What Is Abdominoplasty?
It is an abdominal wall surgery which consists of and tightening the muscles of the abdominal wall.
Abdominoplasty of the abdominal wall is a surgery that improves the appearance of the skin and the abdominal muscles (belly of the rectus abdominis muscle) flaccid and stretched. This procedure is often called a lipectomy or tummy tuck and can range from a simple mini-tummy tuck or mini-lipectomy to a circumferential tummy tuck surgery that goes to the back of your back.
The abdominoplasty is NOT the same as liposuction, since the abdominoplasty removes the flaccid and tense skin, instead the liposuction removes the fat by sucking it without removing the skin. But abdominoplasty is sometimes used with liposuction, in order to decrease the thickness of the flap of the abdominal wall, a more aesthetic result, it is possible to decrease the thickness of the abdominal wall, always taking care not to necrotize the skin of the abdomen by very liposuction. intense.
How Should Abdominoplasty Be Performed?
- Abdominoplasty should always be performed in a hospital operating room. You will always have to have general anesthesia. The procedure lasts from 2 to 6 hours, the majority of hard patients hospitalized one day, in very few occasions it requires two to three days of hospitalization. The majority on the second day are already at home, they leave with trains that will allow us to know how much blood the patient produces each day, amount will always be verified by the Plastic and Aesthetic Surgeon César Fernández to know the evolution of the patient.
- After the anesthesiologist makes the anesthetic induction, the patient will be placed in bed in the operating room, face up and in a slightly semi-sitting position. The Plastic and Aesthetic Surgeon César Fernández will make an incision in the lower abdomen from the pubis to the iliac spines and then a Superior incision above the navel and this will be the amount of skin that is removed in the surgery. The navel will always be isolated and connected to the abdominal wall. I was left here since this is the one that supplies arterial blood. This will allow the navel to survive after lipectomy for excess skin. In very obese patients with a very large adipose panniculus, it will sometimes be necessary to extend the incision to the lateral part, including the back, in order to avoid leaving tires. Well, it will be about facing the abdominal muscles in order to decrease the amount of abdominal volume and additionally mark the waist.
- The patient should always know that the abdominoplasty does not remove the fat that is between the viscera of the abdomen, all human beings have fat between the organs and it is greater in obese patients.
- The mini tummy tuck consists of making a very small incision over the pubis. The mini abdominoplasty is performed if the patient has small accumulated amounts of fat in the hypogastric region, that is, in the lower region of the abdomen. The lower abdomen is resected, but the navel is not touched. Only the skin below the navel is stretched.
- The surgeon always leaves stitches in the muscle and skin that can be absorbable or non-absorbable, this will depend on the patient and the amount of tension required to close the planes.
- Small drains will always be inserted into the abdomen that will allow the small to drain the small amount of blood produced as the serous liquid that is subsequently produced and thus avoid the formation of seromas and bruises.
- An elastic and firm bandage (bandage) will be placed. A post-surgical girdle will always be placed on the abdomen, remaining between 2 to 3 months. You can remove the girdle when you go to the bathroom and when you bathe.
Why Is The Procedure Performed?
The surgery is performed because there are patients who have very flaccid and abundant, this is called a fatty apron. It is almost always because the patient wants it. It is a cosmetic surgery that improves the appearance of the abdomen, flattens and tightens it. In addition, it allows to remove the stretch marks that are under the navel. It is also useful in post-bariatric patients who, after a sudden decrease in weight, are left with skin hanging from the abdomen.
It is frequent that in very obese patients or those who have excess hanging from the abdomen, under their folds, areas with dermatitis or fungus. Removing this excess skin would definitely treat these pathologies.
What Are The Indications For Abdominoplasty?
Tummy tuck can be helpful when:
- It can be used in patients in whom diet or exercise have not been helpful in removing the amount of fat in the abdomen. In addition, they can be useful in those patients in whom they have a greatly diminished muscle tone, in addition to having the abdominal rectus muscles separated either by morbid obesity or by pregnancy. This gives an appearance of separate abdominal muscles and can simulate the appearance of having a hernia, this is known as diastasis recti.
- Abdominoplasty is a major surgery. The patient must always know how the procedure is, the risks and the complications.
- Abdominoplasty is not used to lose weight, it is used in patients who have lost weight and who have excess skin.
