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Would you go under the knife for better abs?

August 10th 2016 / Anna Hunter

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Abdominoplasties are one of the fastest growing surgical procedures in the UK- has our quest for abs of steel gone too far?

It may be one the most expensive, painful and risky surgeries to undergo, but that doesn’t seem to be putting us off: a full abdominoplasty (or tummy tuck) was one the most popular surgical procedures last year, seeing an increase in enquiries of 351% in 2015 alone according to health care search engine WhatClinic.com. Given that we’re becoming far less squeamish when it comes to both stomaching surgery and forking out for it across the board (a record 51,000 opted for cosmetic surgery in 2015), it’s not surprising that the tally for tummy tucks would increase, but it’s the sharp increase over other procedures such as breast augmentation that have proven so striking, as WhatClinic.com director Emily Ross acknowledges:

“The cosmetic surgery and medical aesthetic industries continue to thrive and 2015 saw a massive increase in enquiries for procedures in the UK. On the surgical side of the market, abdominoplasty is the stand out treatment of 2015.”

“This is an industry that moves quickly. Demand is high, but in some cases, so is the risk. That’s why it’s so important for patients to have realistic expectations, and to not be swayed by offers or deals.”

Embarking on surgery under the influence of seductive marketing or societal pressure is clearly a bad idea, but as consultant plastic surgeon and President of the British Association of Aesthetic Plastic Surgeons (BAAPS) Michael Cadier highlights, the increase in cosmetic surgical procedures in general could also be indicative of improving standards in the industry:

“There’s no doubt that we are seeing an increase in demand for cosmetic surgery from both men and women. Whether this is inspired by celebrity culture and a recognition that the results of modern aesthetic procedures in the right hands can be subtle, natural-looking and attractive, what is most important is for patients to remember that surgery is on the whole life-changing and irreversible – far from a trivial ‘status symbol’ beauty treatment. The decision to undergo surgery must be well thought-out, with managed expectations, understanding the risks through fully informed consent and; most importantly; choosing the right specialist provider who is properly trained and accredited.”

Knowledge is power

Consultant plastic, reconstructive and aesthetic surgeon Mr Ian Whitworth thinks that the the term ‘informed consent’ in particular is key when considering any kind of elective surgery, but especially in the case of abdominoplasty, as it’s a very serious operation, and as such the degree of risk is greater than with other cosmetic procedures:

“It’s important to fully understand that this is a ‘proper’ operation. I always see any prospective abdominoplasty patients at least twice before I operate, to ensure that they can give risk-informed consent and have all the information that they need and want about the procedure. It’s always a good sign when a patient asks me lots of questions, for example about the number of procedures I’ve carried out, about the hospital itself and about any potential outcome of the operation.”

“If you’re looking into abdominoplasty, I would first encourage you to seek advice from your GP. Your GP will know which hospitals in your area are reputable and may even be able to advise as to good surgeons. This will hopefully mean that you’re able to avoid any questionable clinics offering abdominoplasty. In addition always do a thorough background check on surgeons and their qualifications. It might also be worth asking if the hospital at which you’re seeking treatment has any patients on record who’ve undergone the procedure that you’re considering and are willing to be contacted to chat through it. This is something that some of my patients ask for, and we have a list of former patients who are happy to talk about their experience.”

Not a weight-loss wonder

According to BAAPS figures, abdominoplasties were more popular amongst women than men in 2015 (incidentally, women had 91% of all cosmetic procedures in 2015 which is quite a shocker). Possible motivations for seeking out the surgery range from stretched, loose skin post-pregnancy or post-weight loss and addressing the ‘pouch’ of fat and skin that can be left behind after a caesarean section. Mr Whitworth notes that the majority of his patients have achieved their weight loss goals by way of healthy eating and exercise, but the skin left behind does not respond to dietary changes or physical activity. One of his patients lost more than eight stone in weight, and having an abdominoplasty made all the difference in terms of making them feel comfortable and achieving their ultimate goal. With this in mind, Mr Whitworth emphasises that abdominoplasty is not a ‘weight-loss’ surgery; you need to have achieved your target weight by the time of having the operation. There are a number of other health and lifestyle factors to consider if you’re contemplating a tummy tuck:

“Firstly a patient needs to be medically fit enough to undergo a general anesthetic, although general anaesthetics are considered to be very safe these days for the most part. Patients who are morbidly obese or have a complicated history, such as having experienced strokes in the past, will not be able to have the procedure. You’ll need to give up smoking if you’re a smoker (smoking increases infection risk and delays healing), be at peak fitness and have a healthy weight. For the operation to be worth it long term, you’ll also need to have finished your family if you have one and stay more or less at the weight you are when you are operated on, otherwise in both cases you’ll be back to square one in terms of slack skin.”

