|
If you're considering abdominoplasty...
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. Please
ask your surgeon about anything you don't understand.
THE BEST CANDIDATES FOR ABDOMINOPLASTY
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.
Abdominoplasty can enhance your appearance
and your self-confidence, but it won't necessarily change
your looks to match your ideal, or cause other people to treat
you differently. Before you decide to have surgery, think
carefully about your expectations and discuss them with your
surgeon.
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 clots 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.
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 smoke, and if you're taking any medications,
vitamins, or other drugs.
Be frank in discussing your expectations with
your surgeon. He or she 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, also know as a
mini-tummy tuck, which can often be performed on an outpatient
basis. You may, on the other hand, benefit more from partial
or complete abdominoplasty done in conjunction with liposuction
to remove fat deposits from the hips, for a better body contour.
Or maybe liposuction alone would create the best result.
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. In most cases, health insurance policies do not
cover the cost of abdominoplasty, but you should check your
policy to be sure.
PREPARING FOR YOUR SURGERY
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 medications.
If you smoke, plan to quit at least one to
two weeks before your surgery and not to resume for at least
two weeks after your surgery. Avoid overexposure to the sun
before surgery, especially to your abdomen, and do not go
on a stringent diet, as both can inhibit your ability to heal.
If you develop a cold or infection of any kind, your surgery
will probably be postponed.
Whether your surgery is done on an outpatient
or inpatient basis, you should arrange for someone to drive
you home after your surgery, and to help you out for a day
or two after you leave the hospital, if needed.
WHERE YOUR SURGERY WILL BE PERFORMED
Many surgeons perform both partial and complete abdominoplasties
in an outpatient surgical center or an office-based facility.
Others prefer the hospital, where their patients can stay
for several days.
TYPES OF ANESTHESIA
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 an 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 is removed. A new hole is cut for your navel, which
is then stitched in place. Finally, the incisions will be
stitched, dressings 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 to 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 through
the skin, will come out in two to three weeks. The dressing
on your incision may be replaced by a support garment.
GETTING BACK TO NORMAL
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 clots, 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.
YOUR NEW LOOK
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.
Back to Procedures
Information provided by American
Society of Plastic Surgeons. |
