BEST CANDIDATES FOR ABDOMINOPLASTY
The best candidates for abdominoplasty are men or women who are in relatively good shape, but are bothered by a fat deposit and loose abdominal skin that won’t respond to diet or exercise. The surgery is particularly helpful to women who, though multiple pregnancies, have stretched their abdominal muscles and skin beyond the point where they are able to return to their normal shape. Loss of skin elasticity in older patients, which frequently occurs with weight loss, can also be improved.
Patients who intend to lose a lot of weight should postpone the surgery. Also, women who plan future pregnancies should wait, since the vertical muscles in the abdomen which are tightened during surgery can separate again with a pregnancy.
ALL SURGERY CARRIES SOME UNCERTAINTY AND RISK
Many thousands of abdominoplasties are performed successfully each year. When done by a qualified surgeon who is 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 may prolong your recovery. You can minimize the risk of blood clots by moving around as soon after surgery as possible and by drinking plenty of fluids.
Poor healing, which results in unacceptable scars, may necessitate secondary scar revisions. Smokers should stop before considering any extensive surgery, as smoking may increase the risk of complications and complicate 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.
PLANNING YOUR SURGERY
In your initial consultation, your surgeon will evaluate your health, determine the extent of fat deposits in your abdominal region, and carefully assess your skin tone. Be sure to tell your surgeon if you’re taking any medications, vitamins, or other drugs.
Be frank in discussing your expectations with your surgeon. He should be equally frank with you, describing your alternatives and the risks and limitations of each.
If, for example, your fat deposits are limited to the area below the navel, you may require a less complex procedure-called a partial abdominoplasty (mini-tummy tuck) which can be performed on an outpatient basis. You may, on the other hand, require a complete abdominoplasty done in conjunction with liposuction to remove fat deposits from the hips, for a better contour.
During your consultation, you should ask about the type of anesthesia, the type of facility where the surgery will be performed and whether you will need to stay overnight, and the costs involved.
PREPARING FOR YOUR SURGERY
You will get specific instructions on how to prepare for surgery, including guidelines on eating and drinking and taking or avoiding certain vitamins and medications.
If you have constipation, make sure you tell your surgeon. Do not go on a stringent diet, as it can inhibit your ability to heal. If you develop a cold or infection of any kind, your surgery will probably need to be postponed.
Most abdominoplasty operations are done in an outpatient center with an overnight stay. You should arrange for someone to drive you home. You will need someone to help you for a day or two after your surgery.
WHERE YOUR SURGERY WILL BE PERFORMED
Many surgeons perform both partial and complete abdominoplasties in an outpatient surgical center with an overnight stay. Depending on whether other procedures are performed at the same time, such as a hysterectomy, tubal ligation or a bladder tack, your surgeon may prefer a hospital where their patients can stay for several days.
TYPES OF ANESTHESIA
General anesthesia is used so that you’ll sleep through the operation.
Complete abdominoplasty usually takes two to five hours, depending on the extent of work required. Partial abdominoplasty may take an hour or two. Most commonly, a long curving incision is made from hipbone to hipbone, just above the pubic area to where the scar will be hidden by a bathing suit bottom. A second incision is made to free the navel from surrounding tissue. With partial abdominoplasty, the incision is much shorter and the improvements are only below the level of the navel.
Next, the skin from the abdominal wall is separated all the way up to your ribs which reveals the vertical muscles in your abdomen. These muscles are tightened by pulling them close together and stitching them into their new position. This provides a flatter, firmer abdominal wall and narrows the waistline.
The skin flap is then stretched down and extra skin removed. A new hole is cut for your navel, which is then stitched in place. Finally, the incisions are stitched, dressings applied, and temporary drainage tubes are inserted to drain excess fluid from the surgical site. You will be placed into a waist compression garment and onto a bed that is flexed like a recliner.
In partial abdominoplasty, the skin is separated only between the incision line and the navel. This skin flap is stretched down, the excess is removed, and the flap is stitched back into place.
For the first few days, your abdomen will probably be swollen and you’re likely to feel some pain and discomfort which can be controlled by medication. Most patients describe it as if you’d done a “million” sit-ups. Because of the extent of the surgery, an overnight stay in the outpatient center or hospital is usually a good idea. You may not be able to stand straight up at first, but you should start walking as soon as possible. Navel stitches will be removed in five to seven days, and deeper sutures will come out in about three weeks.
GETTING BACK TO NORMAL
It may take you weeks or months to feel like yourself again. If you start out in top physical condition with strong abdominal muscles, recovery from abdominoplasty will be much faster. Some people return to work after two weeks, while others take three or four weeks to rest and recuperate.
Exercise will help you feel better. Even people who have never exercised before should begin an exercise program to reduce swelling, lower the chance of blood clots, and tone muscles. Vigorous exercise, however, should be avoided for at least 3 weeks.
Your scars may actually appear to worsen during the first three to six months as they mature, but this is normal. Expect it to take nine months to a year before your scars flatten out and lighten in color. While they will never disappear completely, abdominal scars are placed to not show under most clothing, even under bathing suits. You will be followed on a monthly basis to monitor the maturation of these scars.
YOUR NEW LOOK
Abdominoplasty, whether partial or complete, produces excellent results for patients with weakened abdominal muscles and excess skin. 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 are prepared for a permanent scar and a lengthy recovery period, abdominoplasty may be just the answer for you.