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Abdominoplasty


Doctors

What is abdominoplasty?

Abdominoplasty (from the Latin term abdomen, abdominis - the stomach) is a type of plastic surgery performed with the aim of correcting the shape of the abdomen, removing excess skin and adipose tissue, and sculpting the waist. One of the most common patient categories on whom this kind of operation is performed is women — abdominoplasty makes it possible to remove the stretching and folds that can form after giving birth. In this case, at least 6 months must have passed since childbirth. If you’re breastfeeding - 6 months since the end of lactation.  The operation is often performed in combination with liposuction of other parts of the body — hips, thighs, upper arms, etc. Abdominoplasty is also frequently combined with belly-button surgery.

Belly-button surgery (umbilicoplasty)

Belly-button surgery (umbilicoplasty) makes it possible to correct the appearance of the navel and fix congenital or acquired defects (after childbirth or rapid weight gain-loss) and even completely restore it after its total loss from operations.

Abdominoplasty and diastasis

Abdominoplasty is the only way of eliminating postnatal separation of the rectus muscles of the abdomen - diastasis. Exercise can help improve tone and slightly lift the abdomen - but not eliminate diastasis. The operation most frequently assumes the removal of subcutaneous fat as well. But sometimes using an endoscopic technique we can suture just the muscles from a small access point above the womb (if the skin doesn’t sag into a fold). In any case, the recovery period is equal to the time needed for the complete fusion of the sutured aponeurosis - 1.5-2 months. During this time, it’s important not to do sports or put any significant load on your abs.

Pregnancy and childbirth remain possible after abdominoplasty. The degree of discomfort experienced during the postoperative period also depends on the scope of plastic surgery. And the pain tolerance of each individual also plays a role. It doesn’t “hurt like hell.” It’s tolerable. The most unpleasant week is the first one. If painful sensations become a concern, analgesics are prescribed.

During abdominoplasty, the shape of the belly-button can be corrected as well. 

What’s the difference between recovery after cesarean section and after abdominoplasty?

In the case of cesarean section, surgical penetration goes very deep and healing takes a long time. With abdominoplasty, we work with the superficies. All of our patients note the comfort of the post-operative period, with full recovery occurring over the course of six months. There is no comparison between a C-section and abdominoplasty. A C-section is a more traumatic operation. We often reconstruct abdomens after C-sections, and all of the women are surprised and happy with the post-op period. You can read the diary of one of our patients after such an operation, in which she describes all of the sensations that she experienced.

Anesthesia during abdominoplasty

At our clinic, abdominoplasty is only performed in combination with anesthesia. In other words - a combination of intravenous and local anesthesia (not to be confused with an inhalation anesthesia-mask). Our anesthesia causes temporary, light sleep much like that which occurs naturally. It’s gentle, pleasant drifting off to sleep, even, stable sleep during the operation, rapid yet calm awakening (without hallucinations), a sense of well-being and the absence of pain during the post-operative period.

In which cases is this operation indicated?

  • Indications for abdominoplasty:
  • excess skin in the supraumbilical area;
  • pronounced folds, a sagging cutaneous-adipose “apron”;
  • postnatal stretching;
  • scars in the abdominal area resulting from surgery;
  • poorly-defined or missing waistline;
  • excess adipose tissue in the abdominal area (along the anterior wall);

At the pre-operative stage

Before the operation, the patient’s medical history is taken. The patient undergoes comprehensive examination, which may uncover contraindications for abdominoplasty — co-morbidity, etc.

Diagram

Removal of excess skin Cosmetic sutures

Particularities of the operation

The operation is performed under general anesthesia and lasts for 2-4 hours. At the beginning, the surgeon makes an incision in the lower portion of the abdomen running along the pubic hairline. If necessary, a vertical incision measuring 5-6 cm can be made running from this line. An incision is also made around the belly-button.

Then, the skin and subcutaneous adipose tissue are separated from the abdominal wall of the muscles. Having gained access to the muscular tissue, the surgeon tightens the rectus abdominal muscles and connects them, also performing an SMAS (Superficial Muscular Aponeurotic System), thereby securing the tissue in the required position. In addition, a tube is used to remove the excess adipose tissue, an umbilical retraction is performed and excess skin is removed. At the end of the operation, a subcutaneous drain is placed and the incisions are stitched with absorbable sutures. Dressings and a securing bandage are placed on the area of the abdomen that has undergone surgery.

Recovery period and sutures

After the operation, the sutures become unnoticeable over time (particularly if combined with corrective cosmetic procedures). Everyone has a different scope of intervention - for some it’s from one edge to the other in cases of major surgery. But it won’t look like a scar - more like a fine line. If that frightens you, it means you’re not yet ready for the operation and you’re fine with your appearance. Usually, women are so anxious to get rid of their excess skin and have a pretty tummy that a fine line at the bikini-bottom level (not above the belly-button - much lower!) doesn’t stop them. Many are even happy to conceal this line with the aid of permanent tattooing. The bandage (compression undergarment) must be worn for one-and-a-half to two months. Where possible, physical exertion should be limited as much as possible for 1-2 months after the operation.

Contraindications for abdominoplasty

  • There are a number of possible contraindications, including:
  • oncological disease;
  • diseases of the endocrine system (particularly pancreatic diabetes);
  • obesity;
  • poor blood-clotting;

 Abdominoplasty - Video


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