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Abdominoplasty, more commonly referred to as tummy tuck, is a complex surgical procedure that involves the removal of excess skin as well as fat from the stomach. If necessary, even the muscles in the abdominal wall are tightened. The outcome of this treatment is a smoother, flatter and more shapely stomach area.*
Abdominoplasty was designed for treating skin laxity of the lower abdominal area. This could be related to pregnancy or weight changes. Abdominoplasty is often done to get rid of stretch marks. The procedure takes roughly around an hour and a half, and can be done under general anesthesia or a spinal anesthetic. There is a drain in the treated region for around 3 to 5 days after the procedure. For the first week,activity will be limited to selfcare only and subsequently to gradual remobilization as well as return to other physical activities including exercise. After treatment, there would be a lower abdominal scar as well as some abdominal numbness. This treatment is very effective at reducing the lower abdominal roll.* In addition, resection of the lower abdominal skin can also be done in combination with liposuction.
Who is a Right Candidate?
Candidates for Abdominoplasty can be men and women,who have loose skin on the abdominal area,or large fat depositsin the lower abdomen that don’trespond to diet regimesor exercise. The procedure is also useful for women who have stretchmarks caused as a result of pregnancy. Thetreatment is also popular for people who were once obese and have been successful in losing a lot of weight.
Preparation Needed for Surgery:
Prior to surgery, itis very important that the doctor is aware of the state of your overall health. Let him know of any existing allergies that you have. Also, if you are taking any medication, supplements, or vitamins, let the doctor know of this and also the reason for taking them. It’s also necessary to inform the doctor if you have a tendency for Keloid scarring (wide, thick or raised scars).
In case you are a smoker,it is best to quit smoking prior to proceeding with the treatment. Smoking interfereswith the flow of blood to the skin, and also inhibitsthe healing process of the incisions.Depending upon the patients age as well as overall health,some pre-operative tests such as blood tests or ECG (electrocardiogram)could be ordered.
It is very important that you avoid using vitamin E, anti-inflammatory or aspirin products for at least two weeks before the surgery. Such products are anti-coagulants and may lead to hematoma formation as well as bleeding during the procedure.
How It Works?
Generally, the procedure is performed under general anesthesia and takes around 2to 3 hours.
During the procedure, the incision is made along the lower abdominal area, slightly abovethe pubic line. The incision length depends upon whether you are undergoing full or mini Abdominoplasty. Usually, the incision for full Abdominoplasty stretches from one side of the hip to the other. Normally, the incision cannot be seen while wearing bathing suitsor undergarments.
During abdominoplasty, the doctor will often repair the vertical muscles inthe abdomen, which could get separated during pregnancy. Thesemuscles are tightly pulled together, and sutured into anew position.
After you go back home from the clinic, you must rest in bed and put pillows under your knees to minimize any kind of pull on the incision. You should also make sure to drink a lot of fluids in order to avoid dehydration. Patients are able get up and take short walks 1or 2 days after the procedure. For the first week, the doctor will advise you to not stand perfectly straightto avoid any kind of tension on the treated area.
Majority of the patients who have deskbound jobs are advised to take two weeks off from work. In case your job involves a lot of physical activity,the doctor will advise you on how much time needs to be takenoff.
In between days 5to 7, you should see the doctor to have the drainage tube removed. Following that appointment,you would be able to takea shower. It is advised to do so using lukewarm water and have your back to the spray. The next appointment should be roughly around 10to 14 days after the surgery, in order to remove the sutures.
A surgical compression garment plays an important role during the recovery period. It helps avoid any buildup of fluid up under the skin. The doctor will recommend that you wear this garment for six weeks after the surgery.
Patients should not drive for at least 2weeks afterthe surgery.There will be bruising and swelling for up to three months after the procedure.It is also advised to avoid heavy lifting for six weeks after surgery.
With any type of surgery, there are certain risks associated. Even though the occurrence of complications is rare, the doctor will let the patients know of the all the possible complications before proceeding with the surgery.This treatment is subject to all the same complications that are associated with all other surgical procedures. These include bleeding, infection and failure to heal, which may require suitable treatment including the possibilityof further surgery.Some of the possible complications include:
Haematoma: Blood could gather under the skin and lead to a blood clot. In case this occurs, the doctor will drain the area. Signs of haematoma include a firmand painful lump, which causes a change in skincolor. However, this occurs very rarely,48 hours after the procedure.
