Best Practice Abdominoplasty

Abdominoplasty Surgery with Dr Craig Rubinstein Plastic Surgeon

What is an Abdominoplasty?

An Abdominoplasty is a procedure in which excess fat and skin are removed from the lower abdomen or belly. The muscles are then brought together, while sutures are used to tighten the connective tissues found in the abdomen. This technique is used to restore the stomach and reshape the abdominal profile.

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Most patients choose to have surgery to alter their body contours and reduce their excess tummy skin post-pregnancy or weight loss. Read Having an abdominoplasty combined with a C-Section – Is it a good idea?

Furthermore, an Abdominoplasty can remove stretch marks and excess skin in the lower abdomen, as that skin is often removed. However, it cannot remove any stretch marks found outside the lower abdomen area.

This procedure can also be done simultaneously with other plastic surgery procedures, for example, when combined with any breast surgery it creates a ‘combined‘ surgery package.

Dr Craig Rubinstein is an experienced plastic surgeon in Australia, and he has performed thousands of abdominoplasty with and without muscle repair throughout the years.

MEDICARE UPDATE – The Australian Government has reinstated a Medicare Item Number for a abdominoplasty for some post-pregnancy patients suffering from Diastasis Recti (Split Tummy Muscles) if you are eligible and meet the new criteria. This new 30175 Medicare Item Number – is effective 1st July 2022. Read the 30175 Medicare Item Number factsheet.

If you qualify for the 30175 Medicare item number you may also get a subsidy from your Health Fund. There will still be a significant out-of-pocket GAP as Abdominoplasty Techniques surgery is NOT FREE.

9 Different Abdominoplasty Techniques – Dr Craig Rubinstein

  1. Use of liposuction in an abdominoplasty – Lipoabdominoplasty
  2. Inclusion of a mons lift
  3. Use of permanent deep muscle repair
  4. Placing the incision scars as low as possible to hide them
  5. Belly button placement
  6. The tendency towards ‘drain less’ surgery – avoiding drains where possible
  7. Early mobilization to help recovery
  8. Minimising the abdominoplasty scar

1. Use of Liposuction in conjunction with an abdominoplasty

Liposuction allows for greater fat removal and shaping of the tummy during an abdominoplasty. This is done by shaping and contouring the middle, front-to-back, and side-to-side parts of the abdomen. Liposuction and Abdominoplasty Surgery can be combined into a procedure known as a Lipo-Abdominoplasty.

One of the reasons for using liposuction as a part of the procedure is that it can assist Dr Craig to achieve a more shaped and contoured final result, especially in the Upper Pubic Area.

2. Inclusion of a mons lift during the abdominoplasty surgery

A Mons lift, also known as a pubic lift is a combined surgery option patients wanting abdominoplasty surgery can consider. This procedure reduces a protruding Mons pubis.

The Mons pubis refers to the area or mound above the female genitalia. Also known as the pooch or FUPA (Fatty Upper Pelvic Area). This area can bulge out slightly and can be caused by ageing, weight gain, carrying children, previous surgery or genetics.

While an abdominoplasty may flatten your stomach it can, unfortunately, make your mons pubis look more prominent. That is why some patients require/request the mons lift as a part of their procedure.

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Abdominoplasty Before and After Photos

Abdominoplasty is a procedure that may help reshape the look of your stomach after pregnancy or significant weight loss.

3. Use of permanent deep muscular repair of stomach muscles

In simple terms, permanent deep muscle repair is repairing the abdominal muscles by surgically bringing them back together after they have been stretched out. This stretching can be caused by pregnancy, weight gain, weight loss, medical conditions and other factors.

Unfortunately, it does not matter how much you exercise or how many sit-ups you do,  it will not fix separated stomach muscles. In order to correct muscle separation, surgery is needed. The split muscles need to be fixed in both horizontal and vertical planes. During the procedure, permanent sutures are used to stitch the edges of the muscles together.

Repairing separated muscles is not only about getting rid of loose skin and reshaping the stomach, in some cases, it can also assist in reducing back pain and incontinence issues.

4. Placing the incision scars as low as possible

While scars are an unfortunate part of any surgery they are a small inconvenience when compared to the outcomes of the surgery. However, it comes as no surprise that around 90% of patients want their incision scars as low as possible (below their underwear line). And, while your surgeon will do their best to ensure this happens, in some cases, it isn’t always possible. However, what can and can not be achieved will be discussed in your consult with Dr Rubinstein. We are all different shapes and sizes and not all abdominoplasty surgeries are performed the same way.

5. Belly button placement and design

During your surgery, your navel/belly button will be repositioned.  With the tissue removal and skin tightening if your belly button was not repositioned it could end up sitting on the mons.The surgeon will relocate it without removing it completely.

6. Pain-free or minimal pain recovery

Some pain, swelling and bruising are to be expected in the initial post-operative days. In saying that everyone has a different pain threshold and will experience post-operative pain differently.

Rest is vital. It’s natural that patients want to get back to their daily routine as soon as possible but doing this can actually make recovery longer if you hurt yourself or split stitches etc. In other words, you need to follow the advice of your surgeon.

Furthermore, any pain can be managed with medication and rest. While resting can lessen the strain on your abdominoplasty muscles we do still encourage you to gently move around your house as soon as you can to help keep the blood flowing through the body.

