Tummy Tuck Sydney

Tummy Tuck Sydney

What is a tummy tuck?

An tummy tuck is performed to tighten loose muscles and to remove fat and excess loose skin from the abdomen or tummy area.

During this procedure, your surgeon will make an incision along your lower abdomen and carefully shape and sculpt the area by removing extra skin and fat to produce a beautiful and more flat shape to the tummy. In some tummy tuck patients, the abdominal muscles have been separated so this procedure, so as part of this procedure they will be repaired and sewn back together.

This improves the fullness that was present in this area and also helps to strengthen and support the core and lower back. A second incision is made around the belly button – this is because the skin in the upper abdomen is pulled down, tightened and the loose skin removed, the belly button is stitched into a new opening once this has been done. The surgeon will make an effort to make it look as natural as possible.

It is important to remember that a tummy tuck isn’t performed for the purpose of losing weight and isn’t designed for people who are significantly overweight. This procedure will indeed remove an amount of fat from the abdomen area but it is a body contouring procedure. Meaning that it gives a slimmer shape and your clothes will fit you better, but it is best that you achieve your goal weight first as a tummy tuck will not result in significant weight loss.

If you are more interested in having areas of fat removed then liposuction may be a better option.

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Main reasons why women choose to have a tummy tuck

  • Wear more fitted clothing that may otherwise reveal the loose skin or excess fat they find embarrassing
  • Wear swimwear they want to wear
  • Feel more confident and feminine
  • Restore shape of their tummy after pregnancy
  • Remove skin and fat that can’t be helped through diet and exercise alone

The medical benefits of a tummy tuck can be improved back pain, improved incontinence and improvement in skin rashes under the skin.

A tummy tuck is most suited to women who

  • Have completed their families
  • Are physically and mentally healthy
  • Have already lost the weight they want to lose
  • Have been a stable weight for at least 6 months (ideally 12 months)
  • Have realistic expectations, and are willing to accept the scar of an tummy tuck
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Tummy tuck may not be suitable for women who

  • Have not completed their families i.e. Are still planning more children
  • Have not lost the weight they want to lose
  • Have fluctuations in their weight
  • Are very overweight or obese (BMI >35) – ideally your BMI should be less than 30 for best results
  • Have multiple medical problems
  • Have multiple scars on their tummy, or have had a gallbladder removal through a large incision (open
    cholecystectomy)
  • Are on blood thinning medication
  • Are actively smoking
  • Will not accept a long scar of a tummy tuck

Women who have tummy tucks are generally some of the most satisfied patients as results can be
outstanding.

Some women chose to combine tummy tuck surgery with:

  • Breast Surgery
    • Breast Augmentation
    • Breast lift/Reduction
    • Augmentation-Mastopexy
  • Liposuction
  • Facial cosmetic surgery.
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What is different about a ‘mini-tummy tuck’

A mini-tummy tuck is most suited to people who only require the removal of fat and excess loose skin from the area below the navel (belly button). This also means that there will be a smaller scar, which some patients prefer.

Depending on how much loose skin and fat deposits that need to be removed to make the surgery worthwhile will determine if you can have a mini-tummy tuck or if you should proceed with the full tummy tuck. In most cases we always recommend a full tummy tuck for best results.

Dr Aggarwal

Dr Aggarwal

Dr Aggarwal is a well regarded, respected, highly skilled and experienced Specialist Plastic Surgeon. Graduating at the top of his class throughout his training, Dr Aggarwal has completed fellowship training at some of the world’s most prestigious reconstructive and cosmetic plastic surgery institutions in Canada and the USA. He continues to publish research is prestigious plastic surgery journals, and is actively involved in the training of future plastic surgeons.

What sets Dr Aggarwal apart from others is his personal, affable and warm nature. Not only does he pay attention to detail, to producing natural, beautiful results but he ensures that the patient’s journey is just as special as their outcome. Dr Aggarwal looks after patients at one of Sydney’s most prestigious public hospital campuses (POWH/SCH/RHW), and operates privately on Sydney’s North Shore. Dr Aggarwal has treated thousands of patients throughout Sydney and beyond who have achieved outstanding results under his care.