If you’ve decided that an abdominoplasty is for you, first bear in mind that on average you’re looking at a bill of £5,491, according to WhatClinic.com. Next, as Mr Whitworth stresses, it’s vital to mull over the risks, possible side effects and post-op scarring:

“The treatment is normally straightforward, but infection is a worry, especially if you’re diabetic or taking steroids (this should be thoroughly discussed with your surgeon beforehand). Bleeding and bruising could occur, and in the case of abdominoplasty there’s a specific risk of seroma, a build-up of fluid between your skin and muscle.”

“As for scarring, you’ll be left with a large, long scar on the bottom of your tummy, although it shouldn’t show when you’re wearing underwear or swimwear.”

Time is a healer

Abdominoplasty recovery is also fairly prolonged compared to other cosmetic surgery procedures; Mr Whitworth outlines the rough recovery schedule for an average abdominoplasty operation:

“It can take up to six week to recover fully from a full abdominoplasty. For the first two weeks, you’ll need to rest a lot. That doesn’t mean bedrest- you should do some gentle walking, but if you overdo it, you’ll be wiped out the next day. You definitely shouldn’t do any lifting within the first two weeks of the operation. During weeks three to four you’ll be able to get about more, do some shopping and go for lunches without feeling so tired. Weeks five to six you’ll be feeling fitter and more energetic, but do be aware that, as if you’ve had a caesarean, you’ll likely not be able to drive for six weeks, and if you do a job that’s physical or involves heavy lifting, you’ll need to take the full six weeks off work.”

A ‘full’ abdominoplasty isn’t the only option of course if you’re seeking to remove a small amount of skin and fat- a mini tummy tuck will take care of a smaller area, resulting in a smaller scar and, ideally, a shorter recovery time, although this isn’t a given. During recovery you may be prescribed or recommended certain painkillers, and you may also need to sleep with knees bent to prevent stretching any stitches.

Filter out the flak

There’s no doubt that an abdominoplasty isn’t a cosmetic procedure to be taken lightly (then again, no surgical or cosmetic procedures should be undergone without serious consideration), however, as Dr Whitworth highlights, its effects can be life changing in the most positive of ways if excess skin and fat previously had a detrimental impact on your quality of life:

“As long as your body weight doesn’t fluctuate, you continue to eat healthily and exercise and you don’t have any more children, the effects of the operation should last a very long time, and can make a huge difference to your wellbeing. You’ve got to weigh up the pros and cons and assess whether it’s worth it for you, but the benefits can be very rewarding. I received a Christmas card last year from a patient with a picture of her in a bikini, smiling. She hadn’t worn a bikini for over sixteen years, so that was quite a remarkable change for her, for the better.”

High quality care, top notch treatment and reliable expertise, not to mention impressive results, could be one reason that more ‘traditional’, surgically skilled treatments such as abdominoplasty (first performed in 1899) and liposuction are on the rise, as BAAPS president Rajiv Grover indicates:

“The 2015 BAAPS audit has shown that demand for cosmetic surgery continues to increase following the quieter period in 2014 which mirrored the British economy. The double digit rise in surgical procedures suggests that the public are choosing to spend on treatments with a proven track record such as facelifts and liposuction which remain as the gold standard for facial rejuvenation and body contouring. The plethora of new non-invasive methods for skin tightening and cellulite that are here today and gone ‪tomorrow, often appear too good to be true and fail to make the cut.”

According to BAAPS, another trigger for increased take-up could be a new attitude towards cosmetic surgery itself, as more open minds are driving ‘increased acceptance and the de-stigmatizing of aesthetic enhancement.’ Less judgement is without doubt a constructive step forward, but as Harley Medical Group Psychologist Jo Hemmings relates, a perfectionist culture can prevail without us even necessarily being conscious of it in a world of filtered Instagram #goals:

“Whether we are aware of it or not, social media puts pressure on ourselves to be selfie-perfect. For some this is simply a case of using a filter or an image-adjusting app on their smartphones before posting it, but for others it instills a crisis of confidence and a real desire to make more substantial alterations to their face or body, often above and beyond any procedures that could be considered to help them feel better about themselves. Selfie culture has undoubtedly caused a significant rise in body and facial dysmorphia.”

Doing what’s right for you, and only you, needs to be at the heart of any decision you make, both within and without. Trite, but true.

Want more defined abs, naturally? Here’s a workout and some foodie ideas to get you started…

Find out more about abdominoplasties here

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