Worries over the state of the economy hasn’t deterred many Brits from plastic surgery with recent research showing that there has been an increased demand of 35 percent for cosmetic procedures.

The increased demand since 2007 is across the board according to the Harley Medical Group, although tummy tucks (abdomnoplasty) have seen the largest increase in demand, up 59 percent. Botox is also increasing in popularity, up 51 percent, breast surgery is up 40 percent, and liposuction up nine percent.

Surgeons have said that they have seen new cosmetic trends emerge, particularly with liposuction. Traditionally, liposuction has been mainly used for the tummy, bottom and thighs. But now, it is also commonly used to reduce bingo wings (fat under the upper arms), muffin tops and bra bulges. Thigh boxing (where the inner thighs rub together) and knee saddles (fat deposits above the knees) are also being targeted.

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However, it will not be able to remove stretch marks on the mid or upper abdomen. If you have a thick layer of fat on your upper abdomen, a tummy tuck will not remove this.

Am I suitable for abdominoplasty?
If you have a lot of fat around your middle, your surgeon may not do a full tummy tuck because of the high risk of healing problems. Instead, he will probably perform a panniculectomy which removes skin and fat, but doesn’t tighten the girdle. If you have a smallish layer of fat around your lower abdomen, and you want your stomach flattened and excess skin removed, you are a good candidate for a tummy tuck. It is advisable to only have a tummy tuck when you have decided not to have any more children – more pregnancies may undo all the surgery work.

Is a tummy tuck better than liposuction?
If your skin tone is fairly poor, you have cellulite, and you need excess skin removed as well as fat, a tummy tuck would be the better procedure. If you just need fat removed, and your skin tone is good (so the skin will retract back with no excess skin visible), liposuction is the option you should go for.

Scars
You will have one scar which will extend across the lowest part of the abdomen and another scar which runs around the belly button. These scars should be hidden by a swimming costume. Most scars should heal fairly discretely.

The surgery itself
During pregnancy, the inner girdle – which extends from the rib cage down to the pubic bone and either side of the abdomen – is stretched. After pregnancy, the girdle may not regain its former shape, even though the stomach muscles are well toned. During surgery, the surgeon will tighten the inner girdle to make it flatter. Note that he will not touch the stomach muscles – these are below the inner girdle and will not be touched during the operation.

Post-surgery
Most surgery will be performed under general anesthetics but sometimes, it can be performed under heavy sedation. Surgery will take 1-3 hours and you will probably have to stay in hospital overnight. Depending on the extent of the tightening of the girdle, the pain will be moderate to severe so you will probably be prescribed anything up to one week of pain medications. You should not have any bruising, however your abdomen may be numb in places for anything up to 6 months. You will be able to return to work within one to two weeks, and you will also be able to start driving again. After a month, light exercise can be taken.

What are the risks?
Leg Blood Clots:This is more common in longer operations, and can happen in any surgery. You can reduce the risk of this my asking your surgeon to give you some compression stockings to wear if your surgery is going to last over 2 hours.
Skin death (necrosis): This occurs when then is poor circulation to the skin around the abdomen. This happens because the skin/fat layer must be separated from your girdle. Usually, there is enough circulation to the area to allow healing, but sometimes (particularly if you are a smoker or suffer from diabetes), the circulation is too poor to allow healing which leads to the skin dying.
Hematoma: This is a collection of blood underneath the skin. This occurs because of bleeding after the surgery. Most will clear up of their own accord, but if it is a large hematoma, more surgery may be required.
Seroma: This is a collection of fluid underneath the skin. Most surgeons will put drains underneath the skin at the time of surgery to prevent this. Sometimes, seromas will still occur. The fluid will be drained using a needle and syringe.
‘Dog ears’: These are puckers of skin on each end of your scars. The looser the skin, the more likely you will get dog ears on your scars. The dog ears can be removed under local anesthetic at a later date.

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Procedure: Flatten abdomen by removing excess fat and skin and tightening muscles of abdominal wall. 
Length: 2 to 5 hours. 
Anesthesia: General or local with sedation. 
In/Outpatient: Either depending on individual circumstances and extent of surgery. 
Side Effects: Temporary pain, swelling, soreness, numbness of abdominal skin, bruising, tiredness for a duration of time after the operation
Risks: Blood clots. Infection. Bleeding under the skin. Scarring or skin loss due to poor healing. Need for a second operation. 
Recovery: 2 to 4 weeks: Back to Work
                4 to 6 weeks or more: Strenuous activities (bending, lifting, exercise)
                3 months +: Scar fading 
Duration of results: Variable

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