The abdominoplasty ("tummy tuck")
Introduction
Exercising and weight loss can help to improve the appearance of the abdomen however some permanent changes on the skin and abdominal wall muscles can remain – they become weak gradually. Excessive skin is formed mainly due to repeated pregnancies, genetic predisposition, previous surgeries, repeated weight changes or bigger weight loss. If a larger and faster stretching of the skin presents, so-called striae (stretch marks) can be formed. The abdominal muscle separation and weakening is often a result of the pregnancy. All these alterations can be corrected only by the surgery.
What is an abdominoplasty?
Abdominoplasty is a surgery which involves removal of the excessive weakened skin, fat and striae from the abdominal area. Except for above mentioned the abdominal muscle wall can be firmed up if necessary which leads to improvement of its function too.
What is a miniabdominoplasty?
If the skin is loose and the excessive fat is located only under the navel, so-called miniabdominoplasty is a suitable corrective surgery. The navel remains on the same position and there is no scar after the procedure. The surgery removes only the loose skin and fat located in the lower abdomen, so it is suitable only for some patients.
What can you expect from the abdominoplasty?
Abdominoplasty improves the abdomen profile. During the abdominoplasty the skin is thightened, the excessive and saggy skin from the abdominal area is removed, including striae located under the navel. It is not possible to remove or improve striae outside the removed skin area. If we combine abdominoplasty with the surgery of abdominal muscles we can achieve functional improvement and firming up of the abdomen, too. However abdominoplatsy is not the treatment of obesity and it can not substitute proper diet and exercising.
For whom is the surgery advisable?
The abdominoplasty is advisable for every healthy adult person with excessive saggy skin and fat located on the abdomen, possibly for those with abdominal muscles separation (diastasis recti).
The ideal candidates are healthy adults at any age, in relatively good condition who are not obese and do not suffer from life threatening illness or health state which can alter the healing and recovery, with positive life attitude, well motivated with clearly defined aims of the surgery.
Is the result of abdominoplasty permanent?
The result of the surgery is permanent, but if larger weight reduction or pregnancy occurs the result can be altered again. For this reason patients who plan larger weight reduction or those who plan pregnancy should consider the procedure very carefully.
Where are the scars located after the abdominoplasty?
A horizontal scar is located in the lower abdomen between pubic hairs and navel. We do our best to locate the incision, so it can be easily hidden by underwear or swimsuit. The length and the shape depend on the extent of the surgery that is needed for correction and on the chosen method of the surgery. After the classical abdominoplasty, another scar is located around the navel. A vertical scar from the navel downwards to the pubic hairs is suitable only in exceptional cases in order to achieve better correction of the skin excess. Abdominoplasty leaves a permanent scar which matures, softens and fades within approximately 1 year.
How long does the surgery take?
The length of the surgery differs according to the extent of the excessive tissues which are removed, it usually takes 2-3 hours.
What is the procedure of the surgery itself like?
First, the operating field is being cleaned and disinfected. A transverse surgical incision is usually made in the lower abdomen, if performing the classical abdominoplasty the incision is made around the navel, too. A horizontal incision is made right above the pubic hairs and it is prolonged to the sides. For some types of abdominoplasty a vertical incision is suitable, for more effective removal of excessive skin. When performing the abdominoplasty, we lift the skin to the level of ribs, during the miniabdominoplasty to the level of navel. After the skin is lifted, weakened abdominal muscles are firmed and the excess of loose skin is removed including the fat.
Is it convenient to combine abdominoplasty with other surgeries?
The abdominoplasty is often performed independently, but it is also possible to combine it with liposuction or to extend the surgery to the back and hips (circumferential reduction which is performed after the greater weight loss). If we combine the abdominoplasty with the hips liposuction within one or two surgical procedures, we can achieve noticeable improvement.
Can be abdominoplasty influenced by previous abdominal surgeries?
The scars after the surgeries located in the upper part of the abdomen might negatively affect the healing process after the abdominoplasty. On the other hand scars after the Caesarean section, appendectomy or gynaecological surgery do not affect the healing and can be removed during the abdominoplasty.
General or local anaesthesia for the abdominoplasty?
The surgery is performed under general anaesthesia. However there are some exceptions when we perform the less extensive procedures (miniabdominoplasty) under the local anaesthesia and sedation.
What are the post surgery care and recovery like?
After the surgery few days of hospitalization are advisable. The drains are inserted into the wound after the surgery in order to prevent the liquid accumulation. Drains are usually removed within 1-2 days after the surgery, but they can also be left in the wound longer. Relative physical resting is advisable for 1-2 weeks but the well-timed mobilization helps to prevent the complications. After this period a gradual rehabilitation process continues. A pain, swellings and haematomas can appear as a common side effect of major surgeries. It usually subsides within few weeks. After the surgery it is convenient to wear the special compression underwear which helps to reduce swelling, prevents the liquid and blood accumulation, provides comfort and support during the healing process. According to the extent of the surgery it is convenient to wear compression underwear for approximately 6 weeks after the procedure. All the activities including full physical activity are usually resumed after 6-8 weeks after the surgery.
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