TRANSCRIPT 🔗
WEBVTT
00:00:00.160 --> 00:00:05.040
Despite diet and exercise, some changes to the abdomen don't fully recover on their own.
00:00:05.200 --> 00:00:08.640
Loose skin, stretched muscle fascia, and a weakened core.
00:00:12.320 --> 00:00:15.599
Why do people struggle with this area even when they're fit and healthy?
00:00:24.480 --> 00:00:26.320
Literally, it gets stripped apart.
00:00:26.399 --> 00:00:29.679
And that's something unique surgical intervention can restore.
00:00:29.839 --> 00:00:33.280
Once that's happened, exercise alone can't be correct.
00:00:33.920 --> 00:00:36.240
Bulging a bit and make the core support.
00:00:37.920 --> 00:00:41.359
Abdominal plastic restores the abdominal walls, integrity, and function.
00:00:41.520 --> 00:00:46.799
Patients notice huge functional improvements to big surgery so they understand that they're a trade-off.
00:01:00.960 --> 00:01:04.079
The tummy tuck, also known as an abdominoplasty.
00:01:04.319 --> 00:01:09.280
Despite diet and exercise, some changes to the abdomen don't fully recover on their own.
00:01:09.439 --> 00:01:16.319
Loose skin, stretched muscle fascia, and a weakened core can affect comfort, posture, and function, not just appearance.
00:01:16.480 --> 00:01:25.439
To explain what an abdominoplasty actually involves, who it's for, and what it can realistically achieve, I'm joined by specialist plastic and reconstructive surgeon, Dr.
00:01:25.599 --> 00:01:26.560
Adam Greenbaum.
00:01:26.799 --> 00:01:27.439
Adam, welcome.
00:01:27.760 --> 00:01:28.560
Nicola, hi.
00:01:28.799 --> 00:01:32.480
Adam, let's start with why the abdomen can be so resistant to recovery.
00:01:32.640 --> 00:01:35.920
Why do people struggle with this area even when they're fit and healthy?
00:01:36.239 --> 00:01:39.840
It helps to envisage the layers of the abdomen as a corset, I think.
00:01:40.000 --> 00:01:44.319
Particularly with pregnancy and weight changes, the corset gets stretched.
00:01:44.400 --> 00:01:54.640
And if the stretching is enough, some parts of that layered corset lose the elastic recall needed to spring back to how it once was before pregnancy or weight gain.
00:01:54.799 --> 00:02:00.719
The skin can lose elasticity, and the fascial layer holding the abdominal muscles in place separates.
00:02:00.799 --> 00:02:02.480
Literally, it gets stripped apart.
00:02:02.560 --> 00:02:04.159
And that happens down the midline.
00:02:04.480 --> 00:02:09.919
And so that's a condition called diastasis recti or rectus divarication.
00:02:10.000 --> 00:02:13.360
And that's something only surgical intervention can restore.
00:02:13.599 --> 00:02:17.439
Once that's happened, exercise alone can't correct it.
00:02:17.599 --> 00:02:26.800
People may feel strong overall, but still they'll notice persistent bulging of their tummy, poor core support, and loose skin that won't tighten and just hangs.
00:02:26.960 --> 00:02:28.879
And that's when abdominoplasty will help.
00:02:29.120 --> 00:02:32.240
So what exactly is a tummy tuck or abdominoplasty?
00:02:32.479 --> 00:02:55.360
Tummy tuck, abdominoplasty is a procedure that addresses those three key issues: the excess, loose abdominal skin, separation of the fascial support to the abdominal muscles, and during surgery, we tighten the abdominal muscles, remove excess skin and tissue, and reshape the abdomen to give a better uh support and contour.
00:02:55.439 --> 00:02:58.719
It's important to understand this isn't a weight loss procedure.
00:02:58.800 --> 00:03:03.120
It's about restoring structure and function once you're at your goal weight.
00:03:03.439 --> 00:03:05.120
It's really good to understand that difference.
00:03:05.280 --> 00:03:06.879
You mentioned muscle separation.
00:03:07.039 --> 00:03:09.520
Why is that such an important part of this surgery?
00:03:09.840 --> 00:03:23.919
If we go back to the corset analogy, the abdominal muscles act like a natural corset for the body, but they can only do this if the sheets of fascia, which is a strong connective tissue that's made of collagen, and that envelops the muscles.
00:03:24.080 --> 00:03:26.159
If that's intact, everything works.
00:03:26.319 --> 00:03:30.080
If that's not intact and it's stretched out of shape, then everything is lost.
00:03:30.319 --> 00:03:34.240
When those fascial layers separate, the muscle isn't supported.
00:03:34.560 --> 00:03:36.400
And so they can't contribute.
00:03:36.479 --> 00:03:46.000
What needs to happen, and you can end up with lower back pain, posture, and generally just difficulty engaging your core muscles when you need to.
00:03:46.159 --> 00:03:50.560
And so after pregnancy or significant weight loss, this can be a real problem for people.
00:03:50.719 --> 00:03:59.120
By repairing the fascial separation and repositioning those muscles appropriately, abdominal plasty then restores the abdominal walls, integrity, and function.
00:03:59.199 --> 00:04:06.240
And so done well, patients will notice huge functional improvements as well as changes in shape after the procedure.
00:04:06.479 --> 00:04:08.319
So are all tummy tucks the same?
00:04:08.560 --> 00:04:09.680
No, absolutely not.
00:04:09.840 --> 00:04:10.800
There are different types.
00:04:10.960 --> 00:04:19.439
Some patients benefit from a full abdominal plasty, which addresses the entire abdomen, and as I was explaining, those myofascial components which have separated.
00:04:19.600 --> 00:04:22.160
Others may be suitable for a much more limited procedure.
