Abdominoplasty surgery consists in removing excess fatty tissue and the folds of your skin in the middle and lower abdomen in order to tighten the abdominal wall. Diet and exercise are not enough to produce this result, because this operation is often performed together with the removal of the abdominal muscles and the weakening of the abdominal wall.
Abdominoplasty is a surgery that is not directed to weight reduction. On the contrary, it has been designed to remove, as much as possible, the excess of skin and adipose tissue and to rearrange the muscular wall.
Stretch marks, when possible, can be removed through the removal of the excess . However, the stretch marks that will remain on the residual skin of the abdomen can not be deleted.
Abdominoplasty is considered a challenging surgery and it is generally performed in the operating room during hospitalization. The hospital stay is generally 2-3 days.
Preparation Pre-Operative
It is recommended to avoid any contact with people with colds or other infectious diseases. It is not recommended to take aspirin or medicines with the same active ingredient 2 weeks prior and after the surgery. It is absolutely necessary that patients are healthy before the surgery. Some laboratory tests will be prescribed, an electrocardiogram and a chest X-ray for the preparation of the surgery. At the moment of admission in the clinic it is suggested to wear cotton clothing open at the front.
The surgery
This surgery is performed under general anesthesia, ie the patient is completely asleep. The anesthesia is performed by an anesthesiologist in the operating room. It will be administered a certain amount fluids, intravenously during the surgery and 12 hours after it. You can then return to a regular diet.
It will take about 4 hours to complete the operation. Generally, for such surgery two incisions are necessary: one, rather long, in the lower part of the abdomen, just above the line of the pubic hairs that extends laterally; the other just around the navel, is circular , because, very frequently, the surgery requires a rearrangement of the navel in a higher and more natural position. The skin and the subcutaneous adipose tissue are lifted from the levels below; if necessary, at this stage, the abdominal wall is repaired through the combination of the rectus muscles. So the superficial tissues are stretched downwards and inwards and the excess is removed. Two small and soft tubes for the drainage are inserted into the wound in order to gather blood and serum that may be collected. These drains are removed at the first dressing without any pain. Surgical incisions are closed with intradermal sutures. A copious pressure dressing is then applied and, when it is removed, it is replaced by a sheath which must be worn permanently for 4 weeks. A urinary catheter may be used during the surgery and it will be removed immediately after the surgery or the following morning.
Post-Operative Treatment
The dressing will be changed by the surgeon and should not be touched by the patient before that moment. It is recommended to have rest in bed as much as possible for the first week and gradually it is possible to increase the activities for the following two weeks. It is recommended not to lie on the abdomen for two weeks (prone sleeping position). After the surgery there is always a loss of the perception of the skin in the lower part of the abdomen that is usually temporary and will disappear after a few months.
Possible complications
Complications are rare, but when they occur, generally, they promptly react to an adequate treatment without compromising the final result.
Bleeding. If bleeding occurs after the surgery, blood can accumulate in the operated area and it may be necessary to re-open the wound in order to remove it and prevent further bleeding.
Infections. They are generally rare and react promptly to antibiotic therapy.
Tissue loss. It is very rare; if it happens, it can be performed later in a reconstructive surgery with satisfactory results.
What to expect after the surgery
Activities. After the surgery, patients have to rest for 48 hours, after that they will be able to stand up for short walks.
Pain. In this surgery, pain is usually minimal. However, drugs are available to control it, both in hospital and at home. Coughing, sneezing, and all other activities that involve the exercise of the abdominal muscles, can cause discomfort and minimal pain.
Dressings. At the end of the surgery a hearty pressure dressing is applied that will be removed after 48 hours. On this occasion, a reduced dressing will be applied, however, it will be reinforced by a sheath support. Stitches will be removed by the surgeon on the 6th and 12th day. After the surgery there will be a feeling of tightness in the lower part of the abdomen and it will force in strange positions. This will occur for a short time and usually disappears after 7- I0 days.
Scars. The scars that remain after this surgery will be less evident over time but are permanent. Occasionally, you may need a scar revision in some places to get the best cosmetic result. These small operations can be performed under local anesthesia. After the surgery, there may be a slight protrusion of tissue immediately above the lines of incisions; this is usually temporary and tends to disappear in a few months, as soon as scars soften and tissues relax. You can not judge the final result of the surgery until the edema (swelling) disappears and the area of the surgery is not completely softened.
Resumption of physical activities
With regards to sport activities such as jogging, yoga, dance they will be re-started after 3 weeks while with regard to sports such as skiing, tennis, football, basketball, sailing, diving, swimming, it would be better to wait at least four weeks. Driving a car can be resumed after 2 weeks; sexual activity, sunbath, to travel and work activities after 3 weeks. Social activities and work will have to be reduced for about 2-3 weeks.