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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.

Adrian Richards: ... what we're going to be doing

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