stretch and contract your calf muscles.

  • Early ambulation is encouraged to help reduce the risk of blood clots and deep vein thrombosis. You will find it difficult to stand up straight but you will be encouraged to stand up and start walking around as soon as you are physically able to do so. You will be given assistance getting out of bed until you are confident you can be independent without straining your wound or abdominal muscles.

Getting in and out of bed through side-lying

Recommended method for getting out of bed

  • Gently brace as demonstrated by your physiotherapist. Bracing involves gentle activation of pelvic floor muscles and deep tummy muscles.
  • Make sure the bed is flat. Draw in the pelvic floor as you bend both knees up one at a time.
  • Roll over to your side without twisting too much and keep your knees bent.
  • With your top arm well in front of you, push your upper body forward and up, as you allow your legs to go down at the same time.
  • Remember to keep breathing, keep your knees bent, and come forward and up to sitting in one smooth action.
  • Always try to stand tall, with your shoulders relaxed as you walk.
  • By the time you are ready to go home you will be independent with your daily activities.

Diet

To avoid nausea and vomiting following surgery it is important to slowly introduce foods. You will progress from clear fluids to light diet depending on what you can tolerate. You should be eating your usual diet by the time you leave the hospital.

Wound/sutures/drains

  • You will have a dressing over your wound. Wound drains may be placed on each side of the lower abdomen during surgery to allow any collecting blood to drain away. The tubes are attached to containers so that the fluid can be measured. Take care not to pull on the tubing. These drains are usually removed day one or day two following surgery.
  • An abdominal binder/girdle is used to help prevent the swelling at the operation site.

Hygiene

  • About four hours after you return to the ward, your nurse will assist you to have a wash.
  • From the day following your surgery you may shower. Assistance will be provided as you need it. It is important to keep the dressing on your wounds dry.

Discharge planning

  • If any discharge arrangements were identified on admission, your nurse will discuss these and make the necessary arrangements.
  • You may be ready to go home as early as the day after your surgery depending on the extent of your surgery, your recovery and orders from your medical team. Discharge information will be given to you (refer below) and your nurse will discuss this with you. If you have any questions, please do not hesitate to ask.

The day you go home

It is normally expected that you will be going home on day two following your surgery. Sometimes you may go home earlier or it may be necessary for you to stay an extra day.

You will be ready to go home when:

  • your observations are stable
  • your pain is controlled
  • you are eating and drinking normally
  • you are ambulatory and can attend to your activities of daily living independently
  • there are no signs of complications or infections
  • you have received explanations regarding your wound care and follow up appointments.

Discharge advice following abdominoplasty

Every patient is different when it comes to recovery. The extent of surgery is also different for each patient and that will also affect recovery.

Generally, it will be six weeks before you are able to resume your normal activities. Evidence shows that those patients who were physically fit before surgery recover faster than those who were not as fit. Post operative lethargy can often last a month or more.

Pain

Some pain/discomfort at your wound site is expected. This discomfort will eventually settle and can be managed with oral analgesia.

Wound

You may notice slight swelling and bruising around your wound. This is quite normal. It is also expected that in the first two or three months that your scar colour will redden rather than fade. This is entirely normal. This will fade over time (it may take as long as a year).

Exercise

Exercise can help with recovery. Begin a walking program that progressively increases each week. By six weeks following your surgery aim to be walking 30 minutes on most days of the week.

Avoid very strenuous activities and heavy lifting in the first six weeks. All loads should be carried close to the body, using both hands to support the load and maintaining a neutral spine. It is advised that you store heavy items on shelves between the levels of your knees and shoulders. This decreases the stress on your body.

If you have any questions please contact the physiotherapy department on telephone 07 3163 8787 and arrange a consultation. A suitable individualised program can be arranged especially if you have had any previous exercise restrictions or health conditions.

Return to work

Overall you can expect to be away work for two to three weeks (or as per your doctor's advice) and be back to normal activities after six weeks.

Please contact Mater Hospital Brisbane Emergency Department on 07 3163 811 or your general practitioner (GP) if you experience any of the following after discharge:

  • new wound discharge on your dressing
  • fever (high temperature)
  • dramatic increase in pain that is not relieved by simple analgesia (e.g. Paracetamol). Do not take any more than eight tablets within a 24 hour period
  • increased swelling from/around your wound
  • nausea/vomiting which does not settle
  • any other concerns.

South Brisbane campus

Acknowledgments:

Staff of Mater Hospital Brisbane, Raymond Terrace, South Brisbane, Q 4101

Copyright © 2010 Misericordiae Health Services Brisbane Limited ACN 096 708 922

Mater acknowledges consumer consultation in the development of this patient information.
Mater Doc Num: PI-CLN-420001
Last modified 11/1/2016.
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