As part of the normal ageing process, often fat accumulates on the male tummy. Also, there is a redistribution of fat on the hips and abdomen. Despite exercise and diet, this may be difficult to shift. In most cases this can be removed by liposuction alone, and rarely it is combined with an abdominal reduction. In severe cases an apron of skin may hang down over the pubic area and cause minor skin infections in the fold, particularly in hot weather. In males, this is usually following extensive weight loss.

Am I a suitable candidate?

The most suitable patients for this type of surgery are those with excess skin on the abdomen that has not shrunk back properly following extensive weight loss. It should not be considered as a method of weight loss and cannot be performed unless your weight is stable and healthy.

What does an abdominoplasty involve?

This operation, which takes around two hours, is carried out under general anaesthesia and usually requires a one or two night stay in hospital. An incision is made just above the groin, excess fat is removed and excess skin is removed. The remaining skin is pulled down and repositioned, repairing the incision. This usually means that the navel has to be repositioned and thus results in a further scar around the navel.

How long is recovery?

Recovery after this operation is probably the slowest of all cosmetic procedures. You will need to stay one or two nights in hospital. It will take at least two weeks for you to become fully mobile and at least six before you are able to do strenuous exercise. Patients are frequently left with a numb area in the region between the scar and the navel caused by damage to a nerve supplying the skin of the abdomen. This area of numbness will get smaller with time, over six months to a year, but it may never completely recover. In the initial period there will be swelling above the horizontal scar which will improve over a period of three months or so as the lymph tissue establishes new channels of drainage.

What about the after-effects?

When you wake up from the operation you will be lying with your knees bent and supported on pillows to prevent any stretching of the abdominal skin. There may be a drainage tube coming out through the skin of your pubic area below the operation site. This will be left in place for about 24 hours to prevent any build-up of fluid. You may find it difficult and uncomfortable to stand up straight because of the tightness of the abdomen but this will improve within a day or two.

What are the risks?

An abdominoplasty is a major operation and should be respected as such. As with any surgical procedure there is always a risk of infection, or the development of a collection of blood (haematoma) in the wound which will require a return to the operating theatre for the blood to be drained off. This does not normally affect the final result. In addition, a possible complication of abdominoplasty is the accumulation of lymph fluid (seroma) that may require repeated draining with a syringe over a period of several weeks.

This procedure leaves a long horizontal scar running from hip to hip above the pubic area, which should be low enough to be concealed by shorts or briefs, and a small circular scar around the navel. The central area of the horizontal scar, in particular, is at risk of wound healing problems, which will require frequent dressing changes but will eventually heal. Sometimes a minor scar correction under local anaesthetic is necessary to improve the appearance of the end points of the scar.