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Procedure Snapshot

  • Anaesthetic: GA by accredited anaesthetist
  • Time: 2-3 hours
  • Duration of stay: 2-3 night stay in hospital
  • Hospital: Usually Hunters Hill Private or Castlecrag Private Hospitals.
  • Medicare/Health fund rebate: Tummy tuck for cosmetic reasons does not attract debates.
  • Part of the tummy tuck cost is rebated by Medicare if you have a symptomatic umbilical hernia.
  • A tummy tuck is also rebated for those who meet the following criteria:
  • Significant loss of weight equal to or greater than 5 BMI points
  • Skin condition exacerbated by loose skin and fat
  • Skin condition not resolving with 3 months of conservative therapy
  • Recovery: Most people stay in hospital for 2 nights, and may go home with a drain in their tummy. Patients start walking hunched over and by the end of the first week they are starting to walk almost straight. Heavy lifting or exercise is disallowed for 8 weeks and strenuous exercise for 3 months. For 8 weeks you will be required to wear a binder (which is like a corset) over the tummy. You can shower after 48 hours, but avoid swimming in a pool or beach for 2-3 weeks until all wounds have healed, and all drains are out.
  • Results: One of the most satisfying procedures for patients but it is important to note that results vary from patient to patient.
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Cosmetic Concerns

I want to avoid having the long scar of a tummy tuck – what are my options?
  • If you are overweight, you should try and reduce as much weight as possible through diet and exercise. Fat from the abdominal region is generally very responsive to this, and losing weight also makes you fitter and healthier, and therefore a better candidate for surgery should you wish to pursue this.
  • If you have significant amount of loose skin and fat that is not responding to exercise the only option is to surgically excise this in a tummy tuck procedure, and therefore have the long scar. Unfortunately any surgical procedure will result in a scar.
  • Patients with only a small amount of loose skin and fat, may be candidates for a mini-tummy tuck – please read our section on mini tummy-tuck. While there is a scar it is shorter than that for a conventional tummy tuck and also avoids the scar around the belly button.
I have had multiple kids and my muscles are separated – can this be fixed
  • This is a common concern for women presenting to Mode Plastic Surgery.
  • During pregnancy the belly expands to accommodate the expanding uterus and foetus. Part of this process involves expansion of the abdominal region or tummy wall, and therefore the rectus muscles separate.
  • It is variable to what extent this separation repairs itself after pregnancy and unfortunately no amount of fitness training or exercise will completely repair the separation.
  • During a tummy tuck procedure not only do we excise the excess skin and fat, but under the skin the muscles are carefully tightened and repaired, to correct their separation. This provides a beautiful definition to the waistline and a much flatter tummy.
  • The muscle repair however is one of the main reasons for restricting activity after a tummy tuck and wearing a binder, as they layer on top of the muscles (called the fascia), is slow to heal and scar, and takes at least 8 weeks to strengthen.
I have an outie belly button, but I want an innie – is this possible?
  • An outie belly button can be due to the presence of an umbilical hernia.
  • All umbilical hernias are repaired at the time of tummy tuck surgery and should be able to produce a more normal appearance to the belly button.
  • However the larger the hernia, the more the blood supply to the belly button can be at threat when combined with a tummy tuck. In very large umbilical hernias it may be necessary to remove the belly button altogether and come back to reconstruct it in the future after the tummy tuck and repair of hernia procedure.
  • If you have a symptomatic umbilical hernia, you may qualify for a partial rebate of tummy tuck surgery.
I want a shorter rather than a longer scar
  • The decision of which scar will be employed depends on the amount of loose skin and fat.
  • In a mini tummy tuck the incision is significantly smaller than a conventional tummy tuck.
  • However if you do have significant loose skin and fat it is better to make the scar longer rather than shorter.
  • This is because shorter scars can result in dog ears at either end of the incision line which creates an obvious contour problem noticeable through clothes. Longer scars achieve better contours and can be hidden under clothes or swimwear.
I want to get rid of my love handles
  • It is a common request to remove the excess fat around the sides during a tummy tuck procedure
  • Depending on the amount of fat and skin present around the sides there are different options:
    • It is probably the most common to combine tummy tuck with liposuction of the love handle area which can achieve excellent results in most patients
    • The scar can be extended to go around the sides – this for patients who not only have excess fat but also excess skin around the sides
    • Body Lift Procedure – this is needed when excess skin and fat goes all the way around and is generally needed for patients who have lost a lot of weight. Please read our section on Body Lift for more information.

Procedure Information

The procedure is always performed under general anaesthesia given by an accredited anaesthetist in a fully accredited and licensed facility (usually one of the North Shore’s premier private hospitals). The procedure takes two-three hours and most patients will spend 2-3 nights in hospital.

Imaging
  • If there is any suspicion for hernias in your tummy or you have had multiple previous abdominal operations, you may be sent for an ultrasound or CT scan, but this is not routine.
Incisions
  • A scar has to be placed from hip to hip.

