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Abdominoplasty, known more commonly as a "tummy tuck", is usually a major surgical procedure to remove excess skin and fat from the middle and lower abdomen and to tighten the muscles of the abdominal wall. The procedure can dramatically reduce the appearance of a protruding abdomen. But bear in mind, it does produce a permanent scar, which, depending on the extent of the original problem and the surgery required to correct it, can extend from hip to hip.

THE BEST CANDIDATES FOR ABDOMINOPLASTY

he best candidates for abdominoplasty are men or women who are in relatively good shape but are bothered by a large fat deposit or loose abdominal skin that won't respond to diet or exercise. The surgery is particularly helpful to women who, through multiple pregnancies, have stretched their abdominal muscles and skin beyond the point where they can return to normal. Loss of skin elasticity in older patients, which frequently occurs with slight obesity, can also be improved.

Patients who intend to lose a lot of weight should postpone the surgery. Also, women who plan future pregnancies should wait, as vertical muscles in the abdomen that are tightened during surgery can separate again during pregnancy. If you have scarring from previous abdominal surgery, your doctor may recommend against abdominoplasty or may caution you that scars could be unusually prominent.

Abdominoplasty can enhance the patient appearance and self-confidence, but it won't necessarily change your looks to match your ideal, or cause other people to treat you differently.

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TYPES OF ANESTHESIA

Abdominoplasty at our clinic is performed under general anesthesia in form of i.v. sedation, so you'll sleep through the operation. Awakening is is easy and comfortable.

THE SURGERY

Complete abdominoplasty usually takes about two-three hours, depending on the extent of work required.

Partial abdominoplasty may take an hour or two.

Most commonly, a long incision is made from hipbone to hipbone, just above the pubic area. A second incision is made around the navel to free it from surrounding tissue. With partial abdominoplasty, the incision is much shorter and the navel may not be moved, although it may be pulled into an unnatural shape as the skin is tightened and stitched. If the skin is loosy around the navel but there are only few excess on the abdomen, the original site of the navel is closed with a short vertical scar and the horizontal incision can be kept in the low inguinal crease. Gallery picture

Next, the skin is separated from the abdominal wall all the way up to your ribs and lifts a large skin flap to reveal the vertical muscles in the abdomen. These muscles are tightened by pulling them close together and stitching them into their new position. This provides a firmer abdominal wall and narrows the waistline.

The skin flap is then stretched down and the extra skin is removed. A new hole is cut for the navel, which is then stitched in place. Finally, the incisions will be stitched, dressings will be applied, and a temporary tube may be inserted to drain excess fluid from the surgical site.

In partial abdominoplasty, the skin is separated only between the incision line and the navel. This skin flap is stretched down, the excess is removed, and the flap is stitched back into place.

AFTER SURGERY

For the first few days, the abdomen will probably be swollen and the patient is likely to feel some pain and discomfort which can be controlled by medication. Depending on the extent of the surgery, patient may be released within a few hours or you may have to remain hospitalized for two to three days.
The patient is advised for showering and changing the dressings. And though the patient may not be able to stand straight at first, walking can be started as soon as possible.

Surface stitches will be removed in five to seven days, and deeper sutures, with ends that protrude through the skin, will come out in two to three weeks. The dressing on the incision may be replaced by a support garment.

ALL SURGERY CARRIES SOME UNCERTAINTY AND RISK

Thousands of abdominoplasties are performed successfully each year. Nevertheless, there are always risks associated with surgery and specific complications associated with this procedure.

Post-operative complications such as infection and blood clots are rare, but can occur. Infection or seroma formation can be treated with drainage and antibiotics, but will prolong the wound healing. Patients can minimize the risk of blood clots by moving around as soon after the surgery as possible.
Poor healing, which results in conspicuous scars, may necessitate a second operation. Smokers should be advised to stop, as smoking may increase the risk of complications and delay healing.

One can reduce the risk of complications by closely following the surgeon's instructions before and after the surgery, especially with regard to when and how you should resume physical activity.

GETTING BACK TO NORMAL

It may take weeks or months to feel like old self again. If the patient start out in top physical condition with strong abdominal muscles, recovery from abdominoplasty will be much faster. Some people return to work after two weeks, while others take three or four weeks to rest and recuperate.

Exercise will help healing better. Even people who have never exercised before should begin an exercise program to reduce swelling, lower the chance of blood clots, and tone muscles. Vigorous exercise, however, should be avoided until it can be done comfortably.

The scars may actually appear to worsen during the first three to six months as they heal, but this is normal. Expect it to take nine months to a year before the scars flatten out and lighten in color. While they'll never disappear completely, abdominal scars will not show under most clothing, even under bathing suits.

THE NEW LOOK

Abdominoplasty, whether partial or complete, produces excellent results for patients with weakened abdominal muscles or excess skin. And in most cases, the results are long lasting, if you follow a balanced diet and exercise regularly.

If the patient is realistic in your expectations and prepared for the consequences of a permanent scar and a lengthy recovery period, abdominoplasty may be just the answer for her/him.

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