Abdominoplasty

Abdominoplasty addresses excess abdominal skin and laxity following weight change or pregnancy.

It may be appropriate where these changes do not respond to non-surgical measures. The focus is on determining whether surgery is appropriate and whether expectations are realistic.

My Approach

My focus is on achieving a natural silhouette and proportion, not simply a flat abdomen ("tubby tuck") with no definition. By combining liposuction for contouring with meticulous tissue handling, the waistline and upper abdomen (i.e. the flanks and epigastrium) are refined while preserving softness and mobility. Medically, this is known as a lipoabdominoplasty.

Where present, separation of the abdominal muscles (rectus diastasis) is repaired as part of the same procedure to restore core integrity and improve both contour and function, not just appearance.

Whenever suitable, the procedure is performed as day surgery (sometimes with an overnight stay) using a drain-free technique and ultrasound-guided TAP block (Transversus Abdominis Plane block) for effective pain control. This allows most patients to return home the same day or next morning and recover comfortably.

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Planning & Technique

The incision is placed low across the bikini line, carefully designed to be hidden beneath undergarments (you’ll be asked to bring your preferred piece during consultation for planning). Through this, the abdominal skin and fat are lifted, excess removed, and any separation of abdominal muscles (rectus diastasis) repaired to restore core strength and posture.

A key aesthetic focus is the umbilicus (belly button), often described as the “signature” of an abdominoplasty since it remains visible after surgery. My preference, refined during my time in Oxford and published in Aesthetic Plastic Surgery, is to recreate a natural umbilicus with gentle superior hooding, which enhances the overall harmony of the abdomen.

If a hernia is present, I work with a General Surgery colleague to address it safely at the same time. Liposuction is often added to refine the flanks and upper abdomen for a balanced, tapered contour. A systematic review and meta-analysis of 17 trials enrolling over 14,000 patients found no evidence that lipoabdominoplasty is associated with higher complication rates than traditional abdominoplasty alone, supporting its use as a safe combined approach.

Towards the end of the procedure, long-acting local anaesthetic is administered under ultrasound guidance (TAP block) to minimise postoperative pain and reduce the need for stronger medication, which can make patients drowsy, nauseated, or constipated.

A Note on Technique Variants

Not every patient requires a full abdominoplasty. For patients with excess limited to the lower abdomen and minimal muscle laxity, a mini-abdominoplasty with a shorter scar and no umbilical repositioning may be sufficient. For patients with significant vertical excess in addition to horizontal laxity, typically following massive weight loss, a fleur-de-lys abdominoplasty addresses both planes through a combined horizontal and vertical incision. The appropriate variant is determined at consultation based on the distribution of excess skin, the degree of diastasis, and the patient's anatomy, not as a default choice.

Every patient’s anatomy and goals are different. Dr Ng will discuss the best approach for you during your consultation.

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Recovery & Expectations

Most patients are upright and mobile within a day, with light activities resuming in one to two weeks and exercise after four to six weeks.

Drains, if used, are typically removed within a few days once output is below 20 ml over 24 hours. Mild swelling and tightness are expected early on and subside as the tissues heal.

Scars are positioned low and usually fade well with proper care. A support garment is worn for several weeks to maintain contour and comfort. Manual lymphatic drainage may be recommended as part of recovery to reduce swelling and promote healing.

Post-operative care extends beyond routine reviews - it is an integral part of Dr Ng’s surgical philosophy. Through Doctor Stitch , an aftercare service founded to ensure seamless continuity and comfort, every patient is followed up personally by Dr Ng for attentive, discreet, and consistent care throughout the recovery journey.

Frequently Asked Questions

1. How long is recovery after abdominoplasty?
Most patients are upright and mobile within a day, with light activities resuming within 1 to 2 weeks. Exercise and heavier activity are generally reintroduced after about 4 to 6 weeks as tissues heal and swelling reduces. The TAP block is well-supported for abdominoplasty analgesia. A systematic review and meta-analysis confirmed significantly earlier time to first analgesic use and lower incidence of postoperative nausea and vomiting in TAP block patients, with lower pain scores throughout recovery.

2. Will I need drains after tummy tuck surgery?
Drains, if used, are typically removed within a few days once output is below an acceptable level. Many abdominoplasty techniques now use drain-free approaches combined with ultrasound-guided TAP blocks for pain control, reducing the need for prolonged drainage.

3. What will my scar look like after surgery?
Scars are positioned low across the bikini line so they can be concealed by undergarments. With proper care and time they usually fade well, though individual healing patterns vary.

4. Can abdominal muscles be repaired during abdominoplasty?
Yes, an important part of contour restoration often involves repairing diastasis recti (separated abdominal muscles) to improve core strength and abdominal contour. If clinically present during examination, further imaging (ultrasound, CT scan) will be requested to delineate and rule out any concomitant umbilical hernia.

5. Will abdominoplasty improve stretch marks?
Abdominoplasty removes some skin with stretch marks if it lies within the excised tissue. Therefore, some stretch marks may remain after the surgery. It is however, not primarily a stretch-mark procedure. Improvements are a by-product of excess skin removal rather than a direct treatment.

6. Is abdominoplasty just for cosmetic reasons?
While aesthetic contouring is a major reason patients choose abdominoplasty, it also has functional benefits such as restoring weakened musculature to reduce back strain, and improving core stability after pregnancy or weight changes. Surgical repair of diastasis recti is supported as a safe and effective treatment that improves core stability, back pain, abdominal muscle strength, and quality of life across multiple functional domains. A prospective study of lipoabdominoplasty with rectus plication specifically confirmed significant reduction in low back pain and improved core function and health-related quality of life at 12 months.

Abdominoplasty

My Approach

Planning & Technique

Recovery & Expectations

Frequently Asked Questions

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Abdominoplasty

​My Approach

Planning & Technique

Recovery & Expectations

Frequently Asked Questions

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Related Reading

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My Approach

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