  • The skin of the tummy is lifted all the way to the rib cage, and the belly button is cut out and left where it was originally.
  • The tummy muscles (rectus muscles) are tightened and their separation repaired. At the same time any umbilical hernias are repaired.
  • The amount of skin to be removed is then calculated, and after it is removed, the incisions are closed. The belly button takes a new position on the tummy skin although its physical position has not actually changed.
Drains
  • In general 2 drains are used for tummy tuck surgery.
  • The exceptions are
    • Patients having a mini tummy tuck procedure – where only 1 drain or no drains may be used
    • Patients having largely loose skin only, and therefore needing less lifting (or undermining) of tissues
  • Whilst in hospital the drain outputs are recorded, and the drains removed once fluid drainage is minimal.
  • It is not uncommon for patients to go home with a drain and see Dr Aggarwal or his staff in rooms to have the drain removed after discharge from hospital.
After your tummy tuck (abdominoplasty) surgery
  • Dr Aggarwal will place waterproof dressings over the incisions.
  • When you come out of surgery you will be in bed with your back and legs up.
  • You will be able to walk hunched over (as the tummy will be tight). You may have a catheter in place which will be removed as soon as you are mobile.
  • You will be able to get all areas wet after 48 hours. However you will not be allowed to swim in a pool or beach for at least 2 weeks after surgery or until all drains are removed (whichever is later).
  • You will be given a script for antibiotics by Dr Aggarwal which you must continue for 1 week or until all drains are removed. You will also be given appropriate pain relief medications.
  • When you go home it is best to have someone look after you as you recover.
  • While most sedentary activities can be resumed when you go home, you must lay low and not exert yourself. You will also not be allowed to do any heavy lifting or exercises for the first 8 weeks. During this period you will also be required to wear an abdominal compression garment or binder (resembles a corset).
  • Dr Aggarwal will see regularly after your discharge from hospital.
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Risks & Complications

Every surgery carries risks, and therefore one must consider if risks outweigh the benefits for your own personal situation. If they do then the surgery may be well worth it. Dr Aggarwal will discuss the pros and cons of surgery with you during your consultation.

General Complications
  • Risks of anaesthetic – there are general risks of going under an anaesthetic such as a mild stress on the heart and lungs, risk of reaction to anaesthetic drugs and risk of blotting in the legs. These risks are generally low in patients who are otherwise fit and healthy.
  • Bleeding (1-2%) – any bleeding is controlled during surgery however unexpected bleeding can occur in the immediate postoperative period. If this occurs it will necessitate a return to theatre to control the bleeding.
  • Infection (<1%) – this is very rare. However you are given antibiotics during induction (when you are going to sleep), as well as a course of oral antibiotics after your surgery to keep this risk to a minimum.
  • Seroma (2-5%) – A tummy tuck raises a large flap of skin which must then scar to the underlying fascia and muscles. This ‘injury’ causes the body to respond with accumulation of fluid, and there is a large potential space in which it can build up. Drains are inserted during surgery to remove the excess fluid that your body does not absorb. Drains are only removed when the fluid reduces. Keeping a binder on after surgery, as well as reducing movement is also essential to avoiding the risk of a fluid collection. If a fluid collection develops after removal of drains it may need to be removed via a needle through the skin. The fluid is removed because if it accumulates there is a risk of it getting infected.
  • Poor Wound Healing (5%) – Occasionally absorbable sutures used under the skin can be rejected by the body forming a small pustule where the suture spits out. These issues usually resolve with removing the suture and dressings.
Specific Complications
  • Umbilicus (belly button) compromise – this is a rare complication in tummy tuck surgery. By cutting around the belly button, its blood supply is reduced and it gains it nourishment through small blood vessels from inside the belly. However if you have an umbilical hernia that requires repair can reduce its blood supply even more. The umbilicus can also be at threat when you have had multiple previous abdominal procedures. The risk of umbilicus compromise is higher in patients who smoke or are diabetic. Usually this settles with dressings or worst case may need a belly button reconstruction down the track.
  • Skin necrosis – this is also a rare complication in tummy tuck surgery. By lifting the tummy skin, its blood supply is reduced and it gains it nourishment through blood vessels from near the rib cage. However if you have previous scars on the tummy or have had multiple previous abdominal procedures the blood supply may be reduced even more. The risk of skin necrosis is higher in patients who smoke or are diabetic.
  • Change in tummy sensation – it is common for the lower tummy to be numb after the procedure especially the skin between the belly button and the scar. This area reduces over months after surgery and there may be a small patch that remains numb forever.
  • Widening of the belly button – this occurs in everyone and for this reason Dr Aggarwal will err on the side of making your belly button smaller, as it will stretch over months following surgery.
  • Asymmetrical scars – There can be a difference in how each side of the tummy behaves to surgery and skin tension, and can produce an asymmetry to the scars, albeit the aim is to get them as symmetrical as possible.
  • Hypertrophic or poor scars – How one’s body behaves to scarring is individual and largely genetic. Some types of skin are more prone to hypertrophic or keloid scarring, and some individuals and families are more prone to this. We will routinely advise you on how to improve the quality of scars over time. You should also discuss any history of abnormal scarring with Dr Aggarwal preoperatively.

