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Abdominoplasty, a substantial procedure

While liposuction techniques have progressed significantly through the years and have trimmed the waistlines of many men and women, unfortunately it is not an option for everyone. Whenever the abdominal area has significant skin lesions, many stretch marks or scars, or there is a significant loosening of the underlying muscles (often following significant weight loss), liposuction alone is not enough. For some patients it is then necessary to have another surgical procedure, the abdominoplasty, or tummy tuck. The abdominoplasty is an intervention whose goal is to remove the most damaged areas of skin and to tighten and stretch the healthy skin which is at the periphery. The abdominoplasty can also bring muscles of the abdominal wall closer together that have separated, usually after pregnancy.

In addition to causing irregularities to the figure, excess fat in the abdomen often causes significant inconvenience in everyday life, from sitting to sexual relations can be affected. Patients who are waiting for surgery will say “It ruins my life” it’s not just a physical improvement to their figure, but it’s a complete transformation from the inside out.

The decision to have an abdominoplasty in almost all cases, comes after a long period of thought and reflection. This is very normal and encouraged because the decision to have an abdominoplasty is not easy. This procedure is one of the most serious proposed by plastic surgery. It is for this reason that a full checkup is necessary before the operation. Particular attention should be paid to the presence of abdominal wall herniation or disturbances in digestion and that any abnormalities are accurately analyzed. In addition, patients are advised to be as close as possible to their “normal” weight at the time of the procedure.

Most often, the procedure consists of removing a section of skin, normally the skin in the area between the navel and the pubis. Then the healthy skin, located generally above the navel, is “re-draped” down. We then proceed to the reconstruction of the abdominal wall with good quality skin. This intervention requires the replacement of the navel back into its normal position through the use of an incision.

This procedure will always leave a scar but the severity and the location of the scar depends on the amount and location of the skin to be removed. This scar can be of different shapes, but its length and location are never a surprise for patients: it is predictable and thoroughly discussed with the patient before the intervention. The abdominoplasty is always conducted under general anesthesia. Before the intervention, after taking photographs from different angles, we draw with a marker the line of the future scar, always located within the limits of the “bikini” so that they can be hidden under the swimsuit. Then, the limits of the separation and the areas of the fat deposits to be suctioned are marked. After the incision, the excess fat is removed by liposuction, then the distended muscles are resized. Finally, the navel is repositioned.

To eliminate the unsightly bulge that surrounds the abdomen, medicine has explored many leads and tested several solutions, but the results were far from meeting expectations, and the size of the scars left by the interventions underlined the failure. The techniques are now proven and give satisfactory results, which don’t appear until after a period of six months to a year. In addition to the compression bandage, the support is reinforced by the wearing of a abdominal binder, for about a month. The abdominoplasty requires hospitalization for two to five days post-op. After surgery, the belly is swollen with edema. If the muscle wall has been strengthened, pain can be felt for a few days. It should be emphasized that the abdominoplasty is a very invasive procedure, that requires an interruption of professional life for three to four weeks.

Depending on the specific case, surgeons may use other abdominoplasty techniques:

– The mini abdominal lift is recommended in cases where the skin loosening is moderate and located below the navel. The intervention, less invasive, consists of the removal of a section of skin; it is crucial to leave a distance of at least 10 cm between the navel and the pubis.

the so-called “upper high voltage” technique: longer, it allows to eliminate more loose tissue and to limit the risk of lymphatic effusion; it can recreate a beautiful depression of the wall above the navel.

Though the abdominoplasty is one of the interventions that provides the most satisfaction to patients, it provides the least satisfaction to physicians due to the scarring that it leaves behind. My teacher, Professor Vilain, did not appreciate this procedure referring to it as “abominoplasty”.