 Abdominoplasty,
known more commonly as a “tummy tuck” is a major surgical procedure
to remove excess skin and fat from the middle and lower abdomen and to tighten
the muscles of the abdominal wall. The procedure can dramatically reduce the
appearance of a protruding abdomen. But bear in mind, it does produce a permanent
scar, which, depending on the extent of the original problem and the surgery
required to correct it, can extend from hip to hip.If you’re considering
abdominoplasty, this will give you a basic understanding of
the procedure-when it can help, how it’s performed, and what results you
can expect. It can’t answer all of your questions, since a lot depends
on the individual patient and the surgeon. The
best candidates for abdominoplasty are men or women who are
in relatively good shape but are bothered by a large fat deposit or loose abdominal
skin that won’t respond to diet or exercise. The surgery is particularly
helpful to women who, through multiple pregnancies, have stretched their abdominal
muscles and skin beyond the point where they can return to normal. Loss of skin
elasticity in older patients, which frequently occurs with slight obesity, 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, as vertical
muscles in the abdomen that are tightened during surgery can separate again
during pregnancy. If you have scarring from previous abdominal surgery, your
doctor may recommend against abdominoplasty or may caution
you that scars could be unusually prominent.
ALL SURGERY CARRIES SOME UNCERTAINTY AND RISK
Thousands of abdominoplasties are performed
successfully each year. When done by a qualified plastic 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 will prolong your hospital stay.You can minimize the risk of blood cloths
by moving around as soon after the surgery as possible.Poor healing, which results
in conspicuous scars, may necessitate a second operation. Smokers should be
advised to stop, as smoking may increase the risk of complications and delay
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. 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 smoke, and if you’re taking
any medications, vitamins, or other drugs.In any case, your surgeon should work
with you to recommend the procedure that is right for you and will come closest
to producing the desired body contour.During the consultation, your surgeon
should also explain the anesthesia he or she will use, the type of facility
where the surgery will be performed, and the costs involved. Your
surgeon will give you specific instructions on how to prepare for surgery, including
guidelines on eating and drinking,smoking,and taking or avoiding certain vitamins,
and medication.Your doctor may select general anesthesia, so you’ll sleep
through the operation.Other surgeons use local anesthesia, combined with a sedative
to make you drowsy. You’ll be awake but relaxed, and your abdominal region
will be insensitive to pain.(However, you may feel some tugging or occasional
discomfort.)
THE SURGERY
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, the surgeon will make a long incision from hipbone
to hipbone, just above the pubic area. A second incision is made to free the
navel from surrounding tissue. With partial abdominoplasty,
the incision is much shorter and the navel may not be moved, although it may
be pulled into unnatural shape as the skin is tightened and stitched.Next, the
surgeon separates the skin from the abdominal wall all the way up to your ribs
and lifts a large skin flap to reveal 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 firmer abdominal wall and narrows the
waistline.The skin flap is then stretched down and the extra skin removed. A
new hole is cut for navel, which is then stitched in place. Finally, the incision
will be stitched, dressing will be applied, and a temporary tube may be inserted
to drain excess fluid from the surgical site.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.
AFTER YOUR SURGERY
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. Depending
on the extent of the surgery, you may be released within a few hours or you
may have to remain hospitalized for two to three days.Your doctor will give
you instructions for showering and changing your dressings. And though you may
not be able stand straight at first, you should start walking as soon as possible.Surface
stitches will be removed in five to seven days, and deeper sutures, with ends
that protrude thought the skin, will come out in two to three weeks. The dressing
on you incision may be replaced by a support garment. It may take you weeks
or months to feel like your old self 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 heal
better. Even people who have never exercised before should begin an exercise
program to reduce swelling, lower the chance of blood cloths, and tone muscles.
Vigorous exercise, however, should be avoided until you can do it comfortably.Your
scars may actually appear to worsen during the first three to six months as
they heal, but this is normal. Expect it to take nine months to a year before
your scars flatten out and lighten in color.While they’ll never disappear
completely, abdominal scars will not show under most clothing, even under bathing
suits.Abdominoplasty, whether partial or complete, produces
excellent results for patients with weakened abdominal muscles or excess skin.
And 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 prepared
for the consequences of a permanent scar and a lengthy recovery period, abdominoplasty
may be just the answer for you.
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