Procedure FAQs

Do I need a referral for a tummy tuck?
  • In general it is not necessary as most cases attract no Medicare or health fund rebate.
  • However we advise patients to obtain a referral for tummy tuck as it is possible to claim a Medicare rebate of approximately $73 for the consultation if you have a referral
  • It is also possible that a Medicare/Health Fund rebate may apply to you if you have an umbilical hernia, or if you have undergone massive weight loss.
Where can I see Dr Aggarwal?
  • You can see us at our main practice at Gordon, or at our other locations at Hornsby, Hunters Hill or Camperdown.
  • Please scroll to the bottom of the page to find out more information about these locations.
Where will I have my operation?
  • Any of the hospitals where Dr Aggarwal works – but more commonly at Hunters Hill Private hospital.
What can I do to prepare for surgery?
  • Cease fish oil, and other supplements such as Ginkgo, Ginseng.
  • Please discuss with Dr Aggarwal if you are on blood thinning medications as to when you should stop and recommence those.
  • Stop smoking well in advance of surgery – Dr Aggarwal does not offer tummy tuck surgery to patients who are actively smoking.
After surgery, will I need to wear a special surgical garment?
  • You will also be required to wear an abdominal binder for 8 weeks.
Will I be able to exercise after surgery?
  • You will need to walk hunched over initially but you straighten a little day by day.
  • Heavy lifting and exercise will need to be avoided for 8 weeks to allow the abdominal tissues to heal.
  • Heavy gym exercise will need to be discontinued for 3 months.
Will I need special medications after surgery?
  • Dr Aggarwal will provide you with the necessary scripts for antibiotics and pain relief. The antibiotics need to be continued for a week or until when the drains are out.
Will I need further surgery?
  • No.
Can I travel in an airplane after surgery?
  • Yes
  • However we always encourage patients not to be away overseas shortly after having a procedure, so that we can closely follow your recovery and address any concerns that may arise.
When will I be able to swim after tummy tuck?
  • You may do gentle swimming in a pool or beach after 2-3 weeks once all wounds have healed and all the drains are out. Heavier swimming (like doing laps) will need to be deferred for 3 months.
When will I be able to drive after tummy tuck?
  • It is best to not drive for the first 1-2 weeks after tummy tuck surgery.
Do you offer local anaesthetic or sedation for tummy tuck?
  • No, patients will require a general anaesthetic in an accredited private hospital.
  • Patients also need to stay in hospital for 2 nights to allow drain monitoring, pain control and supervision during early stages of walking,
Will tummy tuck change the sensation of my tummy skin?
  • Yes.
  • Initially a lot of the skin between the belly button and the incision or scar line will be numb.
  • This gradually recovers over month following surgery and can take up to 12 months.
  • There may always be a patch of numb skin just above the incision and below the belly button.
Are there any alternatives to tummy tuck?
  • Diet and exercise is best to try to lose as much weight as possible.
  • Surgically all procedures will result in some degree of scarring. The lesser procedure called Mini-Tummy Tuck is for those needing less skin and fat excised. Click here to read more about mini tummy tuck surgery.

Procedure Pricing

  • The price for tummy tuck starts from $20000 all inclusive, which includes
    • Surgical fees
    • Hospital theatre fees (for 3 hour procedure) and fees for 3 night stay in hospital
    • Anaesthetist fees
    • Assistant fees
    • Follow up
  • Please note that for most cosmetic abdominoplasty there is now no Medicare or health insurance rebate (the rules changed in 2016).
    • If you have lost a lot of weight, fulfill the Medicare guidelines for a tummy tuck surgery, and you have appropriate health insurance cover, the out of pocket cost could reduce substantially to around $10000-12000.
  • Please note that the above prices do not include
    • Preoperative consultation fees – which are $280 for the initial consult and $140 for additional preoperative consultations
    • Hospital fees for procedures longer than 3 hours, or more than a 3 night stay (both will incur extra hospital fees)
    • Other procedures such as liposuction, breast or face surgery.
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Know you are in the safest of hands with a Plastic Surgeon who is experienced, highly respected, and appointed at premier Sydney hospitals- including Sydney Adventist, Hunters Hill Private, POWH and RHW.

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