What Are The Risks Of Abdominoplasty?
Bleeding, infection, suture dehiscence, skin necrosis, bruising, seromas, abscesses, necrotizing fasciitis of the skin, difficulty breathing due to excess stress on the muscle, atrophic scar, hypertrophic scar, keloid scar, skin numbness , skin anesthesia, burning skin pain, chronic skin pain, chronic pain syndrome, chronic wounds, death.
There are risks of anesthesia, pulmonary thromboembolism, deep vein thrombosis, intraoperative cardiac arrest, myocardial infarction, stroke, pneumonia, atelectasis, pulmonary bronchoconstriction syndrome, asthma, hypotension, arterial hypertension, cardiac arrhythmias, asystole, and death.
Before The Procedure
Tell your plastic surgeon:
- The reasons for the surgery.
- When was the date of your last menstruation. If I could be pregnant.
- Contraceptive methods used.
- If you take aspirin, naproxen, sulindac, ketorolac, nimesulide, celecoxib, dipyrone, Tramadol, morphine, losartan, valsartan, Enalapril, captopril, verapamil, amlodipine, nimodipine, amiodarotine, acetylsalicylic acid, furosemidazide, hydroosemidazide, furosemidazide, furosemidazine, hydroosemidazide, furosemidazine, hydroosemidazide, furosemidazide , Empagliflozin, Salbutamol, Beclomethasone, Ampicillin, Amoxicillin, Omeprazole, Clonidine, Clopidogrel, Warfarin, Enoxaparin.
- In addition, you must report what medications you are taking, including medications, supplements, or herbs that you have purchased without a prescription.
- You must indicate the reasons why you want to operate.
- You must honestly say of all the pathologies you currently suffer and all the recreational medical history you suffer.
Before The Surgery:
- A few days before the operation, the anesthesiologist will tell you which antihypertensive drugs you can continue taking until the day of surgery.
- Also, it will tell you which painkillers to discontinue such as aspirin, ibuprofen (Advil, Motrin) 10 days before.
- The internist and anesthesiologist will tell you when to discontinue warfarin (Coumadin), among others.
- The anesthesiologist will tell you if you can continue with hypothyroid drugs, levothyroxine until the day of surgery.
- Always discuss with your Plastic and Cosmetic Surgeon César Fernández what medications you should take even on the day of surgery.
- If you smoke, try to quit, you must stop one month before.
- Smoking increases the probability of respiratory problems in surgery, poor wound healing, and increases the risk of complicating the patient in every way.
- You will always have to pay the costs of the surgery that include the cost of the surgeon, anesthesiologist, operating room, clinic, post-surgical care, postsurgical medications and follow-up appointments.
On The Day Of Surgery:
- You must arrive with 8 hours of fasting. Failure to observe a fast will cancel the surgery.
- You should bring the venous compression stockings formulated by your plastic surgeon.
- You should bring the abdominal compression girdles formulated by your plastic surgeon.
- You must arrive with a companion before, during and after surgery.
- You will be able to eat for up to 6 hours after surgery.
- You can get up to 6 hours after surgery, always assisted by a nurse or family member to go to the bathroom.
- I always arrived an hour before the surgery.
After The Procedure
- As a that the patient presents slight or moderate pain after surgery. The anesthesiologist and the Plastic and Cosmetic Surgeon César Fernández will administer medications to relieve your pain.The Plastic and Aesthetic Surgeon César Fernández will always administer analgesics by oral antibiotics to prevent infection.
- When the patient rests, she will do so in a semi-sitting position with a slight inclination of the head of the bed.
- When the patient gets up, do it if you want to tilt the abdomen. You must walk semi-crouched.
- You should always use Peace is to master at least one of two months after surgery.
- You should avoid running or strenuous physical exercise for at least a month after surgery.
- You may return to work for up to 15 days to a month after the operation.
- The scar crust will fall off 2 to 3 weeks after surgery. The scar will begin to mature between 12 to 18 months. After 18 months the scar will be permanently mature. Patients should take care of the sun to avoid hyperpigmentation of the scar. It is recommended not to expose yourself to the sun for a year in the abdomen.
Most men and women are happy and satisfied states obtained from the tummy tuck. Most will again have increased self-esteem that will allow them to show their abdomen to other people.Also, the surgery improves on themselves.