The Condition
Pregnancy stretches and permanently alters abdominal skin, underlying fascia and abdominal muscles. Diastasis recti (separation of the rectus abdominis muscles) is present in over 30% of women following pregnancy and cannot be corrected non-surgically. Excess skin, stretch marks, umbilical position changes and C-section scarring further contribute to distress. These changes are normal, common and do not reflect lifestyle or effort.
Surgical Options
Full abdominoplasty (tummy tuck): Removal of excess lower abdominal skin, tightening of the abdominal fascia and repair of diastasis recti, with repositioning of the umbilicus. The scar is placed low, within the bikini line. Suitable for patients with significant skin excess and muscle separation.
Mini-abdominoplasty: Smaller incision addressing lower abdominal skin excess without umbilical repositioning. Appropriate where excess is limited to below the navel.
C-section scar revision and shelf correction: The "overhang" or "shelf" above a C-section scar results from adhesion of the scar to deeper structures. Mr Naparus performs C-section scar excision and revision, releasing the adhesion and improving scar appearance and the contour overhanging it. This is a highly targeted procedure that may be performed alone or combined with mini-abdominoplasty.
Fleur-de-lis abdominoplasty: Includes a vertical component for patients with significant horizontal excess (e.g. post-major weight loss).
It is recommended to have completed your family before undergoing abdominoplasty, as future pregnancy may compromise the result. Discuss this with Mr Naparus at your consultation.
Indications & Contraindications
Indications: Completed family; significant skin excess and/or muscle separation; BMI ideally below 30; non-smoker; good general health; realistic expectations.
Contraindications: Active smoking (absolute); BMI >35 (significant risk increase); planning future pregnancy; significant medical comorbidities; previous upper abdominal surgery affecting blood supply (relative — requires individual assessment).
The Procedure
Full abdominoplasty is performed under general anaesthesia as an overnight stay procedure. Operating time 2.5–4 hours. Prineo dressing applied to the incision in most cases, providing excellent wound support. Drains may be used (typically removed at 24–48 hours). C-section scar revision may be performed as a day case under local anaesthetic or sedation.
Aims & Expected Outcomes
Flatter, firmer abdomen with restored waist definition. Improved contour of lower abdomen. Resolution of overhanging C-section shelf. Low, discreet scar concealed within underwear or swimwear. Diastasis repaired — improved core strength and back pain in many patients.
Risks & Complications
Seroma
Most common complication, 5–20%. Fluid accumulation under the skin; managed by aspiration in clinic.
Haematoma
1–4%. May require surgical drainage.
Wound Dehiscence
Wound opening, typically at tension points; higher risk in smokers. Conservative management usually successful.
DVT / Pulmonary Embolism
Risk mitigated by stockings, LMWH injections, early mobilisation. Incidence approximately 0.5–1% in abdominoplasty.
Infection
1–4%. Prophylactic antibiotics given; managed with antibiotics or drainage.
Umbilical Necrosis
Rare (<1% in non-smokers). Risk significantly increased by smoking.
Altered Sensation
Numbness of lower abdomen common initially; usually improves over 6–12 months.
Scarring
Scar is concealed; maturation takes 12–18 months. Hypertrophic scarring uncommon; managed with silicone and massage.
Aftercare & Recovery
- Overnight hospital stay
- Compression garment worn for 6 weeks
- Shower after 48 hours; protect Prineo dressing from soaking
- Avoid straightening fully for first 1–2 weeks (abdominal tension)
- Drains removed at 24–48 hours
- Return to office work: 2–3 weeks
- Driving: 2–3 weeks (ensure able to perform emergency stop)
- Light exercise: 4–6 weeks
- Full exercise, including abdominal work: 3 months
- Swimming/sauna: once wounds fully healed, typically 3–4 weeks
- Contact sports: 6 weeks minimum
- Final result: 6–12 months
Alcohol impairs platelet function, increases bleeding risk, interferes with anaesthesia, and impairs wound healing. Abstain for at least two weeks before and after surgery.
Nicotine (cigarettes, vaping, patches, gum) dramatically increases risk of wound breakdown and poor scarring. Minimum six weeks nicotine-free before and after surgery.
Stop weekly injections at least one week before surgery; daily formulations 24 hours before. Declare at pre-assessment.
Face sutures removed at 5–7 days; body sutures at 10–14 days. Absorbable sutures require no removal. You will be clearly advised which type has been used.
Micropore tape reduces scar tension. Silicone tape/sheets commence at 2–4 weeks. Prineo mesh dressing used for longer incisions. Avoid direct sun on scars for 6 months; SPF50+ mandatory.