Surgery of the abdomen
Definition of abdominoplasty
It is a surgery of the abdominal wall that tightens the muscles of the abdomen and removes excess skin. Unlike a lipectomy that only removes the skin.
Abdominoplasty is a surgical procedure that improves sagging, wrinkling of the skin and excess external fat of the abdomen. Also, fold the abdominal muscles (abdominal rectus muscle) flaccid and stretched. These muscles become flaccid due to the absence of exercise, obesity and pregnancy.
You can perform mini tummy tuck on the pubis and groin, to a circumferential tummy tuck that goes to the back of the back.
Abdominoplasty is NOT the same as liposuction, since tummy tuck removes flaccid tissue and tightens it, while liposuction removes only fat without removing skin. But the abdominoplasty is sometimes used with liposuction (called lipoabdominoplasty), to reduce the thickness of the abdominal wall with a more aesthetic result, it is possible to reduce the thickness of the abdominal wall a little without necrotizing the skin.
How is a tummy tuck?
- The tummy tuck should be done in a surgery room. Do not expose your life in places of low reputation. You should always have general anesthesia. The procedure lasts from 2 to 6 hours, most patients stay hospitalized one day, rarely 2 to 3 days of hospitalization are needed. The majority on the 2nd day is already in your home, coming out with drains that will let you know how much blood the body produces from the wound; the plastic and aesthetic surgeon César Fernández will always verify the amount to know the evolution of the patient.
- After the anesthesiologist performs the anesthetic induction, the patient will be placed in the bed of the operating room, in the supine position and in a semi-sitting position. Cosmetic and plastic surgeon César Fernández will make an incision to resect the skin between the pubis and the upper edge of the navel. The navel will be insulated always connected to the abdominal wall so that it can receive arterial flow. This will allow the navel to survive after surgery. In very obese patients with a giant fatty apron, it will sometimes be necessary to extend the incision to one side, including the back, to avoid leaving “little or fat”. The abdominal muscles will be plicated to reduce the amount of abdominal volume and define the waist.
- The patient should know that the abdominoplasty does not remove the fat that is between the peritoneum and inside the viscera, all human beings have fat between the organs and this can not be removed.
- The mini tummy tuck consists of making a very small incision in the pubis. The mini tummy tuck is performed if the patient has small accumulations of fat in the hypogastric region, that is, in the lower part of the abdomen. The lower part of the abdomen is removed, but the navel is not touched. Only the skin below the navel is stretched.
- The surgeon always leaves points in the muscle and skin that can be absorbable as non-absorbable, this will depend on the patient and the amount of tension required to suture the tissues.
- Small drains will always be left under the skin of the abdomen that will allow the small amount of blood to drain and, therefore, the formation of seromas and bruises will be avoided.
- An abdominal belt will be placed. A postoperative girdle will always be placed on the abdomen for 12 weeks. This can be removed when going to the toilet and when bathing.
Why is abdominoplasty performed?
The surgery is done because there are patients who have very flaccid and abundant abdomen, this is called fat apron. It is a voluntary decision of the patient. It is a cosmetic surgery that improves the appearance of the abdomen, flattens and tightens it. In addition, it allows to eliminate the stretch marks that are below the navel. It is also useful in post-bariatric patients who, after a sudden drop in weight, have the skin hanging from the abdomen.
It can be used in very obese patients or those who have excess skin of the abdomen, in the folds of the skin they will suffer dermatitis or mycosis. By eliminating this excess skin, your symptoms would improve.
Abdominoplasty is indicated in:
Patients in whom the diet or exercise routine did not eliminate the amount of fat in a region of the body. In addition, they can be useful in those patients in whom the abdominal diaconate muscles (separated) are seen.
Tummy tuck surgery is a major surgery. The patient should know how the surgery, the risks and the complications.
Abdominoplasty is not used to lose weight, it is used in patients who have lost weight and have excess skin.
What are the complications of abdominoplasty?
Haemorrhage, infection, sepsis, opening of the wound, skin necrosis, bruising, seroma, abscesses, necrotizing fasciitis of the skin, dyspnea due to excessive tension in the muscle, impaired healing, skin anesthesia, chronic pain in the skin, chronic pain syndrome, chronic wounds, death.
There are risks of anesthesia, venous thrombi to the lung, venous thrombi in the legs, heart attacks, arrhythmias, hypertension, stroke, respiratory tract infection, atelectasis, pulmonary bronchoconstriction syndrome, asthma, hypotension, asystole and death.
Before the procedure
Tell your plastic surgeon:
- Why do you want to operate?
- Your last menstruation. Use of contraceptives.
- If you take any medication for blood pressure, thyroid, pain, sugar, clotting, etc.
- In addition, you must report what medications you are taking, including any medications, supplements, or herbs you purchased without a prescription.
- You must indicate the reasons why you want to perform a tummy tuck.
- He must honestly say all the pathologies he suffers at this moment and the whole medical history that he suffers.
Before the surgery:
- In the pre-anesthetic assessment, the anesthesiologist will tell you which drugs you can continue to use until the day of the tummy tuck and which ones you should stop.
- Analgesics are discontinued 2 weeks before.
- The internist and the anesthesiologist will tell you how to use warfarin (Coumadin), among others.
- The anesthesiologist will tell you if you can continue with the medications for hypothyroidism, levothyroxine, until the day of the procedure.
- Always talk to your anesthesiologist and your plastic surgeon about what medications you should take even on the day of surgery.
- If you smoke, try to stop doing it, you should suspend it a month before. Smoking worsens healing, increases the risk of pneumonia and heart attacks.
- You must always pay the costs of the surgery at the second appointment to be able to schedule your surgery.
On the day of surgery:
- Must arrive with 8 hours of fasting. If the fast is not fulfilled, the surgery will be suspended.
- You should bring the venous compression stockings suggested by your plastic surgeon.
- You must bring the sashes suggested by your plastic surgeon.
- You must arrive with a companion before, during and after the surgery.
- You can feed with liquid food until 6 hours after surgery.
- You can ambulate up to 6 hours after the surgery always accompanied by a nurse or a relative.
- I always arrived in advance, at least 1 hour before the procedure.
- You may have mild or moderate pain after the tummy tuck. The anesthesiologist and plastic and aesthetic surgeon César Fernández will formulate drugs to alleviate his pain. Always plastic and aesthetic surgeon César Fernández will administer antibiotics to prevent infection of his wound.
- The patient, when resting, will do so in an upright position with an inclination of the head of the bed.
- To walk, you should bend the chest forward by bending the abdomen. It can not stretch the abdomen.
- It is recommended to use the strip for at least 8 weeks after surgery.
- You should avoid running or doing intense physical exercise at least 30 days after surgery.
- You can return to work up to fourteen days or a month after the tummy tuck.
- The wound will close in 3 weeks after the surgery. You may need to remove stitches up to 3 weeks after surgery. The scar will be definitive in the 1st postoperative year.
- For 12 months, patients should avoid the sun to avoid darkening the scar.
Most patients are happy and satisfied with our surgery. The majority will improve their self-esteem that will allow them to show their body to other people, improve their relationships with their peers and improve their sexuality.
Cosmetic surgery of the abdomen; Abdominal plastic surgery; Abdominoplasty