7. The tendency towards ‘drain less’ surgery (avoiding the use of drains where possible)

While one of the top trends is to avoid drains when doing abdominoplasty procedures they are sometimes necessary to achieve an optimal outcome. There are specific surgical techniques that help lessen the use of drains, such as; deep quilting sutures and other sophisticated and aesthetic interventions.

If ever a drain tube is necessary, it is important that you listen to the instructions on how to take care of and handle the drains post-surgery.

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Abdominoplasty Before and After Photos

Abdominoplasty Surgery is a procedure that can help reshape the look of your stomach after pregnancy or significant weight loss.

To view some of Dr Rubinstein’s previous abdominoplasty patients, click here to direct you to the abdominoplasty before and after gallery.

8. Get Moving but take it easy – Early mobilisation helps

As stated previously, we encourage patients to move about, (within reason) in such a way that does not put a strain on the body.  Blood clots are a risk of any surgery and not moving increases this risk.

Another disadvantage of staying in bed for prolonged periods is the loss of muscle mass, as well as back and neck pain.  In the hours after the surgery, there should be a supervised appropriate guard mobilization process for the patient.

The day after surgery, the patient should walk around slowly.  It is important to stretch the muscles but not too much. Exercise should be avoided for at least 4 weeks and you should consult with your surgeon to ensure you can ease back into it. However, strenuous exercise is not recommended for 8 weeks.

9. Minimising Abdominoplasty Scars

After your surgery, dressings will be applied to the incision area. A compression garment will also be used to prevent swelling and minimize the chance of blood clots forming. The compression garment is used to support your body’s midsection. It should be worn at all times, except when you shower or when it is in the wash. Furthermore, the compression bandage should be worn for approximately six weeks after the surgery. 

Take action early to avoid infection and watch for any signs of healing problems.

Keeping your incision clean is very important as it reduces the risk of infection. However, it is important to note the following symptoms and see your surgeon if you are experiencing any discomfort.

  • Uncontrolled bleeding was found along the incision
  • Extreme swelling, bruising, and/or redness that is not going away
  • Medication that you are using for pain isn’t relieving pain at all
  • Or, you have a reaction
  • If you have a drain;
    • The drainage from the incision is either yellowish or greenish
  • The discharge from the incision has an unpleasant odour
  • Fever or chills
  • Numbness

The use of Vitamin E

Vitamin E can improve the appearance of scars, as well as keep them from drying out. Pure vitamin E cream will give optimal results and should be applied gently once or twice a day. You don’t need any other fancy cream or oil. It is the massaging movement itself that assists with healing.

Moreover, you should initially keep your incision/scar out of the sun and then apply sunscreen (SPF of 30 or higher) over the scar after it heals. Using sunscreen on the scar every day for at least a year can help the scar retain its pigment. This stops it and the surrounding area from getting darker. Scars consist of new/virgin skin, that has not had exposure to the elements and therefore reacts differently.

The use of Lasers to minimise Scars and reduce redness faster

Aside from the above methods for keeping the scarring to a minimum, the use of lasers can also help. The Fraxel and V lasers are a couple of options designed specifically to help with scars.

Although even Fraxel and V lasers have their limitations. Fraxel lasers can not address discolouration. While the V laser can help with scar pigmentation but does not fix thickness or texture. In other words, both are necessary to keep or maintain an aesthetic scar from any plastic surgery, not just abdominoplasty surgery.

The safety and well-being of every patient is the most important aspect. This is why our surgeons make sure to recommend only appropriate options.

Best Practice in Surgery

  1. Breast Lift  – Options for Breast Uplifting Surgery
  2. Top Breast Reduction – Options for Breast Reduction Surgery by Dr Craig Rubinstein
  3. Breast Augmentation – Options for Breast Augmentation Surgery
  4. Breast Implant Removal – Options for Breast Implant Removal Surgery

Further Reading: Medical References

About Dr Craig Rubinstein
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Dr Craig Rubinstein FRACS (Fellow of the Royal Australasian College of Surgeons) is an experienced Melbourne Specialist Plastic Surgeon for breast and abdominoplasty surgery.

Dr Rubinstein offers women personalised abdominoplasty surgery and all forms of cosmetic breast surgery.

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Next Steps in Your Surgical Journey

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Want more information about your Procedure?

  • Download a Free Procedure Guide on your chosen surgery.
  • Visit the FAQs and read patient reviews to learn more about your intended procedure.
  • For more information about pricing visit our cost page.
  • You can also talk to our Patient Care Team from 9 to 5 pm Monday to Friday on (03) 8849 1400

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About Your First Consultation

  • Dr Rubinstein’s Consultation fee is $300.
  • A referral from your GP or specialist is essential.
  • A referral helps when claiming Medicare or Private Health Insurance coverage.
  • Please contact the Patient Care Team at Coco Ruby Plastic Surgery to book your consultation.
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What to Bring to Your Consultation

  • You are more than welcome to bring a friend or relative to help discuss the information and your choices.
  • Ensure you also take a lot of notes and thoroughly examine the documents provided.
  • Please be aware you may need to undress for a physical exam so wear simple clothes.