Abdominoplasty is the surgical procedure that removes the extra skin and fat tissue in the abdomen, beneath the bellybutton, also known as Tummy Tuck and Lipectomy. This procedure joins the abdominal muscles in the center or the sideways areas; this is known as Plication, giving to the abdomen a flat look, with a better definition of the waist.
This procedure is indicated in patients that by hormonal changes, pregnancies, abdominal surgeries, overweight and treated obesity, shown signs of a sagging abdomen and fat tissue with extra skin beneath the bellybutton and, in some cases, the patients also shown weakness in the abdominal wall muscles, with poor definition of the waist, giving a pregnancy look.
Abdominoplasty is performed with a horizontal incision or wound in the lower region of the abdomen, above the pubic, between the hips, the length will depend on the patient, it can be as short as a caesarean section, this is called a mini-Abdominoplasty (Mini-tummy Tuck). It also can be long, extending to the back as a belt, in the case of obese patients or patients post-reduction (after a surgical procedure as the bariatric surgery or the gastric bypass). Through this incision the skin and the adipose tissue is detached (flap), the bellybutton is released and is usually preserved in the same position, afterwards is pulled down removing the extra skin. The muscles are joined in the center and sideways. The result, beside a flat abdomen with waist, has a scar in the mentioned area, with time it will take the resemblance of a long, thin striae, that can be hide beneath the underwear, and other scar inside the bellybutton. If there are stretch marks in the upper side of the abdomen the Abdominoplasty can be performed with an upper or inverse incision, underneath the ribs bottom edge. If the patient has upper and inferior scars of the bellybutton this procedure may not be right, given that the skin and flap circulation can be altered.
The abdomen liposuction is not part of this surgery and if it is performed is in addition of the Abdominoplasty. If is performed at the same time there is a high risk of compromise the circulation and cause skin distress and the fat flap; this is why we recommend, that if a liposuction is necessary, is better to do it three months after the Abdominoplasty, when the abdomen circulation is stabilized.
The Abdominoplasty lasts one and a half up to three hours, depending if it’s a mini-abdominoplasty or an Abdominoplasty; is preformed under general anesthesia in most cases, or local; it must not be combined with other surgical procedures in the abdomen region, such as gynecological, gastrointestinal or urologic surgeries, given the high risk of infection. Its ambulatory in most cases, unless there is an especial clinic condition on the patient, previous or after the surgery, that indicate hospitalization, or if the surgery was combined with other procedures.
During the postoperative, there will be swelling, pain, bruises (ecchymosis), stress and tension felling on the skin and muscles, transit decrees of felling and serosanguineous drainage that will last five up to fifteen days, depending the fat tissue on the patient.
Within adverse eventualities, we can find seromas or hematomas that persist in spite of the drainages, infections, distress on the flab skin and/or wounds, poor cicatrization or transitory decrees of sensibility. The anesthetics and surgical risks are similar to all other surgical procedures.
Recovery implies the use of analgesics and antibiotics for a week, sleeping semirecumbent and with bended legs, since the second day of the surgery the patient can walk and move restraining him/her self of big efforts. Drainages must be kept as long as is necessary, but usually is five up to fifteen days, until the drain is not higher that 50 cc in 24 hours. Is also needed to use abdominal foam for two weeks, strips for two months, moisturizing creams, general scars cares, the patient must attend the medical controls as scheduled. The stitches removal will be done three or four weeks after the surgery. For two months the patient must restrain of big efforts as lifting heavy weights or practicing any sports, it will also be necessary to strength the abdominal muscles starting three months after the surgery. The medical leave of absence will depend on the job preformed by the patient, but it goes between one to two weeks