Clinica Cirugia plastica Saint Paul Aesthetic Plastic Surgery

Introduction

This operation consists in excess abdominal skin and fat removal and the correction of muscle flaccidity. This situation of skin excess and abdominal wall relaxation usually occurs in patients who have had weight gain and subsequent weight loss or in women who have had multiple pregnancies. Abdominoplasty can help you obtain a flatter, firmer stomach, and a narrower waist line.

The procedure is performed under general anesthesia, making an incision above the pubic hairline and navel. The skin is set loose from the abdomen and, if necessary, the abdominal muscles are reinforced with stitches. The excess skin is pulled down and removed.

After surgery the patient would wear a special belt, reinforced with a bandage, according to each individual case. The scars around the navel and lower abdomen will improve in time. However, in some cases it is necessary to make a scar revision under local anesthesia. More than in any other cosmetic surgery it´s worth the phrase, "the surgeon makes the suture and the patient makes the scar.”

As possible, but rare complications we must mention the vitality loss (necrosis) of the skin above the pubic area, which may require a longer postoperative treatment. There can also appear seromas and / or hematomas requiring evacuation.

What is abdominoplasty?

Abdominoplasty is an extended surgical procedure with the final purpose of removing the excess skin and fat from the middle and lower abdomen and strengthen the abdominal wall musculature. This procedure can dramatically reduce the appearance of abdominal bulge (colloquially known as "gut"). On the other side, it leaves a permanent scar which, depending on the extent of the original problem and the surgery required to correct, it may be more or less significant. If you are considering undergoing an abdominoplasty, you must get basic information about the surgery, when it is indicated, how it is performed and what are the results to expect. However, it is impossible for all of your questions to be answered, since it mainly depends on personal factors and the plastic surgeon`s preferences.

Before abdominoplasty: the incision is placed above the pubic area to allow removal of excess skin and fat.

Who is the ideal candidate to undergo an abdominoplasty?

The ideal candidates to undergo an abdominoplasty are those women or men who have a relatively good shape but are concerned about the accumulation of fat or excess skin in the abdomen that does not improve despite diet or exercise. This surgery is especially useful in the case of women who have had multiple pregnancies, after which the skin and abdominal muscles have relaxed and have not recovered their initial tone. It can also improve the loss of skin elasticity in older people, a situation often associated with moderate obesity. Those patients who must lose too much weight must postpone the surgery, the same as the patients who intend to have future pregnancies, as during surgery the vertical muscles of the abdomen contract and might relax again after the pregnancy. If there are previous scars on the abdomen, this surgery may be contraindicated or scarring can change position. In other cases, through this surgery the scars get eliminated.

Planning the surgery

In your initial consultation, your plastic surgeon will evaluate your health state, will determine the extent of fat accumulation in the abdominal region and your skin tone. Be sure to mention if you are a smoker, you are taking any medication or vitamins. You must express your expectations in an honest and straightforward manner so that the plastic surgeon would also be open and show you the alternatives available for your problem, with the risks and limitations of each. If, for example, you only have fat accumulation in the area below the navel it might be sufficient to conduct a less complex procedure called mini-abdominoplasty, which needs a minor hospital stay and takes less time to perform. In other cases, a full abdominoplasty or a mini-abdominoplasty may be associated with liposuction of the hips in order to improve the body shape in a more harmoniously manner. Some cases may even be solved only by liposuction of the abdomen. In any case, the plastic surgeon together with you, will determine the optimal procedure that would give you a more suitable body shape. During the consultation, the plastic surgeon will also explain what type of anesthesia will be used, whether or not it is necessary to be hospitalized the clinic where the surgery is performed and the costs of the intervention. Abdominoplasty, except in cases disabling, excepto en casos invalidantes it is not included in Social Security benefits.

Where is the surgery performed?

The mini-abdominoplasty and abdominoplasty are always performed in the operating room, within a clinic or hospital. These are procedures that must not be performed without a previous consultation. Liposuction must, also, be performed in the operating room under strict aseptic conditions.

What type of anesthesia it is used?

The type of anesthesia used to perform an abdominoplasty is general anesthesia, during which you will be asleep until the end of surgery. In some cases, especially in the mini-abdominoplasty and abdominal liposuction, local anesthesia and sedation may be used, so that during surgery you will be awake but relaxed, and the abdominal region will remain insensitive to pain (at times you may feel some discomfort).

