Abdominoplasty: All You Need To Know About The Procedure
Dr. Wilberto Cortes is a plastic surgeon who practices in Houston, Texas. He received numerous awards and distinctions during college and graduated Magna Cum Laude. As he pursued his dream of becoming a plastic surgeon, he was accepted at Ponce School of Medicine, a U.S. accredited medical school located in Ponce, Puerto... more
Introduction
A drastic diet and long sessions of abdominals at the gym are sometimes not enough to help you get a beautiful tummy area. Multiple pregnancies, weight fluctuations due to different diet regimens, lack of physical activity, certain consequences of previous interventions in the area, and the natural aging process all contribute to the unaesthetic appearance of the tummy. Abdominoplasty is the aesthetic surgery performed with the purpose to improve the aspect of the abdominal area. This intervention can restore the beautiful shape of the tummy, a flat and firm abdomen, and strengthens the abdominal wall muscles.
While the tummy tuck can be performed with a strong medical recommendation (muscle diastasis and umbilical hernia), it is mainly a procedure performed for cosmetic purposes.
Medical indication for the tummy tuck
During the preoperative consultation, the plastic surgeon will perform a clinical examination. He will evaluate the fat distribution in the area, the skin tonus, and the level of skin sagginess. If the skin presents stretch marks, this is usually a sign of a poor skin condition. Some patients might even present what we call an “abdominal apron” (a layer of fat and skin that is sagging, partially or completely covering the pubic area.) This usually occurs after bariatric surgery or multiple pregnancies with significant weight gain and loss.
If the patient has good skin tonus, no sagginess at the level of the abdomen and no muscular distension, the abdominoplasty can be replaced with a simple abdominal liposuction. This is a good treatment option especially for young patients whose skin will be able to retract easily on the new contours of the body.
If the excess skin tissue comes with significant cutaneous sagginess and muscle distension, the tummy tuck is the only procedure that will efficiently and permanently improve the condition of the abdomen.
How does the abdominoplasty work?
A general anesthesia is performed for abdominoplasty. The tummy tuck surgery is performed in several steps. There are many surgical techniques to choose from, and the plastic surgeon will decide which one is suitable for a particular patient. As you may already know, when it comes to surgery there is no such thing as “one size fits all.”
The first stage of the procedure can be liposuction. If the abdominal wall has a considerable thickness due to the fat layer under the skin, liposuction will help reduce that layer. Once liposuction is performed on the abdominal area (and sometimes even on the flanks), the plastic surgeon can begin the actual tummy tuck intervention.
The next step is to detach the skin and fat tissue from the abdominal area and lift them up to the level of the rib cage. The purpose of this detachment is to be able to tighten the skin downwards and to flatten the whole abdominal area, after having removed the excess skin located below the navel.
If the surgeon observes a diastasis recti or loosening of the abdominal muscles, he will suture the muscles in order to strengthen them with the aim to flatten the tummy.
The scars after the abdominoplasty
Like any surgery, cosmetic or not, abdominal plastic surgery will leave behind a scar. This scar is located as low as possible in the inferior region of the tummy, hence easily masked with panties or a bathing suit.
The result of a traditional abdominoplasty is also a circular scar around the navel, but this one remains not as visible. In the case of a moderate skin distension on the abdominal area, a mini-tummy tuck might be enough. The mini tummy tuck has the benefit of not creating a scar around the navel.
The scars left after the tummy tuck surgery are quite extensive compared to other plastic surgery interventions. Due to their length, they will heal slowly and mature within the first year after the procedure is performed. It is strongly recommended for the patient to avoid sun exposure at all costs during the first six months following the surgery to allow the surgical scars to heal nicely and avoid discoloration.
What are the results of the tummy tuck?
The abdominoplasty allows for a flattening the abdominal area, and the abdomen regains its flat and tight aspect. The abdominoplasty thus offers a considerable rejuvenation of the tummy and of this area. The results are different from patient to patient and also depend on the surgical techniques used and if the procedure is performed as a standalone or in association with other plastic surgery procedures. For example, in the case of the traditional tummy tuck, the patient might be left with a SpongeBob square shape. If the hourglass tummy tuck is performed, then an alluring hourglass silhouette might be achieved. The hourglass tummy tuck involves liposuction and fat transfer to the hips, aside from the traditional tummy tuck procedure steps.
Will I be left with a fat pubic area and a flat tummy after the procedure?
The fear of certain patients is to have a relaxed and unaesthetic bulge in the pubic area, compared to the flat appearance of the tummy. An experienced plastic surgeon knows that this might be the case, so in the case of excess fat and skin tissue in the pubic area, a slight detachment of the skin can be performed in order to carry out a natural restoration in tension. The scar is easily masked by pubic hair.
If there is no skin extension in the pubic area, a simple liposuction can be enough to improve the aspect of this area and make it more proportionate with the new aspect of the tummy. In this manner the patient can therefore enjoy a general rejuvenation of her figure in the middle area and pubic area.
Risks and complications
Like any surgical procedure, an abdominoplasty can always present risks, either during the operation or post-operatively. Nevertheless, the preoperative consultations with the anesthesiologist and the plastic surgeon, as well as the preoperative clinical and blood tests, aim to avoid or reduce the risks as much as possible.
Choosing an experienced, board-certified plastic surgeon to play out your tummy tuck intervention can minimize the risks of the procedure, even if they can’t be completely eliminated. The benefits of having a skilled plastic surgeon looking after your case are also obvious in the case of treating the potential complications that might occur.
Among the complications associated with the tummy tuck surgery are delayed wound healing, excessive bleeding, hematoma and seroma, and infection. The plastic surgeon will prescribe antibiotic medication to be taken after the procedure for at least a week in order to avoid the risk of developing an infection at the incision site. Proper hygiene of the surgical wound is also important to minimize the risk of infection.
Delayed wound healing can be triggered by smoking as a result of a lack of proper oxygenation of the abdominal tissues. Excessive bleeding can occur if the patient has taken anti-inflammatory medication prior to surgery or if she is unable to avoid intense movements or physical exercises shortly after the procedure is performed.
After the tummy tuck intervention
The results and aesthetic benefits of a tummy tuck are not immediately visible. It is necessary to wait a few weeks until the edema following the intervention is resolved and the bruises disappear. A compression garment adapted to the patient's morphology is strongly recommended by the surgeon and should be worn for about three weeks or longer.
Conclusion
The surgical technique used for abdominal plastic surgery has made a great deal of progress in recent years. This surgical procedure offers multiple benefits for the patient, both in terms of aesthetics and functionality. The new tonus and tension in the abdominal muscles can help avoid potential back pain issues.
The benefit of the tummy tuck procedure is also felt psychologically, allowing the patient to regain or get a boost of self-esteem. Patients thus regain their mobility and their muscular comfort. The procedure is now less painful than it was years ago, and the recovery of the activity, both physical and professional, is also faster. The patient usually needs about two weeks off from work to recover after the intervention. If only a mini-abdominoplasty is performed, the recovery time is shorter.
To sustain the results of the tummy tuck intervention for as long as possible, all patients are strongly advised to follow a healthy lifestyle in terms of sports activities, but also to have a balanced diet that is adapted to their needs.
