Abdominoplasty also called abdominal lipectomy or tummy tuck is a surgery that involves the removal of excess fat and skin. In addition, in most cases the repair of weakened or separated muscles is required, creating a smoother and firmer abdomen.
Many of us struggle to have a flat, well-toned abdomen through exercise and weight management. Sometimes with these methods we do not achieve our goals. Even people with a normal, well-proportioned body weight can develop a flabby, hanging abdomen.
Among the most common causes of this are:
- Pregnancies.
- Aging.
- Significant weight fluctuations.
- Inheritance.
- Previous surgeries.
Indications and types of abdominoplasty:
It is indicated when there is an excess of skin and fat at the abdominal level. There are several techniques depending on what the main problem is:
- The minilipectomy allows to stretch especially the lower abdomen area and correct the separation of the anterior rectus muscles of the abdomen. It is very common after pregnancies. If there is a previous scar of cesarian can be corrected and perform the stretch taking advantage of the fact that the patient already had a scar. It is sometimes accompanied by liposuction of the upper abdomen and flanks.
- Lipectomy with transposition of the navel in thin people. Very common after pregnancies with great abdominal dilation and after large weight losses. In this case, the skin is stretched, the dehiscence or separation of the anterior rectus muscles is corrected and the navel transposition is practiced.
- The Saldaña technique: This technique is indicated in people who have an abdominal skirt but also have an excess of fat and allows us to combine liposuction of the entire abdomen with the stretching of the skin. With this we achieve really surprising results with very high levels of safety in this type of surgical combinations that were not previously performed for fear of serious complications in the closure of the wounds.
Contraindications:
It is not indicated if you have an obesity problem, if the excess volume is as a result of an increase in abdominal fat or if your main problem is abdominal muscle distension.
Sometimes despite not having a dehiscence of the anterior rectus muscles of the abdomen and being with a normal weight we have an excess of abdomen not related to internal fat but with distension of the muscles of the abdomen (almost always after pregnancies without posterior strengthening of the muscles). This last condition is not surgical and can benefit from a type of gymnastics called hypopressive.
Abdominal fat:
The fat of the abdomen is deposited mainly in two sites, under the skin and inside the abdominal cavity where the viscera and abdominal organs are housed. In women these deposits occur mainly under the skin, while in men they are often located within the abdominal cavity in the omentum which is an apron covering the intestines and in the epiploic appendages which are sachets of fat attached to the intestines.
The fat that is under the skin can be reduced with diets, exercises, or liposuction, the fat that is inside the abdomen is treated with diets and exercises. Although this type of arrangement of internal fat is more typical of men as I have already said, we also find it in women. In these cases where the predominant fat is internal liposuction or abdominal lipectomy does not make sense.
What we can't expect from a tummy tuck:
A tummy tuck is not a substitute for weight loss and does not allow you to have a muscular abdomen. Although the results of a tummy tuck are technically permanent, significant weight fluctuations can greatly reduce a positive result.
For this reason we recommend postponing the tummy tuck if you plan to do substantial weight loss or if you are a woman and are considering pregnancies in the near future. A tummy tuck also fails to correct stretch marks, although some can be removed if they are located in the areas of skin that will be removed.
¿Es el tratamiento más adecuado para mí?
Is the treatment best suited for me?
Abdominoplasty is a good option for you if:
- You enjoy good physical health and have a stable weight.
- You have realistic expectations.
- You don’t smoke.
What you can expect during your appointment:
You will be asked several questions about your health, your expectations, and your lifestyle.
Be prepared to comment:
- Why do you want to have surgery? What are your expectations and what do you hope to obtain?
- Conditions, Drug allergies.
- Treatments and medications.
- If you drink alcohol or drugs regularly.
- Previous Surgeries.
Preparing for Surgery:
- Before surgery we will ask you for a laboratory analysis, an ECG and a chest x-ray.
- If you smoke it is important to stop smoking at least 20 days before.
- Avoid taking aspirin or derivatives 20 days before surgery.
- The Plastic Surgeon will explain in detail the risks associated with the Surgical Intervention.
- We will give you written consent explaining the potential risks or complications. It is important that you read and fully understand this booklet.
Recovery:
- You will leave the operating room with a bandage and 2 draining tubes so that blood does not accumulate.
- You will get out of bed before 12 noon.
- The next day we will give you the first cure. Hospital discharge is usually given in 1 day.
- After surgery you should wear a compressive girdle for a minimum of one month.
- On the day of discharge you will receive specific instructions on how to care for the wounds and what you can do.
- Stitches are removed between 7 and 10 days.
- During the first 8-10 days you will take medications that we will recommend.
- Much of the success of any surgery depends on postoperative care. Following medical instructions is vital to achieve the results that the doctor and patient have considered.
- Remember that recovery time varies depending on your own physical condition. Patients usually need 1 to 3 weeks before returning to normal activities.
- You should sit up and walk as soon as possible, in order to prevent the formation of venous thrombi in the legs. This exercise should be done slowly.
- The dressing that has been placed after surgery should be used continuously for 1 week.
- Drains, if any, are removed after 2-4 days. There are patients who do not want to leave with the drains on and in these cases they will require more days of hospitalization until they can be removed.
- Sutures are removed after 7-12 days.
- The feeling of tightness and swelling will gradually decrease during the postoperative period.
- You will receive antibiotic medication in order to prevent the development of any infection, as well as analgesic medication to control postoperative discomfort.
Recommendations:
- After surgery and when the doctor discharges you, you should go home and have a person to take care of you during the first days of convalescence.
- You should not take aspirin, acetylsalicylic acid, or any medication that contains this compound, due to its anticoagulant effect.
- It is advisable to limit any type of activity for up to two weeks after the intervention.
- The patient should completely refrain from lifting heavy things, children or pets.
- It is preferable not to wet the treated area until the doctor recommends it.
- You should not sleep in a prone position (face down) for the first four weeks after surgery or for as long as your doctor tells you to.
- Do not sunbathe directly for the first two months after surgery.
- At the end of two weeks the surgeon can authorize you to return to your normal activity.
- During the three months following the operation, the patient must limit their sports activities.
- Scars on the navel and abdomen improve significantly over time.
- The full result can be seen up to one year later.
- Your surgeon will recommend wearing a girdle for 1 month, 24 hours, and then another month only at night.