What does surgery consists of?

A full abdominoplasty usually takes between 2 and 4 hours, depending on the amount of correction needed. A mini-abdominoplasty usually takes between 1 and 2 hours. Abdominoplasty is performed through a long incision from one hip to the other, just above the pubic bone. A second incision is made around the navel to separate it from the surrounding tissues.

In mini-abdominoplasty a much smaller incision it is made, also above the pubic area, without requiring an incision around the navel, which in some cases can be lowered when stretching the skin.

Next, the skin is separated from the abdominal wall upward to the ribs, exposing the abdominal muscles. These muscles are tightened and united in the midline, providing a firmer abdominal wall and a narrower waist. The separated skin is stretched towards the pubis and the extra skin is removed; the navel is placed in its new position. Finally, suturing is performed, then a bandage is applied and a temporary drainage tube is fixed to remove excess fluid that may accumulate in the affected area. In mini-abdominoplasty, the skin is separated only between the incision and the navel, the excess skin is removed and stitches are made.

The skin is separated from the abdominal wall up to the ribs.

The muscles and tissues of the abdominal wall are brought near to one another to get a smaller, slimmer waist.

The excess skin is removed; in full abdominoplasty in the navel is repositioned.

Post surgery care (post-operative)

During the first days, the abdomen is usually a bit swollen and you can feel some discomfort or pain, manageable with medication. Depending on the extent of the surgery, you may go home after a few hours or stay 2 or 3 days in the clinic. Your plastic surgeon will give you instructions on how to shower and change your bandages. Although you must not stretch at all in the beginning, you should start walking as soon as possible. The stitches on the external skin will be removed in 5 to 7 days; the inner stitches, with the ends coming out through the margins of the incision, will be removed in 2 or 3 weeks. The bandage will be replaced by an elastic abdominal binder.

Returning to normality

It may take you weeks or months to feel like your old self again. If your physical condition before surgery was good, including strong abdominal muscles, recovery from abdominoplasty will be much faster. Some people return to work in about 2 weeks, while others need 3 or 4 weeks of rest and recuperate. Physical exercise helps you recover sooner. Even people who have never exercised before, must undertake a exercise program to reduce inflammation, decrease the chance of venous thrombus formation and tone the muscles. However, heavy exercise should be avoided until you can do it comfortably. Scars can leave the impression of getting worse during the first 3 to 6 months, as they are in a healing period; this is normal. You must wait between 9 months and 1 year for the scar to flatten and lighten in color. Although the scars will never disappear, they will not be visible, even when wearing bikini or a swimsuit.

Are there risks? Are there any guarantees?

Hundreds of abdominoplasties are successfully performed every year. When done by a qualified plastic surgeon trained in body contouring, the results are generally quite positive. Nevertheless, there are always risks associated with surgery and specific complications associated with this procedure. Post-operative complications such as infection and blood clots are rare, but can occur. Infection can be treated with drainage and antibiotics, but will prolong your hospital stay. You can minimize the risk of blood clots by moving around as soon after the surgery as possible. Poor healing, which results in conspicuous scars, may necessitate a second operation. Smokers should be advised to stop, as smoking may increase the risk of complications and delay healing. You can reduce your risk of complications by closely following your surgeon's instructions before and after the surgery, especially with regard to when and how you should resume physical activity.

The results

Abdominoplasty, whether partial or complete, produces excellent results for patients with weakened abdominal muscles or excess skin. And in most cases, the results are long lasting, if you follow a balanced diet and exercise regularly. If you're realistic in your expectations and prepared for the consequences of a permanent scar and a lengthy recovery period, abdominoplasty may be just the answer for you.

Abdominal scar surgery

There are sometimes unaesthetic scars in the abdominal region, usually due to previous surgery on the abdominal cavity. Although there is no way to remove a scar completely, its appearance can be improved through a new intervention in which the scar is removed and re-sutured in optimal conditions. These interventions are almost always performed under local anesthesia with or without sedation; usually, it doesn`t require hospitalization. The procedure normally lasts for an 1 hour. The recovery is rapid.

The information contained on this page cannot, and does not replace the information provided individually by your plastic surgeon. In case of doubt, your plastic surgeon will provide appropriate clarifications. If you are planning to undergo an intervention or Aesthetic Plastic Surgery, see a specialist in Plastic, Reconstructive and Aesthetic Surgery.

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