Over time --as a result of pregnancy or weight loss --women often develop excess abdominal skin, fat, and stretched abdominal muscles. Abdominoplasty corrects these problems through surgical removal of lax skin and excess fatty tissue. If the patient's only complaint is excess fat in the abdomen, the problem can sometimes be corrected by liposuction alone.
Abdominoplasty is usually performed under general anesthesia and takes two to three hours to perform. The patient usually must spend one to several nights in the hospital. Following discharge, doctors prescribe oral pain medication to control typically mild to moderate pain. The patient also is given an abdominal binder to provide support while healing. Following surgery, patients should restrict their activities for two to three weeks, and all exertional activities are strictly interrupted for a full four weeks. The stitches generally are removed in one to two weeks following surgery.
Abdominoplasty is performed through a transverse incision across the lower abdomen. An incision is made around the umbilicus (belly button), leaving it attached to the abdominal wall. The skin and fat are then elevated from the abdominal wall and muscles to the level of the rib cage. Sometimes, surgeons may remove some fat from the flanks with supplemental liposuction. If needed, the abdominal muscles are tightened by suturing them together in the midline and shortening them. Surgeons remove excess skin and fat at the upper line of the incision. The umbilicus is then brought out through a small incision and sutured to the new skin in its normal position. Some stretch marks and old scars will be removed in the course of the surgery, but all may not be removed.
In some cases, drains are left beneath the skin for several days following surgery. There may be swelling and collection of fluid following surgery that is occasionally treated by needle drainage in the office. It may be months before all the swelling has completely subsided. Generally, patients experience reduced sensation in the abdominal area and, in some cases, the upper thighs. This will subside in the months following the procedure.
The scars around the umbilicus and the lower part of the abdomen will gradually fade and become less visible. However, these scars tend to be wide because of tension and are variable in final size among individuals.
While most patients with extra abdominal tissue are candidates for abdominoplasty, not all are. Obese patients often are not candidates or require modifications in the procedure as recommended by the surgeon.
Potential complications of abdominoplasty include bleeding, infection and healing problems, which can lead to heavy scars. Some lack of symmetry also may occur. Because the skin is undermined, there is a slight risk of inadequate circulation and loss of some skin. This risk is greater in smokers and in patients with specific kinds of old scars. Patients should quit smoking for 14 days prior to and following surgery, and stop taking aspirin 14 days before surgery.
Following surgery, the patient will enjoy a more attractive figure with a firmer, flatter abdomen.
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