Seroma:Serum could accumulate under the skin. It is necessary to have the fluid drainedout.
Infection:Indication of infection includes localized heat, fever, redness and pain. For this the doctor will prescribe antibiotics in order to treat the infection. Occasionally the affected area will need to be drained.
Necrosis: Loss of tissue that can occur when the supply of blood to the skin as well as tissue is compromised.
Numbness/Hypersensitivity: The sensation of the abdominal area can be altered either temporarilyor permanently.
Swelling:There may be persistent swelling on the lower abdominal region.
What is Abdominoplasty?
Abdominoplasty is a surgical procedure that helps correct excessive looseness, protrusion, saggingand weakness of abdominal wall. This helps make the abdominal area flatter and tighter. The abdominal area becomes firmer, smoother and a lot more proportionate to overall body shape and weight.
What type of people need Abdominoplasty?
Women, particularly after multiple pregnancies start developing loose and saggy abdominal skin. This could also occur in people who have undergone surgeryearlier, people with significant fluctuations in weight,and individuals with a hereditary factor. This looseness and sagginess is also not acceptable cosmetically, particularly for people who wear tight clothes orgo swimming. Sometimes such patients also have an associated herniathat can be treated during the abdominoplasty procedure. Women planning future pregnancies might need to postpone this surgery. Even men suffering with problems of excess fat and loose saggy skin can benefit from abdominoplasty.
How does the procedure work?
During treatment, the surgeon removes all the excess skin as well as fat on the abdomen, particularlyfrom the umbilicus level. In case there is any deep intraabdominal pathology (hernia, uterine mass),it is treated as well. The deeper muscles that become weak or separated(due to aging, pregnancyorweight loss) are strengthened through suturing. The umbilicus is repositioned through umbilicoplasty. For people with previous caesarean sections, the existing scars are often included in the new incision. The line for the final suture is often lowerdown in the abdomen.
Are there any variations?
Liposuction can be done alone or in conjunction with abdominoplasty. The variations in incisions as well as umbilicus depend upon individual patient assessment.
Are there any preoperative tests?
Besides the routine tests, an ultrasound scan of the abdominal area is done in order to rule out the possibility of intraabdominal and intrapelvic pathology e.g. uterine mass. This is done so that the problem can be dealt with during the abdominoplasty procedure. The other tests are conducted for the purpose of administering anesthesia. The patient should be ingood overall health withoutany life threatening diseases or medical disorders.
What are the preoperative preparations?
Smokers need to stop smoking at least 3 weeks prior to the procedure. Any other medication that is being presently taken might need to be altered after discussion with the physician, surgeonand anesthetist. The patient is admitted one day prior to the treatment. Overnight fasting as well as thorough antiseptic scrub of the abdominal area is essential. The doctor will also prescribe some antibiotics. It is advised to practice deep breathing exercises, in order to minimize any breathing problems following surgery.
What is the anesthetic?
The anesthesia is epidural analgesia, which is safe and convenient for the abdominoplastyprocedure. A major advantage it offers is that itcan be continued for 2to 3 days after the surgery to control the pain.
Is there any postoperative treatment?
Initially,it is quite comforting to placea pillow under the knees. A drainage tube is placed to drain off any excess blood collection and is removed after 2to 3 days. Blood transfusion is seldomneeded. A urinary catheter is placedfor 2to 3 days. After the initial period of rest for 2to 3 days,patientsareable to walk. However, walking fully upright could get difficult during the initial period but this soon becomes normal. Relief from pain is excellent due to the continuation of epidural analgesia for around 2-3 days. An oral diet canbe resumed in a day or two after the operation. Sutures are removed in 9to 10days untill which a protective dressing is essential.
Is therea follow uprequired?
In order to maintain the firmness of the abdomen,acompression garment needs to be worn for around3 months. Resuming routine activities and work is possible after 2to 3 weeks. It is bestto avoid lifting weights or bending for about six months. Abdominoplasty is not an exercise programme or a substitute for weight loss. Although the results are permanent, theycan be affected greatly due to significant fluctuations in weight. Therefore, maintaining weight and overall fitness is very important. Any numbness and stiffness in the abdomen subsides within a few months. The new scar remains hidden under the underwear.
Is there any risk?
Hematoma (blood clot), infection, fluid collection,delay in wound healingor scarringcan occur. Like any other surgery, this procedure also carries the complications associated with anesthesia. A thorough discussion with the surgeon is required to answer all queries, and to clarify anydoubts.