I’ve discussed how an abdominoplasty, a.k.a. tummy tuck, is performed in previous posts. Today I’d like to delve a little deeper into subject by discussing the possible complications. I’ll divide these into normal expected postoperative sequelae, and true complications.
Normal postoperative side effects include:
- Numbness: Abdominoplasty surgery involves elevating the skin up to the level of the ribs and removing the excess. This process means that small cutaneous nerves which give sensation to the skin are divided. So numbness over the abdomen is normal after abdominoplasty. The nerves take several months to regrow, and there may be permanent numbness right over the incision.
- Swelling: In addition to dividing the nerves, raising the skin up means that lymphatic system is disrupted as well. The lymphatic system is responsible for draining excess fluid from tissue and rerouting it back into the blood supply. Disrupting this system results in swelling, which may take several months to completely resolve.
- Bruising: Bruising is very common after most types of surgery surgery, and can take a few weeks to resolve.
- Excess skin. Skin does stretch over time. If you have an abdominoplasty and then gain weight or become pregnant, your skin may stretch, resulting in laxity.
- Blood clots: Blood clots in the deep veins of the legs known as a DVT (deep vein thrombosis), and can happen after periods of immobilization, including anything from surgery to a long plane ride. The risk is increased with age, smoking, hormonal birth control, and certain medical conditions. If a clot forms, part of it can break off and travel to the lungs. This is known as a pulmonary embolism (PE), and can actually be fatal. Fortunately the risk of both DVT and PE are very small. Your physician will assess your risk preoperatively, and may start you on a blood thinner in the postoperative period if your risk is higher than average.
- Hematoma: A hematoma is a collection of blood that develops in a surgical site. This is a risk of any type of surgery, and abdominoplasty is no exception.
- Seroma: A seroma is a collection of clear fluid within a surgical site. This is the fluid which your lymphatic system normally drains. To prevent this fluid from collecting, drains are placed after surgery which stay in place for 1-2 weeks. If either a hematoma or a seroma develop after surgery, they can usually be drained in the office, and only rarely would require a return to the operating room.
- Wound healing problems are also a risk of any type of surgery. If a wound-healing problem develops, it usually shows up as a small area of the incision which heals more slowly than the rest. A more severe wound healing problem occurs if some of the skin on the abdomen does not have good blood supply after surgery, and dies. This is called skin necrosis. It is more common in patients predisposed to healing problems, such as diabetics or smokers. It can also happen if liposuction is done over the abdomen at the same time as an abdominoplasty.
- Infection: Antibiotics are given before the start of surgery to prevent infection. This is a very rare complication after abdominoplasty.
- Contour deformities may also occur after abdominoplasty. The skin over the upper abdomen is thicker than the skin over the lower abdomen, and this can result in the edges of the incision being uneven. This will get better as the swelling resolves, but a scar revision may need to be done down the road if there is a significant step-off between the top and bottom of the incision, or if the incisions bunch up at the ends.
This isn’t an exhaustive list, but it does cover the more common, and more serious, risks of abdominoplasty. If there are other topics you’d like to learn about, I would love to hear them!