Contraindications for tummy tuck

Introduction

Abdominoplasty can also be defined by terms such as the tummy tuck, tummy lifting, and even abdominal lipectomy. The tummy tuck may be of interest to patients who are not able to get rid of a belly with an unsightly appearance; even prominent, sagging or presenting a belly apron made out of skin folds. The patients are often confronted with saggy skin and also stretch marks.

This procedure is considered restorative but also aesthetic: it is as much a matter of comfort as of beauty. This procedure is more and more common, especially in women following deformations related to pregnancy. Abdominoplasty is not intended for obese patients as obesity is a contraindication to the procedure. It is even advisable to get to the patient’s ideal weight before surgery as close as possible for a better targeting of surgery and achieving better results.

The techniques of abdominoplasty have been refined, allowing better results with fewer consequences and risks. However, because we are talking about a serious surgical procedure, there are always complications that can occur during or after the tummy tuck is performed. To eliminate or reduce the risks of complications associated with the procedure, we need to first eliminate any contraindications that the patient might have.

In this article, we will discuss the tummy tuck and what are considered contraindications to this procedure.

Tummy tuck versus liposuction

Modern plastic surgery offers two methods for redefining the abdominal area. First is abdominal liposuction. Liposuction is a good procedure when the patient has a good skin tonus, the muscles are in a good condition, and there is no skin sagginess present on the inferior part of the abdominal wall. Liposuction removes the localized adipose pockets from the tummy that can accumulate in the area and are resistant to exercise and diet.

On the other hand, when the tummy is saggy and the skin is damaged, distended and presenting stretch marks or cellulite, liposuction is not recommended. Poor quality skin can’t retract properly after liposuction alone; removal of excess skin and re-tensioning of healthy skin are necessary methods used during the tummy tuck. Also, it is important to mention that the abdominal prominence may be due, in some cases, to the distention of the muscles of the abdominal wall. The surgeon thus combines the removal of abdominal fat with a tummy tuck.

When is the tummy tuck recommended?

• Adipose excess localized on the abdomen that is resistant to physical exercise and balanced eating regimen;

• Residual skin excess caused by significant weight loss or pregnancy;

• The presence of stretch marks and/or cellulite as they are often the signs of poor skin tonus and quality;

• The existence of diastasis hindering the muscles of the abdominal wall: this is a separation between the muscles of the abdominal wall widening the white line of the abdomen connecting each side of the abdominal muscles. Diastasis can sometimes be accompanied by umbilical hernia. The condition often occurs following pregnancy as the muscles of the abdominal wall fail to rejoin properly due to the growing of the uterus. The abdominal wall is weakened and the belly remains bulging, despite the fact that the patient has lost the baby weight. Only surgery can treat diastasis recti by restoring muscle tone through sutures.

Contraindications for the tummy tuck surgery

Even if abdominoplasty is mostly performed for aesthetic purposes nowadays, the procedure is not suitable for all patients who have an unsightly looking abdominal area. Conditions such as poor blood circulation, lung disorders or history of phlebitis can deem the patient as ineligible to undergo a tummy tuck. Other contraindications include:

1. The patient desires to bear more children in the future.

If the patient is planning pregnancy in the next two years, it is better not to undergo the tummy tuck as an ulterior pregnancy could negate the effect of the surgery. Indeed, even if the skin has good elasticity, it may be difficult to regain its initial appearance after pregnancy, especially in the case of multiple pregnancies. Thus, to trigger a process of loosening the skin in one or two years by a possible pregnancy, it is better to postpone the tummy tuck procedure. You can always postpone it after delivery because the surgery does not guarantee that you will keep your stomach flat afterward.

It is true that the tummy tuck delivers long-term and even permanent results. However, an ulterior pregnancy has a high chance of altering the results achieved and the patient might need new abdominoplasty after childbirth. Wanting more children in the future is not a medical contraindication to the procedure, and the fact that the mother had a tummy tuck before getting pregnant again won’t be problematic for the mother or the baby. The contraindication discussed here is just a matter of aesthetics.

2. The patient does not want to be left with a permanent scar.

One of the prices we have to pay for getting a firmer and flatter tummy with the help of plastic surgery is being left with a permanent scar. In the case of this procedure, the scar can be as long as from hip to hip on the supra pubic area. The size and appearance of the scar are dependent on the amount of tissue to be removed and also the patient’s ability to follow the post-op recommendations for nice scarring. The scar will take a year to heal and mature completely, and after this time it will often look like a fine white line that is easily covered with panties or a bathing suit.

Before scheduling your tummy tuck procedure, it is essential to understand that the scar will never disappear. It will be barely visible, but the scar left after the tummy tuck is permanent. Not being able to accept this fact can make the patient ineligible for the procedure.

3. The patient doesn’t understand the risks and potential complications involved.

Plastic surgery should only be performed on patients aware of the risks of the procedures they want to undergo. These patients must be prepared to undergo surgery. This means that a certain level of emotional maturity is required to be eligible, as well as a balanced mental state. It is the plastic surgeon’s responsibility to present the risks and complications that can occur during or after abdominoplasty. If the patient is uncomfortable with the potential risks, this is a serious contraindication to the tummy tuck.

4. The patient is a smoker and doesn’t want to stop smoking before or after the procedure.

Cigarette smoking is one of the contraindications in that it exposes the patient to a risk of increased skin necrosis. Cutaneous necrosis does not facilitate healing and therefore delays the recovery process. The plastic surgeon will advise smoking patients interested in undergoing a tummy tuck to cease smoking at least three weeks before and after the procedure (even more, if possible). If you do not think you can stop smoking, do not even consider a tummy tuck to avoid complications that might occur due to the lack of oxygenation of the tissues that are associated with smoking.

5. The patient is overweight or obese.

This operation is for people who have stretch marks or a large fat deposit on the stomach, associated with a certain level of skin sagginess and muscle diastasis. It can’t and shouldn’t be performed if the weight of the potential patient is the primary cause of fat accumulation on the abdomen—that is, the belly is proportional to the rest of the body. Indeed, abdominoplasty aims to flatten a tummy that is disproportionate to the rest of the body. If the patient is overweight or obese, treatment for these conditions should be sought before scheduling plastic surgery. The tummy tuck can complete and perfect the results achieved after weight loss through diet or bariatric surgery, but it is not a treatment for obesity.

Conclusion

The tummy tuck is a complex plastic surgery procedure that should be performed on patients in good physical and emotional condition. There are certain lung, heart and blood conditions that make the patient ineligible for the procedure; however, in a vast majority of cases, the patients can have the abdominoplasty even if confronted with health issues such as diabetes for as long as the plastic surgeon is briefed before the procedure. At the same time, there are other contraindications that are not related to the medical condition of the patient that should be taken into consideration.