00:04:22.319 --> 00:04:26.959
It depends on the amount of excess skin and whether or not there's myofascial laxity.
00:04:27.040 --> 00:04:28.639
And that's why assessment is so important.
00:04:28.800 --> 00:04:32.160
The procedure needs to be tailored to an individual's anatomy and goals.
00:04:32.639 --> 00:04:33.439
That's really good to know.
00:04:33.680 --> 00:04:36.240
Scarring from a tummy tuck is something people worry about.
00:04:36.560 --> 00:04:37.600
What should patients
Load full transcript
expect?
00:04:38.079 --> 00:04:40.000
Tummy tuck does involve a scar.
00:04:40.480 --> 00:04:43.519
Typically it's a horizontal scar, low on the abdomen.
00:04:43.920 --> 00:04:47.439
Positioned, it can be hidden by underwear or swimwear, certainly.
00:04:47.600 --> 00:04:51.839
It's similar to and slightly longer than that you'd have after a cesarean section.
00:04:52.000 --> 00:04:56.000
So if you've had a C-section, I would reuse that scar and rework it.
00:04:56.240 --> 00:05:02.720
There's also a scar around the belly button because that's repositioned during surgery, but that's usually uh relatively imperceptible.
00:05:03.199 --> 00:05:06.560
Scars are notable initially, but they'll soften and fade over time.
00:05:06.879 --> 00:05:12.160
In any consultation, I'll discuss scar placement carefully with patients so they understand that there are trade-offs.
00:05:12.639 --> 00:05:14.639
So, what does surgery and recovery look like?
00:05:14.959 --> 00:05:18.639
Abdominoplasty would always be performed under a general anesthetic.
00:05:18.879 --> 00:05:26.879
Most patients would stay in hospital for at least one night, as this is a a large procedure, and it does require careful monitoring by nursing staff afterwards.
00:05:27.199 --> 00:05:30.160
After surgery, patients would feel tight through the abdomen.
00:05:30.319 --> 00:05:31.040
That's quite normal.
00:05:31.279 --> 00:05:35.040
Pain is quite well managed, but recovery requires some patience.
00:05:35.279 --> 00:05:39.360
I'd encourage patients to walk early on, but certainly that night if possible.
00:05:39.519 --> 00:05:42.079
And standing fully erect takes some time.
00:05:42.319 --> 00:05:48.160
Patients will be wearing a compression garment to support healing, and activity will gradually increase over several weeks.
00:05:48.560 --> 00:05:53.519
Full recovery can take time, but it's important not to rush it so that you get the best result you can.
00:05:53.839 --> 00:05:55.439
And when do people see the final result?
00:05:56.160 --> 00:05:57.680
You'll notice a change immediately.
00:05:57.920 --> 00:06:01.439
There will be swelling, as I've said, and that can take several months to settle.
00:06:01.600 --> 00:06:05.680
But the final result becomes clearer as healing progresses and the tissues soften.
00:06:06.000 --> 00:06:08.879
Between three and nine months, you'll be getting a very good idea.
00:06:09.120 --> 00:06:14.160
But results are long-lasting, and providing that you keep your weight stable, everything will look good forever.
00:06:14.560 --> 00:06:23.360
That's important though, not to be confused that if you get pregnant again or if your weight changes again, that will uh have an effect on that final outcome and result.
00:06:23.759 --> 00:06:25.439
And who is best suited for a tummy tap?
00:06:25.920 --> 00:06:29.040
People who are non-smokers who are at a stable weight are ideal.
00:06:29.279 --> 00:06:32.639
Again, ideally, you'd have completed uh all your pregnancies.
00:06:32.879 --> 00:06:35.439
It's good to be in good general health and quite fit.
00:06:35.680 --> 00:06:42.879
If you have loose skin and muscle and muscle fascial separation that hasn't improved with exercise, then you're an ideal candidate.
00:06:43.199 --> 00:06:50.079
An important thing to realize that this is big surgery, and so recovery takes time and you need to be committed to doing what we've um suggested.
00:06:50.639 --> 00:06:54.800
So, what defines cutting-edge plastic surgeries approach to tumuto surgery?
00:06:55.040 --> 00:06:56.959
Uh I take a careful approach.
00:06:57.120 --> 00:07:02.879
I base everything on this being a reconstructive procedure as well as to some degree an aesthetic procedure.
00:07:03.040 --> 00:07:06.800
I focus on the anatomy and the function uh to get the long-term outcomes.
00:07:07.279 --> 00:07:16.000
Pre-operative consultations are thorough and slow, and we discuss the pros and cons and the likely outcomes so that people have realistic expectations.
00:07:16.399 --> 00:07:23.920
Part of my training as a reconstructive plastic surgeon is to deal with both complex abdominal wall reconstruction and aesthetic balance.
00:07:24.160 --> 00:07:26.720
And this is uh a perfect fusion for this procedure.
00:07:27.279 --> 00:07:30.079
So to finish up, what are the key messages for our audience?
00:07:30.560 --> 00:07:34.240
Tummy tuck is about restoring structure, not about losing weight.
00:07:34.480 --> 00:07:39.360
But muscle and fascial repair is a key part of the procedure, so it is reconstructive.
00:07:39.680 --> 00:07:47.040
Recovery takes time, but results can be significant and long-lasting if things are taken appropriately and time is taken.
00:07:47.360 --> 00:07:52.720
If you think you've got problems with abdominal function, then this is a conversation you should have.
00:07:53.199 --> 00:07:58.240
An audience can learn more or book a consultation at CEPS.nz.
00:07:58.800 --> 00:07:59.120
Absolutely.
00:07:59.600 --> 00:07:59.759
Dr.
00:07:59.839 --> 00:08:01.759
Alan Greenband, thank you for joining us.