Abdominoplasty Surgery Day: Anaesthetic, Hospital Stay and Drains

An abdominoplasty is major surgery. It is done under general anaesthetic in hospital, usually takes several hours, and is followed by a few nights on the ward with drains and a compression binder in place.

This guide walks you through the day with Dr Reema Hadi, specialist plastic surgeon, from the weeks of preparation to the moment you go home. Knowing what to expect makes it easier to plan, and Dr Hadi's advice for you always comes first.

Is abdominoplasty a big operation?

Yes. Abdominoplasty ismajor surgery. Skin and tissue are removed from the lower tummy, the muscles are often repaired, and in a full tummy tuck the belly button is repositioned.

That is why it happens in hospital, under general anaesthetic, with an overnight stay. It is also why the Medical Board of Australia requires two consultations and a cooling-off period of at least seven days before cosmetic surgery can be booked.

The weeks before surgery

Good preparation lowers your risk of complications. Dr Hadi asks you to:

• Stop smoking for 6 weeks before and 6 weeks after surgery. Smoking significantly increases complication rates [CHECK 25].
• Stop blood thinners unless you have agreed otherwise with Dr Hadi. Over-the-counter products that thin the blood, such as fish oil, krill oil and ginseng, stop too. You get a full list.
• Eat well so your body has what it needs to heal.
• Arrange help: someone to drive you home from hospital and to stay with you when you first get home.

The night before and the morning of surgery

• Shower with an antibacterial soap the night before or the morning of surgery. It reduces the bacteria on your skin.
• Fast (no food) for at least 6 hours before surgery. The hospital gives you your exact fasting time.
• Wear loose, comfortable, dark clothing and remove all jewellery.

Where the operation happens

Dr Hadi's preferred hospital for abdominoplasty surgery is Kareena Private Hospital in Caringbah or the Swan Clinic in Miranda. Only overnight stay is available in the Swan clinic

The anaesthetic

An abdominoplasty is performed under general anaesthetic, so you are asleep for the whole operation. A specialist anaesthetist looks after you throughout. Discuss the risks of the anaesthetic with your anaesthetist.

Dr Hadi's approach to pain combines local anaesthetic blocks, pain relief medicines and a gentle surgical technique. The binder you wake up in also helps with discomfort from swelling.

How long the operation takes

It depends on which operation you have and whether liposuction or muscle repair is added.

• Reverse (upper) abdominoplasty: usually two to three hours.
• Belt lipectomy: three to four hours.
• Full, partial and fleur-de-lis abdominoplasties: Dr Hadi gives you a time at your consultation. As a general guide, the operation can take between 2 and 4 hours.

What happens during the operation

1. Dr Hadi makes the incision she planned with you, usually low across the tummy above the pubic area. See abdominoplasty scars and belly button.
2. Loose skin and tissue are removed from the middle and lower tummy.
3. If needed, the separated tummy muscles are stitched back together (diastasis repair) using 4 layered suturing.
4. In a full tummy tuck, the belly button is brought out through a new opening in its new position.
5. Thin drains are placed under the skin to carry fluid away.
6. The wound is closed in layers with dissolvable stitches and dressed.

Waking up

You wake in the recovery area and then go to the ward. You will notice:

• Drains: one or more thin tubes running to small bottles that collect fluid. These are usually removed before you go home as we use a quilting technique.
• A compression binder: an elastic garment around your tummy that reduces swelling and supports the area. See compression garments and swelling.
• Leg stockings: worn for two weeks to reduce the risk of blood clots.
• Tightness: your tummy feels tight, and you may find it more comfortable to walk a little bent at the waist for 1 to 2 days. Then you slowly straighten up. When you sit in a chair, straighten your back completely to prevent back pain.

Your hospital stay

For a belt lipectomy you stay in hospital for two to four nights. The stay for other tummy tucks depends on the operation and how you are recovering. Dr Hadi visits you regularly while you are in hospital.

The nurses help you get up and move gently, check your drains and manage your pain. Moving early, even a few steps, helps your circulation.

Drains: how long they stay

A drain comes out once it produces less than 30 ml of fluid a day. Usually it is removed prior to discharge.

While the drains are in, you take antibiotic tablets to prevent infection and you cannot shower. Dr Hadi or the nurse tells you when you can shower.

Going home

You leave hospital with antibiotic and pain relief tablets, your binder on and your leg stockings on. You also get an after-hours phone number and Dr Hadi's number. Someone needs to drive you home, as you cannot drive for at least the first week.

Call 02 9526 6885 after your surgery to make sure all your follow-up appointments are booked. Follow-up visits with Dr Hadi are at no extra charge. The next stage is covered in our abdominoplasty recovery timeline.

Results and risks

All surgery carries risks, and results vary from person to person. Read abdominoplasty risks and when something goes wrong before you decide. To book a consultation with Dr Hadi, call 02 9526 6885 or use our contact page.

Frequently asked questions

Is abdominoplasty a big surgery?

Yes. It is major surgery under general anaesthetic, usually with a few nights in hospital and several weeks of recovery.

Will I be asleep for my abdominoplasty?

Yes. It is done under general anaesthetic, with a specialist anaesthetist looking after you throughout.

How long does an abdominoplasty operation take?

Usually several hours. A reverse abdominoplasty takes two to three hours and a belt lipectomy three to four; Dr Hadi gives you a time for your operation.

How many nights will I stay in hospital?

Plan for usually 1-2 nights. For a belt lipectomy it is two to four nights.

How long do drains stay in after an abdominoplasty?

Until each drain produces less than 30 ml a day. It is usually removed before you go home as we use a quilting technique.

Why do I need to stop smoking for 6 weeks?

Smoking delays wound healing and significantly increases the risk of complications. Dr Hadi asks you not to smoke for 6 weeks before and 6 weeks after surgery.

Will I be able to stand up straight after surgery?

Many people walk a little bent at the waist for 1 to 2 days because the tummy feels tight. You then straighten up gradually.