Abdominoplasty or “tummy tuck” is a cosmetic surgery procedure used to make the abdomen more firm. The surgery involves the removal of excess skin and fat from the middle and lower abdomen in order to tighten the muscle and fascia of the abdominal wall. This type of surgery is usually sought by patients with loose tissues after pregnancy or individuals with sagging after major weight.
Abdominoplasty operations vary in scope and are frequently subdivided into categories. Depending on the extent of the surgery, a complete abdominoplasty can take 1 to 5 hours. A partial abdominoplasty (Mini-Tuck Abdominoplasty) can be completed between 1 to 2 hours.
In general, a complete (or full) abdominoplasty follows these steps:
- An incision is made from hip to hip just above the pubic area.
- Another incision is made to free the navel from the surrounding skin.
- The skin is detached from the abdominal wall to reveal the muscles and fascia to be tightened. The muscle fascia wall is tightened with sutures.
- Liposuction is often used to refine the transition zones of the abdominal sculpture.
- A dressing and sometimes a compression garment are applied and any excess fluid from the site is drained.
A partial (or mini) abdominoplasty proceeds as follows:
- A smaller incision is made.
- The skin and fat of the lower abdomen are detached in a more limited fashion from the muscle fascia. The skin is stretched down and excess skin removed.
- Sometimes the belly button stalk is divided from the muscle below and the belly button slid down lower on the abdominal wall.
- Sometimes a portion of the abdominal muscle fascia wall is tightened.
- Liposuction is often used to contour the transition zone.
- The flap is stitched back into place.
An extended abdominoplasty is a complete abdominoplasty plus a lateral thigh lift. The resulting scar runs from the posterior axillary line (when placing you open hands on your hips, the thumbs lie along the posterior axillary line.) The operation does all of the abdominal contouring of a complete abdominoplasty plus allows further improvement of the flank (waist), as well as smoothing the contour of the upper lateral thigh.
High lateral tension tummy tuck
This is an advanced technique that takes a little more than four and half hours to perform. Conventional abdominoplasty tightens muscles in a vertical line. In this new method, known as high lateral tension abdominoplasty, in addition to vertical-line tightening, muscles are tightened horizontally. The final result with this technique is a dramatically flat abdomen with significantly better-defined waistline.
An circumferential abdominoplasty is an extended abdominoplasty plus a buttock lift. The resulting scar runs all the way around the body, and the operation is also called a Belt Lipectomy or Body Lift. This operation is most appropriate for patients who have undergone massive weight loss.
An abdominoplasty is a component of a lower body lift and can be combined with liposuction contouring, breast reduction, breast lift, or occasionally hysterectomy, depending on the reason for the hysterectomy. A popular name for breast enhancement procedures performed in conjunction with an abdominoplasty is a “mommy makeover”. Recent literature in MEDLINE also has noted implementation of barbed suture in these procedures.
- Depends on the problem to be treated, surgical technique(s), and other factors. Can take one to four weeks and patients are advised to take at least a portion of this recovery time off from work.
- Heavy activity especially is best avoided during this time.
- Initially there may be bruising and discomfort.
- A supportive abdominal binder or compression garment can minimize swelling / bruising, and support the repaired tissues.
- Patients are advised to avoid all forms of nicotine for a month or longer prior to surgery and also during the recovery period.
- Full recovery takes 3 – 6 months, with further fading of scars thereafter.
Abdominoplasty carries certain risks that may be serious or life-threatening. When taking the decision to undergo such a procedure it is recommended to compare the benefits with the potential risks and complications. Hence, all patients must be informed on all the risks they are exposing themselves to.
Abdominoplasty surgery is a cosmetic operation that is performed by a plastic surgeon to thin the abdominal region.
Although “tummy tucks” are considered safe procedures, as with any other type of surgery, different complications may arise. The majority of the risks can be avoided if the patients follow carefully the instructions they receive from their surgeon. Severe complications occur however in rare cases and these include blood clots, thrombosis, cardiac and pulmonary complications or infection.
Infection and blood clots are a serious potential risk after abdominoplasty, but which occur rarely. Infection is usually treated with antibiotics and drainage. Patients are recommended to move around as soon as possible after surgery to minimize their risks of developing blood clots. Pulmonary embolism, heart attack or stroke are very rare complications that may result after any type of surgery due to immobility after surgery which results in blood clots that may travel to the heart, lung or brain. Thus, pulmonary embolism is a serious risk after “tummy tuck” procedure and if they occur, they commonly happen within 3 weeks of the surgery, but more commonly within the first 72 hours after the procedure has been performed.
If complications occur, they usually delay the healing process. In rare cases, another surgery is needed to fix a potential complication. Skin necrosis is one of the complications that may require another procedure as the dead skin must be replaced by a skin graft. Although necrosis is extremely rare, smokers have an increased risk to develop skin necrosis. Stopping nicotine use and smoking several weeks before and several weeks after surgery cleans the body and improves the chance of an uneventful recovery.
One of the more common problems after an abdominoplasty is collection of fluid under the skin after the drains have been removed.A surgeon can aspirate the fluid with a needle. The drainage stops within a month and does not affect the final results.
The scars resulting from abdominoplasty are long, brutal in appearance, and permanent. The size of the scar depends on the amount of skin that has been cut-off, the techniques used for the surgery, the surgeon’s skills, and the body’s ability to recover. Although this scar will never become invisible, it is usually placed under the swimsuit line so it is covered by clothes. It normally takes nine months to a year before scars flatten out and lighten in color.
Possible risks of abdominoplasty include:
- Fluid accumulation
- Poor wound healing
- Skin loss
- Numbness or other changes in skin sensation
- Anesthesia complications
- Skin discoloration and/or prolonged swelling
- Fatty tissue found deep in the skin might die (fat necrosis)
- Major wound separation
- Recurrent looseness of skin
- Pain, which may persist
- Persistent swelling in the legs
- Nerve damage
- Possibility of revisional surgery
- Hematoma (may occur in 3 to 4% of cases)
- Keloid (heavy scar)
- Suture rupture
- Visible scar
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