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Adrian Richards: ... what we're going to be doing
on our lady is a tummy tuck. You can see in the whole of this area she's got a lot of
stretch marks. She had children when she was very young. Can you see all these stretch
marks. So I can't obviously remove all the skin on her tummy, because it's just too much
skin. But the main bit that she's worried about is this lower bit. So this is what we're
going to focus on, this lower bit. Pull it all down, so first I'm going to round the
belly button, and like a standard tummy tuck. Bring this bit down then bring the belly button
through there. All of the skin here between my marks is going to go. I'll show you that
in a second. I'm also going to tighten up her muscles. I've assessed her muscles with
her awake, being gapped between there and there.
So what I've done now is lifted up all of this skin. I'll just show you, so this skin's
all been lifted up. And if you just hold there Charlotte. So this is the...I don't know whether
you can see, this I'm just drawing with our ink here - got a refill? - the muscle. So
this is where the muscle's split, so that's that side of the muscle, this is this side
of the muscle. Have you got some forceps as well?
I'll just show you. So that's where I'm going to sew the muscle together. So that's the
muscle there, that's the muscle there. These muscles should be together, yeah? And they
split because of child birth, and this is the belly button here. It's on a stalk, I
don't know whether you can see that there.
The next stage is to sew up the muscles all the way along, so that the muscles are back
in their normal position. This muscle here is called the rectus-abdominis. Rectus means
straight, and abdominis means, of the tummy. So this is the straight muscle of the tummy.
That's the one that you get those six pack striations across. It should be together.
This bit here is called the linea alba, which means, I think, the white line, because it's
supposed to be white. This is normally, as I mentioned, very narrow, but after pregnancy
when the tummy's been stretched it widens. So we're going to sew it back to its normal
position.
You can see I've sewn up two layers here. So the muscle wall is together. This is my
line of stitches in two layers which has pulled the muscle nice and flat. It's got a number
of benefits. It's better if you don't have a weakness in the front. Muscles act better
so you're better at sit-ups. Often less backache, and with the added bonus of a much flatter
stomach. There's the belly button there, which I've sewn in, and then that's the extra skin
I'm going to remove.
In the next stage, I'll just show you is I just put a local anaesthetic in here, which
is called a rectal block, so I'm just going to put that underneath that layer there. So
the top layer is called the fascia, and I'm just pushing five mils of local anaesthetic
each side, because this will just numb it up after the operation and make it much more
comfortable for our patient. This is long lasting, eight hour acting local anaesthetic.
The next thing to do is just we 'break the table', which means we sort of sit the patient
slightly up, and then I've marked the mid-line here. So I'm going to sew that point to that
point and work out how much skin to remove, and I'll show you that in a second.
...skin we've removed, this is the bit from the left. This was where her belly button
used to be. This skin was there. And Charlotte, can you just bring yours in a little bit there.
I think yours would have gone like that. So I take it off in two halves. We measured the
two halves and they're within two grams of each other in this case. This is the skin
essentially that we've removed, and this skin was above her belly button and we've brought
it all down. Created a new hole and brought the stalk of the belly button through it.
... the end of the operation. We put a dressing over the tummy button, brown tape over the
incision. I think you can see her tummy is lovely and flat now. I'll just show you from
that angle there. That's because of the muscle repair, and all looking good. You can see
that I've sewn the blue line here all the way along to the middle of the blue line here,
and then the belly button's right in the middle. That always helps me get orientated.
Thanks for watching the video. I hope you enjoyed watching the tummy tuck procedure.
This is a procedure we specialise in in Aurora Clinics. So if you are interested in tummy
tucks, and you'd like to find out a little bit more about what's involved, click on the
link below the description, that will take you through to the tummy tuck area of our
website, where you're going to find lots of information. Stories from patients who've
had the operation, testimonials, more videos, and information about how to recover. All
the information you might wish for if you are considering tummy tuck surgery. Again,
thanks for watching.