The skin of the abdomen is stretched by pregnancy or weight gain. Following childbirth or significant loss of weight the stretched skin becomes lax and overhangs the pubic area. No amount of diet and exercise can overcome laxity of skin especially if it has stretch marks. In this situation the excess skin and fat has to be removed by surgery.


Why do patients seek an abdominoplasty?

Patients are embarrassed by appearance of the abdomen when the skin is stretched, overhangs the tops of trousers and skirts, causes a bulge under fitted dresses and is visible above and below bikini bottoms. Patients are also distressed by prominent stretch marks and a stretched bellybutton which they find very unappealing. There inhibited about wearing swimsuits and bikinis and do not like to take their children swimming or go out on the beach on holiday. These problems can be corrected by an abdominoplasty.


What does an abdominoplasty involve?

Patients should not be on blood thinning medication such as aspirin or warfarin and ideally should not take nicotine in any form for six weeks before surgery. The procedure is carried out under general anaesthetic and usually involves two nights in hospital. Plastic tube drains are inserted under the abdominal skin to remove any excess blood or fluid for the first 24 to 48 hours. These drains are then removed, the patient is able to have a shower and have the dressings changed before being discharged home. An appointment is made for removal of sutures a week following surgery and for a review in two weeks after surgery.

What is the normal postoperative course?

The abdomen feels tight for the first few days after the operation and patients are not able to stand fully erect. On the first postoperative day an elasticated abdominal binder is applied to the abdomen for support and gentle mobilisation is begun. By the second postoperative day most patients are mobile and discharged home.

It is advisable to have help around the house and with young children for the first couple of weeks after surgery. At the end of two weeks most patients are able to drive, carry light shopping and prepare light meals. At the end of four weeks patients are expected to be able to return to normal lifestyle including gym, sport and aerobics unless they have had tightening of the abdominal muscles or repair of an abdominal hernia at the same time as the abdominoplasty.

How much time do I need off work?

Most people are able to return to work which does not involve heavy lifting in approximately two to three weeks after surgery. It may take up to six weeks for some patients to be would return to normal work and leisure activities.

What are the complications of this procedure?

A very small percentage of patients who undergo a tummy tuck will have complications just like any other surgical procedure. These include bleedings, haematoma (blood clot under skin), seroma (fluid collection under skin) and infection. There can be delayed wound healing in the centre of the wound, slight asymmetry in the size and shape of the scar or the position of the bellybutton and a change in sensation over the abdomen.

 

 

 

 

 

Arm Reduction
...........................................................................................................................................

What is Arm Reduction? Arm reduction is a procedure for removal of excess skin and fat from the inside of the upper arm. This is usually carried out in patients who have saggy skin.

 

What are the causes of excess skin in the inner aspect of the arm?

Most patients who have this problem develop this either as a result of ageing or due to significant weight loss.



Why do patients seek treatment for this condition?

Most patients are embarrassed by what they call a "batwing" appearance of the arms. This refers to the sagging of skin below and on the inside of the arms when the arms are held up. They are embarrassed to wear clothes which are either sleeveless or have short sleeves and are inhibited about wearing swimwear.

What does the surgery for this condition involve?

Surgery for this condition usually involves a general anaesthetic. It maybe done as a day procedure or may require a one night stay.

What is the normal postoperative course after this procedure?

There is swelling and bruising of the upper arms and the inner aspect of the elbows which lasts for a period of one to two weeks. The sutures are trimmed at the end of the first week and patients are encouraged to massage the scars to help them soften and fade.
Most patients are able to carry out light activities after a week and are able to return to work within a fortnight of their surgery.

What are the possible complications of this procedure?

Like all operations this procedure can have complications such as bleeding, haematoma formation (blood clot underneath the skin), infection, a visible scar and asymmetry. A small percentage of patients (normally less than 5%) may require a small revision procedure to improve the scar.

 

 

 

 

Thigh Reduction
...........................................................................................................................................

Why do patients request this procedure? Patients request this procedure for the treatment of excessive skin on the inner aspect of their thighs.

Why does this condition occur?

Patients develop sagging or wrinkling of skin on the inside of the thigh as a result of excessive weight loss or as part as the normal process of ageing.



Why do patients seek treatment for this condition?

Patients with this condition are self-conscious and embarrassed about the appearance of their thighs. They do not like the wrinkling on the inside of the thigh and the excessive skin and fat just above the knee. In addition they also suffer physical discomfort as the insides of the thighs rub against each other causing chafing. The condition is also uncomfortable in hot weather due to sweating.

What does surgery for this condition involve?

This condition can be treated by surgery, which is carried out under general anaesthetic. It involves removal of excess skin and fat on the inner aspect of the thigh. The resulting scar is usually well hidden in the groin and in the inner aspect of the thigh.

How long do I need to be in hospital?

Most patients spend one night in hospital after this operation.

What is the aftercare following this procedure?

Following the operation the surgeon may put a drain (a plastic tube) underneath the skin which stays in place for approximately 24 hours. This is removed the day following surgery. The patient is usually able to have a shower and change of dressings before being discharged from hospital.
An appointment is made for removal of sutures a week following surgery and a review appointment with the surgeon is arranged in approximately a fortnight following the operation.
Most patients are mobile within a couple of days following surgery and are able to return to work at approximately a fortnight following the operation.



What are the complications of this procedure?

Just like any other operation this procedure has complications such as bleeding, haematoma (a blood clot underneath the skin), infection, visible scars, a change of sensation in the skin and asymmetry.
A small percentage (usually less than 5%) of patients may require a secondary revision.

 

 

Labial reduction
...........................................................................................................................................


The labia minora (inner lips of the vagina) differ in size and shape. Patients may find very large labia physically uncomfortable or aesthetically displeasing.



Why do patients request labial reduction?

In some patients the labia may be too large and cause discomfort with underclothes and fitted jeans, difficulty with maintaining hygiene during menstruation and pain during and after intercourse. In some cases large labia may be visible through underclothes and swimwear. The two labia may also be visibly different and cause embarrassment.



What does labial reduction involve?

The procedure is usually carried out under general anaesthetic as a day case. Surgery involves very careful reduction in the size of the labia by trimming of excess skin followed by repair with fine dissolving sutures. An antiseptic dressing is applied and held in place with a panty liner. Patients are discharged home the same day. A review appointment is made for a week after surgery.

What is the normal postoperative course?

Patients experience minor discomfort for 24 to 48 hours following this procedure. The labia are slightly bruised and swollen for a few days after the procedure. The sutures normally dissolve within two to three weeks leaving a fine well-healed scar. Patients are usually very satisfied with the results.



How much time do I need off work?

Most patients are able to return to work within a couple of days following surgery.

What are the complications of this procedure?

Just like any other operation labial reduction can also have complications such as bleeding, haematoma (blood clot under the skin), infection and a tender scar. These are uncommon. Most patients have mild residual asymmetry, as it is extremely unusual for anyone to be perfectly symmetrical.