However, the abdominal region is one of the most rapidly deforming body parts, especially in women, following childbirth and body weight fluctuations. Giving birth to a child loosens, cracks abdominal skin and lead to weakness of abdominal muscles, resulting in a belly that protrudes forward. Fat accumulation mostly occurs around the umbilicus and waist, especially after menopause. Abdominoplasty can be performed to solve such problems that occur in the tummy.
Abdominoplasty involves removal of excess fat from abdomen and low back as well as excess skin below the bellybutton and repairing the loose abdominal muscles.
Abdominoplasty is commonly used for individuals who gave birth or lost weight following severe weight gain. Having excessive skin above umbilicus and presence of a layer that can be grasped while in sitting position are indicators of being an appropriate candidate for complete abdominoplasty. Mini abdominoplasty is preferred for excessive skin and fat accumulation confined to below the bellybutton.
In complete abdominoplasty; liposuction is applied first to entire abdominal and lumbar regions. Next, a long incision which will be covered by underwear is made on lower part of the abdomen. Abdominal skin is lifted from abdominal wall up to ribs. Umbilicus is separated from the skin. Abdominal wall is tightened by stitching the loosened abdominal muscles. Next, the skin below the umbilicus is completely removed. The skin that is left above is pulled down and a new pouch is opened for the bellybutton. Complete abdominoplasty ensures a young look characterized by tightened skin below and above the umbilicus, slimmed waistline, tight abdominal wall and vertical umbilicus.
Mini abdominoplasty is performed for patients who have excessive skin solely below the bellybutton in association with no or minimal excessive skin above the umbilicus. Similarly, a generalized liposuction is performed before this surgery. A smaller incision which will be covered by underwear is made on lower part of the abdomen. The skin below the umbilicus is elevated and excessive parts are removed. Umbilicus is shifted down by 1-2 cm if there is certain amount of excessive tissue above the umbilicus. Muscles of abdominal wall may also be repaired, if it is deemed necessary.
Being overweight causes a risk in all surgeries. Recovery of these patients is more difficult following the surgery, their wounds heal late and lung problems are more likely. Obese patients are, therefore, recommended to lose weight before the surgery. However, abdominoplasty may be planned just to decrease the load, if they cannot move sufficiently due to weight of their belly and cannot lose weight.
Abdominoplasty is performed under general anesthesia at operating theatre conditions.
Patients are worn anti-embolism stockings; a urinary catheter is inserted and drains are placed during the surgery. Abdominal corset is worn after the surgery. Patients are allowed to eat and they are mobilized 4 to 5 hours after the surgery. Patients are required to walk by bending the trunk slightly forward during first several days after the surgery to avoid too much load on stitches. They may stand up straight four to five days after the surgery. This period is shorter for mini abdominoplasty. The catheter is removed and the patient is discharged on the next morning. The drains are left for a few more days, if necessary. Patients may lie down to their sides on the night following the surgery. They may take shower 24 hours after the drains are removed. Removal of stitches is unnecessary as all sutures are placed beneath the skin. Patients may resume their routine daily lives one week after the surgery. They may start exercises three weeks later, excluding abdominal exercises. All sports activities are allowed after six weeks.
Most serious complication of the surgery is the pulmonary embolism. This risk is higher for old, obese and diabetic patients and heavy smokers. Overweight patients are recommended to lose weight before surgery. Another problem is the loss of skin and non-healing wounds. Improper preoperative planning, removal of too much skin, poor hemostasis (controlling the bleeding) and smoking worsen such problems. Other potential problems include collection of body fluids beneath the skin several weeks after the surgery. In this case, it may be necessary to drain the body fluid with a syringe. Abnormal scar formation is likely in certain skin types and if the abdomen is closed too tightly. A revision procedure under local anesthesia may be performed after a year to reduce scarring, if it is caused by tightness.
Abdominoplasty offers a radical solution for all abdominal problems and it can be speculated that the outcomes are permanent. The outcomes may be lost to a certain extent after the surgery due to repeated weight loss following serious weight gain and pregnancy; however, it is not possible to regress into former condition.
Patients are required to be careful with their bodyweight and follow a balanced diet after abdominoplasty. It is beneficial to decrease alcohol consumption for lessening the fat accumulation inside the abdominal cavity. Use of body lotions and moisturizers are necessary to prevent cracks in tightened skin. Regular exercise ensures that the abdominal muscles regain their strengths and the tight abdominal look gained from the surgery is maintained.
Patients can get pregnant after the abdominoplasty; however, abdominal wall and skin may loosen again in response to pregnancy. Therefore, this surgery is not recommended for patients who plan a pregnancy at short term. On the other hand, the surgery does not hinder pregnancy.
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